OpenUCT :: Browsing by Author "Shung King, Maylene"

Browsing by Author "Shung King, Maylene"

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Open Access
Antiretroviral roll-out in South Africa: where do children feature?
(Children's Institute, 2004) Shung King, Maylene; Zampoli, Marco
Open Access
Assessing palliative care policies in Africa: Implication for paediatric palliative care
(2020) Ngowi, Epiphania; Shung King, Maylene; Meiring, Michelle
Around the world, there are millions of children who need palliative care from the moment they are diagnosed with life-threatening and life-limiting illnesses, yet very few children have access to palliative care services. In many African countries, where palliative care is still new, many children with chronic illnesses continue to experience needless pain and suffering. The World Health Assembly Resolution 67.19 made a clear call for governments around the world to implement palliative care policies. Such policies should support the “comprehensive strengthening of health systems to integrate evidence-based, costeffective and equitable palliative care services in the continuum of care, across all levels of care”. However, despite these frequent calls, no specific policies target the provision of paediatric palliative care in Africa. This dissertation consists of three parts. Part A is the study protocol, which consists of the introduction and the study methodology. The study is qualitative in nature and it adopted the Walt and Gilson framework for extraction of data and analysis of palliative care policies in Africa. The study used publicly available policy documents, which were identified and obtained from government websites, international agencies' websites and through communication with palliative care experts. An excel spreadsheet was used to extract data, which was analysed thematically. Part B is a literature review of available published and unpublished work pertaining to paediatric palliative care in Africa. It provides the historical background of palliative care and defines palliative care and paediatric palliative care as well as exploring the general literature on paediatric palliative care, and the evidence on the existence of palliative care policies in Africa. Part C is a journal manuscript. It follows the structure and guidelines of the journal of the Health Policy and Planning. The manuscript begins with introduction and the study methods. Further, the study used publicly available policy documents on palliative care in Africa published from 2002 until 2018. An appropriate conceptual framework was chosen, and the results of the policy analysis are provided and followed by the discussion section and conclusions. The study findings indicate that few palliative care policies exist in Africa, and children's palliative care needs are not adequately included and addressed. The findings further show that there was no single policy targeting paediatric palliative care, and children were included among the larger population. As such, palliative care needs were not sufficiently addressed. Only three policies (South Africa, Zimbabwe, and Malawi) clearly address paediatric palliative care needs. The study, therefore, argues that for children with life threatening and life-limiting conditions to be free from pain, African governments need to formulate specific policies that will guide the provision of paediatric palliative care. This study is likely contribute to policy making processes, acts as a reference document for academics and students and provides an advocacy tool for activists, nongovernmental organizations (NGOs), and civil society organizations (CSOs) working on children's welfare and human rights issues more broadly. Further, the findings of the study may contribute to formulating specific palliative care policies for children, particularly in African countries that lack such policies.
