School of Public Health (ETDs)

Permanent URI for this community

https://hdl.handle.net/10539/37953

Browse

Browsing School of Public Health (ETDs) by SDG "SDG-8: Decent work and economic growth"

Now showing 1 - 4 of 4
  • Thumbnail Image
    Item
    Efficacy of noise control measures at high noise zones from a copper mine in Zambia
    (University of the Witwatersrand, Johannesburg, 2024) Nchimunya, Bbautu; Hayumbu, Patrick; Masekameni, Masilu Daniel
    Noise exposure is a global problem, it is estimated that about 30 million workers in the United States of America (USA) are exposed to high noise levels while across Europe, 28% of the workers are exposed to high noise levels. Hazardous noise exposure is associated with a wide range of health effects that include noise induced hearing loss (NIHL), stress, poor concentration, communication difficulties and fatigue due to lack of sleep. The mining industry worldwide is struggling with hearing loss due to noise overexposure and in a copper mining set-up, the concentrator section is assumed to be among high noise zones exposing workers to noise above the occupational exposure limit (OEL) of 85 dB(A). This study aimed at evaluating the efficacy of noise control measures at various sections at Konkola Copper Mine concentrator section in Zambia. This quantitative cross-sectional study was conducted at Konkola Copper Mines (KCM) Konkola Business Unit (KBU) in Chililabombwe District in the Copperbelt Province of Zambia. A walk through survey was conducted to collect information to describe the operations, identify noise sources, understand noise release mechanisms and describe noise control measures. Quality control was achieved by triplicate noise measurement per location using an instrument with a valid annual calibration certificate. Raw data was pre-processed by cleaning to make it ideal for use. An ethical waiver W-CBP-230428-01 was granted as this study did not involve animal or human subjects but only area noise samples using CR: 172B SLM. The study identified the noise sources, described noise release mechanisms, described the noise controls and assessed the efficacy of noise controls in four sections within the concentrator of a copper mine in Zambia. Seventeen noise generating equipment were identified with about 53% of the equipment operated at the crushing section, 18% operated at the Flotation and Filtration section respectively and 11% at Milling section. A substantial portion (65%) of the identified noise sources in the concentrator are not housed, and among these, 36% are mobile in nature. It was also found that none of the noise areas were demarcated There are three types of noise controls (enclosure, silencer & HPD) that are in use at the concentrator and they fall in two categories of the hierarchy of controls (engineering & PPE). Out of the nine noise sources at the Crushing section, 56% (5 of the 9) utilized enclosure as control, 33% (3 of the 9) had HPDs as control and 11% (1 of the 9) source was installed with a silencer as a control. Enclosure is utilized to control noise from the two sources found in the Milling section while HPDs and enclosure are the noise control measures in use at both Flotation and Filtration sections of the concentrator. Enclosure is the most available control in the concentrator at 53%, followed by HPDs at 41%, and the least available is silencer at 6 %. About 76.5% (13) of the noise controls at the concentrator had efficacy strong enough to reduce noise levels to below the OEL while 23.5% (4) of the controls had weak efficacy that failed to reduce noise levels to below the OEL. This has prompted the need to strengthen efficacy in areas where controls were found to be weak. There is need to sustain controls that were found to be strong to maintain their efficacy. About 75% (3 of the 4) of the controls with lower efficacy were from the Crushing section while 25% (1 of the 4) was from Filtration section
  • Thumbnail Image
    Item
    Exploring inter-professional collaboration between community health workers and health care providers in two clinics in the City of Johannesburg district
    (University of the Witwatersrand, Johannesburg, 2024) Bokaba, Dorah Dorothea; Nxumalo, Nonhlanhla
    Background: Large-scale community health worker (CHW) programmes gained renewed interest over time. This was more pronounced during the emergence of the Coronavirus disease 2019 (COVID-19) pandemic, with CHWs exemplifying the role of task-shifting to alleviate already fragile and resource-scarce health systems. Many low- to middle-income countries (LMICs), including South Africa, implemented CHW programmes to complement health workforce. Thus, health care providers (HCPs) including professional nurses, health promoters, allied health workers, operational manager clinic, social workers, and CHWs are expected to collaborate with CHWs to provide health care service. Aim: The aim of the study was to explore inter-professional collaborations (IPC) between CHWs and HCPs in two primary health care (PHC) facilities in the City of Johannesburg, Gauteng Province. Methodology: This study used an exploratory qualitative design. In-depth semi-structured interviews were conducted with purposively sampled CHWs (n=12) and HCPs (n=10) in two PHC facilities from two sub-districts. All interviews were transcribed verbatim. Thematic content analysis was used to analyse the data. Results: Team structures were reported to be centred around the CHWs and Outreach team leader (OTLs), however other HCPs like nurses, health promoters, and social workers also played a role. Reporting procedures were hierarchical, with CHWs reporting to OTLs, who reported to operational managers (OPMs). CHWs were at the bottom of the hierarchy with the reporting structures being described as challenging as they were related to power dynamics. Communication was poor and with unplanned meetings. Participants suggested the need for improved support and communication to strengthen IPCs. Conclusion: IPC between the HCPs and CHW is critical in ensuring patient care continuity. Some dimensions of IPC, such as shared responsibility and mutual understanding of roles by team members, were evident. The communication processes showed some weaknesses, including the consequences in power relations. In order to enhance the contribution of CHWs in PHC and universal health coverage (UHC), it is necessary to explore ways to strengthen IPC between HCPs and CHWs
  • Thumbnail Image
    Item
    Factors associated with burnout among healthcare workers in a rural context, South Africa: a cross-sectional study