Open Access
Basic health care services for children
(Children's Institute, 2010) Westwood, Anthony; Shung King, Maylene; Lake, Lori
Open Access
Child Protection Week 2003. Fact sheet No. 1: child deaths
(Children's Institute, 2003-05) Shung King, Maylene; Proudlock, Paula; Smith, Charmaine
Open Access
The current situation of children's nursing training in South Africa
(2017) Chukwu, Uchenna Nneka; Shung King, Maylene; Sieberhagen, Stephanie
The high rate of Infant and child mortality, much of which is preventable, especially in developing countries, continues to be a global public health concern. Improving the numbers and competencies of child nurse professionals is vital for health system strengthening. Child nurses are important group of health professionals who are responsible for delivering effective health care services to infants and children at all levels of the health system, yet their training situation is being under-investigated. It is documented in various literatures that the high rate of under-five morbidity and mortality in South Africa can be prevented by strengthening the training needs of child nurses, in order to ensure that their competencies adequately align with the priority health needs of children who present at the health facilities. This dissertation is organized into three parts. Part A is the research protocol which outlines the background and the study methodology. Mixed methods comprising qualitative and quantitative methods is adopted for the study. Documentary review and self-administered structured questionnaire is used for the data collection. The questionnaire is designed by applying the basic principles that informs a good questionnaire design. Purposive sampling method is used for sampling the nursing institutions and research participants for inclusion into the study. Defined inclusion and exclusion criteria are used to identify and select the Nursing Education Institutions and key informants suitable for the study. The nursing institutions that are accredited with the South African Nursing Council and conducts child health nursing is an inclusion criterion for the study. In addition, key informants who are nursing educators with expertise knowledge in children's nursing are identified as an inclusion criterion for the study. Documentary review is used to extract secondary data that identifies the South African policy and legislative framework for general nursing and children nursing in particular. Documents will include appropriate policy and strategy documents. The workshop minutes of a sentinel Nurse Educator Forum that took place at Groote Schuur hospital in December of 2016 will be included as an important secondary data source. In addition, primary data collection will be done using a self-administered structured questionnaire where key informants will address a combination of qualitative and quantitative questions. The self-administered questionnaire is used to thoroughly investigate the current situation of children's nursing training in South Africa, with the aim of identifying the numbers trained annually for a five-year period and the curriculum foci of children nursing training across the nursing institutions that host children nursing programs in South Africa. Part B is the literature review which examines the preventable causes of under-five mortality in South Africa and the need to train up suitable, well qualified and competent Child Nurse Professionals needed to improve the health of infants and children in South Africa. Part C is the journal article manuscript which begins with the background and the study methods, followed by the results, discussion and conclusion. The result indicates that a total of five relevant policy and strategy documents were identified for the documentary review. Of the five documents, three documents suggest strategies for improving the nursing education and training programmes in South Africa. The strategies include increasing the supply of the nurse specialists, transforming all nursing colleges to Higher Education Institutions and improving the curriculum guidelines of the nursing programme, in order to ensure that the competencies taught to the nurses aligns with the health care needs of the communities. The two other documents posit the primary roles of the nursing professionals, which is to provide effective care and respect the rights of the health care users. The findings from the documentary review recommends that the nursing education in SA can be strengthened by identifying all nursing colleges as Higher Education Institutions, reviewing curricula and producing more numbers of competent nurses in South Africa. For the primary data collection, out of the seven accredited nursing institutions which conducts children nursing training in South Africa, five respondents from five institutions completed and forwarded their questionnaires. The completed questionnaires provided details on the profile of children's nursing training, including the annual numbers of children nurse trainees and graduates over a five-year period and details of their curriculum components. The results showed that a total of 637 children nurses were enrolled from 2012-2016. Of the 637, 587 graduated successfully which indicates that the number of child nurse trainees and those who successfully graduated over a five -year period across five nursing institutions were very impressive, although the number of child nurses produced annually are still few to address the child health needs in South Africa. In addition, the findings from the questionnaire reveals that the curriculum of children's nursing training across the five institutions are similar and contains topics that are capable of equipping the child nurses with the relevant skills necessary for improving the health of infants and children. However, they exist some variations in the degree the courses are covered by the institutions, as well as variations in the way the courses are conveyed to the nurse learners. For example, some topics where covered to a high degree by some institutions, while some where not covered at all, or where covered to some extent via classroom and clinical placement and assessments. This suggests that the curricula of child nursing in South Africa requires standardization and frequent reviewing to ensure it coincides with the child health needs in South Africa. The dissertation is likely to increase the knowledge of the current training situation of children's nursing in South Africa, and also identify gaps for future research. In addition, the dissertation also provides a better understanding of the curriculum foci of children's nursing training in South Africa and can help inform the human resource training plans for child health nursing in the country.
Open Access
Deaths at Red CrossChildren's Hospital, Cape Town 1999-2003 - a study of death notification forms
(2006) Grandin, Wilson; Westwood, Tony; Lagerdien, Kashifa; Shung King, Maylene
Objectives. The availability of cause-specific mortality data for children in South Africa is limited. Hospital-based data have the potential to contribute to understanding of the causation of childhood death in South Africa. The objectives of the study were to gain insights into the causes of death in a South African children’s hospital. Design. Prospective, descriptive study of death notification forms. Setting. Red Cross War Memorial Children’s Hospital, Cape Town. Methods. Data from 1999 to 2003 were analysed by direct and underlying causes of death (using a modified Global Burden of Diseases (GBD) classification) and demographic variables. Death rates per 1 000 hospital admissions were calculated for certain common causes of death. Seasonal correlates of mortality were examined. Results. There were 1 978 deaths. The number of deaths per year increased by 11.4% over the period. The death rate rose from 15.9 to 18.4 per 1 000 admissions from 1999 to 2002, declining to 17.4/1 000 in 2003. The death rate was higher for females than for males (18.4/1 000 versus 17.6/1 000, p = 0.007). Sixty per cent of deaths occurred in children less than 1 year old. GBD group I diseases (infectious, nutritional, perinatal) accounted for the greatest proportion of deaths (58.6%), followed by non-communicable diseases (29.1%), and injuries (7.9%). HIV/AIDS accounted for 60% of infectious deaths (31.6% of all deaths). Diarrhoea-related mortality was 3 times higher in summer than in winter. Congenital conditions dominated GBD group II (57.5%). Conclusion. The analysis shows the value of routinely recording data on childhood hospital deaths. The results mirror those of the South African Medical Research Council’s Burden of Disease studies but also reflect the hospital’s tertiary functions. Female children were at higher risk of death. Childhood HIV related deaths are a major challenge to the health system.
Open Access
An evaluation of the nutritional status of preschool chldren living in a rural health district : implications for a community based nutrition programme in the Northern Province
(1999) Saitowitz, Romy; Shung King, Maylene; Hendricks, Michael
The study aimed to evaluate the nutritional status of pre-school children (0-6 years), and the activities of a local CBNP serving these children, in the Ngwaritsi health district of the Northern Province. The following objectives were identified: o To determine the anthropometric status of children 0-6 years o To determine the dietary intake of children 0-6 years o To evaluate the nutrition services offered to these children by a local CBNP o To make recommendations, based on these findings, for improving existing strategies to address malnutrition in the area.
Open Access
Exploring decision space: a case study of two South African central hospitals
(2018) Roman, Tamlyn Eslie; McIntyre, Di; Cleary, Susan; Shung King, Maylene
Background: The objective of this study is to explore the determinants of decision space and to investigate how it functions within a central hospital in South Africa, where policy proposals regarding the decentralization of management authority are being considered in the context of concerns about poor hospital management, and in terms of planned implementation of the National Health Insurance policy. Methods: Using a mixed methods qualitative approach, the case study methodology involved the purposive selection of two central hospitals as case study sites in the South African province of Gauteng. Nested case studies that focused on the human resources and supply chain management departments involved exploratory and explanatory phases that included document review, work shadow with non-participant observation, and in-depth interviews. Thematic analysis was used to analyse the data and generate findings. Results: Emergent outcomes of the interactions between authority, organisational capacity and accountability were identified and contributed to the development of an analytical decision space framework. The framework outlines the way in which decision space influences the allocation of responsibilities, the responsiveness of decision-making and the use of resources within the organisation or system. Recommendations: In the context of national policy changes regarding the decentralisation of hospital management authorities, this framework can be used to understand how decision space functions in other settings, and to guide implementation of interventions for improved management.