    (2024) Moses, Alexandra
    Background. Healthcare providers (HCP) were at risk of burnout related to high levels of occupational stress in the workplace. However, there was little research in rural and primary care settings in subSaharan Africa. This study aimed to describe the individual and workplace factors of public sector HCP working in Mpumalanga province, their experience of burnout and to examine the factors associated with burnout.. Methods. A quantitative study design using a cross-sectional survey was employed. The research site was Nkomazi Local Municipality in Mpumalanga Province. All HCPs (n=1 139) working at the primary healthcare clinics, community health centres and district hospitals were invited to participate in the survey. Data were collected between April and September 2022 via a selfadministered, electronic questionnaire. A demographic and occupational questionnaire, the General Help Seeking Questionnaire and the Health and Safety Executive (HSE) indicator tool were used to assess individual and workplace factors. Burnout was assessed using the Maslach Burnout Inventory– Human Services Survey. Univariate and multivariate regression analyses were used to examine factors associated with burnout. Results. Just over a quarter (n=302; 26.5%) of HCP participated. Participants were aged between 23 and 61 years, mostly female (n=252; 83.44%) and nurses (n=235; 77.81%). Most participants (n=215; 71.19%) would seek help if they had an emotional problem, most likely from mental health professionals, and least likely from traditional healers. Increased work-related stress was present due to the demands and roles of HCP. High levels of burnout were observed for Emotional Exhaustion (Median score 26 (IQR: 18)) and Personal Accomplishment (median score 29 (IQR: 9)) but not for Depersonalisation (median score 7 (IQR: 9)). On univariate regression analysis, the individual factor of being married and the workplace factor of increased years of experience were statistically significant to all three subscales of burnout. HSE factors of demands, control, management support, peer support, relationships, role and change were highly statistically significant to Emotional Exhaustion, Depersonalisation and Personal Accomplishment. On multivariate regression analysis, no individual demographic, occupational or HSE factors were significantly associated with Emotional Exhaustion or Depersonalisation. Personal Accomplishment ii improved by 0.49 (95%CI: 0.10-0.89) for every one point increase towards improved work demands, by 0.84 (95%CI: 0.01-1.67) for every point score increase towards improved management support, and by 1.19 (95%CI: 0.48-1.90) for every point score increase towards having improved role. Conclusions. During 2022, HCPs working in a rural area in South Africa displayed high levels of burnout for Emotional Exhaustion and Personal Accomplishment but not for Depersonalisation. Improvements in work demands, managerial support and role were significantly associated with an increase in the experience of Personal Accomplishment. Further research is recommended to better understand the nuances of the work environment. Solutions should be explored and implemented to prevent burnout, with special consideration given to work demands, managerial support and role clarity as part of the effort to retain rural HCP in the public health system.
  • Thumbnail Image
    Item
    Occupational characteristics and economic activities of health workers in the quarterly labour force survey: 2008-2017
    (University of the Witwatersrand, Johannesburg, 2024) Dinga, Aphiwe; Blaauw, Duane
    ackground There is global emphasis on the importance of research and analyses of health labour markets. The latter is defined as dynamic systems consisting of the demand and supply of health workers, influenced by a country’s regulations and institutions. However, there is limited national data to inform a health labour market analysis. Aim The aim of the study was to analyse the demographic, occupational characteristics and the economic activities of health workers who were surveyed in the Quarterly Labour Force Survey (QLFS) from 1 January 2008 to 31 December 2017. Methodology This study was a cross-sectional secondary data analysis of the health workers captured in the QLFS, a household survey that is conducted every three months by Statistics South Africa. The survey focuses on the labour market activities of individuals aged 15 to 64 years who live in South Africa. The sample analysed for this study was all health workers surveyed in the QLFS during the study period. Both the South African Standard Classification of Occupations (SASCO) and the Standard Industry Classification (SIC) codes were used to extract data on all health occupations to ensure that the entire health workforce in the QLFS was included in the current study. To identify predictors of employment a multiple logistic regression was carried out. STATA ® 15 was used for the statistical analysis. Results The study sample comprised a total of 5 502 health workers. Nurses constituted the highest proportion of health workers in the survey (60.1%) while medical doctors and dentists represented 10.0%. Nurses were older than the other categories of health workers with a mean age of 43.6 years (SD±10.3), compared to the mean age of 41.8 (SD±10.8) for doctors, 38.6 (SD±10.4) for mid-level health workers and 37.8 (±10.8) for allied health workers. The majority (59.0%) of health workers were employed in the public sector, and in urban areas (83.8%). Only 4.6% of doctors and 7.0% of allied health workers were employed in rural areas. Overall, the study found that fewer than 1% of health workers reported more than one job during the 10-year period. The results of the logistic regression showed that the odds of employment were approximately two times higher for health workers between the ages of 36-45 and 46-55 years old and 1.8 times higher for health workers between the ages of 26-35. There were 0.5 odds of employment for health workers aged 56-64 years compared to the reference age group of 18–25-year-olds. Females were less (0R=0.56) likely to be employed as compared to males. Compared to health workers in urban areas, those in rural areas were less (0.47) likely to be employed. Health workers were 0.53 times less likely to be employed outside the health industry as compared to being employed in the health industry. Conclusion Although the QLFS provides useful information on the health workforce in South Africa, the results highlight the need for investment in a robust human resources for health information system