Open Access
Facts about child deaths: an overview of child deaths for decision-makers and service providers in South Africa
(Children's Institute, 2002-05) Shung King, Maylene; Proudlock, Paula
Open Access
Gender analysis: Sub-Saharan African nurses' migration experiences - a systematic review
(2017) Mavodza, Constancia; Shung King, Maylene; Govender, Veloshnee
Alleviating the global shortage of health workers, particularly nurses, is critical for health systems and health worker performance. Nurses are mostly women and make up the majority of the health workforce. Several factors have been identified as key players in the shortage crisis and migration is one of these factors. Nurses' migration from Sub Saharan Africa (SSA) increases the nurse shortage in the region and further constraints the already struggling health systems. Migration literature has dominantly focused on macro push-pull, brain drain and ethics theories of migration with limited exploration of relationships, interaction, norms, beliefs and values shaping migration trajectories and decisions. Despite the potential role of gender as an influential component of migration trajectories, there has been little research done to investigate gender in the context of migration of SSA nurses. This review aims to identify, describe, and summarize SSA nurses' migration experiences by assessing the influence of gender on these experiences. The dissertation is organized into 3 parts. Part A is a systematic review protocol that describes the background, justification and methodology of the review. A scoping exercise is conducted to to familiarize with the literature. This is followed by a qualitative systematic approach is utilised and the literature in eight databases is searched using key words and terms derived from an initial scoping exercise and the review questions. Suitable articles are defined and selected using a set inclusion and exclusion criteria. The suitable articles are then appraised and a thematic analysis using a gender focal lens is applied to them. Part B is a literature review of existing primary and theoretical research on health worker shortages; migration and gender analysis in health worker migration and shortages. It provides a background for the systematic review by defining migration, gender and gender analysis as well as presenting the scope on health worker and nurse shortages. The literature review encompasses the scoping exercise and concludes on the relevance of a gender-focused research on nurse migration. Part C. is the full systematic review presented as an article for Human Resources for Health Journal. Articles published on Sub-Saharan African (SSA) nurses' migration experiences between 2005 and 2016 are presented, subjected to a gender analysis to illuminate the results. The discussion and conclusion then follow. The results indicate that there is a paucity of empirical work on nurse migration experiences that is explicitly gender-focused. Gender analysis that is situated in social contexts and identifiers revealed that SSA nurses continuously renegotiate and reconfigure gender roles in child care as they move from one social context to another. Moreover migrating SSA nurse face challenges and limitations at macro, meso and micro levels of the system- that are linked to their identities as either professionals, African migrants and/or women. Therefore, the review underscores the importance of the relationships between gender and local/individual nuances and global/national determinants of migration. However, these studies are limited in their explicit gender and social focus and how it contextually affects health worker performance and quality care provision. More empirical studies are needed to investigate gender influences for migrating male nurses; nurses who remain; and by different geographical & cultural region – to allow comparison across different groups of nurses and determine conceptual generalizations for doing gender research. This dissertation will likely increase understanding of the role of gender in migration decision-making and experiences for SSA nurses across different professional, migrant and woman identities. This understanding has impacts on nurse motivation, capacity and capability as well quality care provision. Additionally, the dissertation provides a better understanding for incorporating gender analysis in health systems research, and also identifies avenues for future research.
Open Access
Healing Inequality: targeting health care for children
(Children's Institute, 2005-12) Shung King, Maylene; McIntyre, Di; Jacobs, Marian
Open Access
Health systems factors that impact on access to maternal services for women with disabilities in sub-Saharan Africa: a systematic review
(2015) Mheta, Doreen; Shung King, Maylene
Maternal mortality is an enormous global challenge that is most prevalent in sub-Saharan Africa (SSA). Its prevalence in the SSA region has been attributed to inadequate access to maternal services (MHS) amongst the poor and rural women. In an attempt to improve access to maternal services, women with disabilities (WWDs) have generally been neglected. Little is known about the health systems factors that facilitate or hinder access to MHS for WWDs. However, available studies for women in general in SSA, examining health systems determinants of access to MHS, utilise the silo approach thereby providing fragmented and ineffective solutions to maternal mortality. Globally, taking a comprehensive health systems approach to understand the full range and interconnectedness of health factors is now recognised as crucial in understanding and planning complex health problems such as access to MHS. This paper presents findings from a qualitative systematic review of empirical studies providing evidence on the health systems factors that impact on access to MHS for WWDs in SSA. This dissertation comprises three sections, namely Part A, Part B and Part C. Part A reviews the Protocol; it presents the background and the qualitative systematic review methodology that is utilised in this study. A systematic search of five data bases is outlined and inclusion and exclusion criteria set out to select the suitable tool. A data extraction tool is designed to summarise the studies in a common format and to facilitate synthesis and coherent presentation of data. Part B is the review of existing empirical literature on access to MHS for both women in general SSA and for WWDs globally. Theoretical frameworks of access to health care services and health systems frameworks are also presented in this section. Furthermore, Part B provides the background on why access to MHS for WWDs is important. This section explores how health systems approach can be adopted to reveal the factors that impact on access to MHS; it links the complex systems framework to the availability, accessibility, acceptability and quality framework. Part C is a complete systematic review journal manuscript. The background of the study and methodology are described. This section also includes the findings from the systematic review of original journal articles published in English from 2000 to 2014 that report empirical findings on health systems factors that impact on access to MHS WWDs in SSA.
Open Access
A new kid on the block: the Children's Institute at the University of Cape Town
(Children's Institute, 2001-12) Shung King, Maylene
Open Access
A quick guide to the clinical care of children infected with HIV
(Chlidren's Institute, 2002-04) Shung King, Maylene; Giese, Sonja; Hussey, Gregory
Open Access
Submission on the Committee of Inquiry's Report: Comprehensive Social Security for Children
(Children's Institute, 2002-06) Guthrie, Teresa; Jacobs, Marian; Shung King, Maylene; Giese, Sonja; Proudlock, Paual; Berry, Lizette
Comment made to the Department of Social Development on the Report of the Committee of Inquiry into a Comprehensive Social Security System for South Africa, June 2002.
Open Access
Submission on the draft National Health Bill
(Children's Institute, 2002-02) Proudlock, Paula; Shung King, Maylene
Written submission to the Portfolio Committee on Health, February 2002.
Open Access
This Little Light of Mine... Caregivers of children affected by HIV speak out at the National Children's Forum
(Children's Institute, 2001-12) Abrahams, Eva; Shung King, Maylene
Open Access
Unique developmental screening programme
(Children's Institute, 2003-11) Adnams, Colleen; Michelson, Lori; Shung King, Maylene
Published by the Democratic Nurses Organisation of South Africa.
Open Access
The Western Cape Screening Programme for developmental disabilities in pre-school children: results of an evaluation
(Children's Institute, 2003-12) Michelson, Lori; Adnams, Colleen; Shung King, Maylene
Open Access
What are the attitudes, beliefs and knowledge of health care professionals about chronic fatigue syndromes and fibromyalgia : a systematic review to guide curriculum development
(2016) Reypert, Garth; Parker, Romy; Shung King, Maylene
Chronic Fatigue Syndrome or Myalgic Encephalomyelitis (CFS/ME) is a relatively unknown disease and is often referred to as a diagnosis of exclusion. Diagnostic tests are not available for this disease because a single empirical cause or marker has yet to be discovered. This means that diagnosis and management is almost solely based on the skill of the health care professional to notice the signs and symptoms of the disease, the subtleties of which often only come with experience. While some studies have assessed the knowledge, attitudes and beliefs of health care professionals (HCP) towards CFS/ME, none have reviewed all the studies focused on health care professionals to aide students and inexperienced professionals to avoid negative behaviours that might lead to a CFS/ME patient not being diagnosed as having CFS/ME. This review contains three parts. Part A is the protocol for the review. This will highlight the background of CFS/ME knowledge and outline the review's methodology. The review will take the form of a qualitative systematic review. Six databases will be searched with the relevant keywords and search terms outlined in the protocol. Appropriate articles will be selected based on the inclusion and exclusion criteria defined in the protocol. Part B is the literature review of the existing research available in the field of CFS/ME, the knowledge of the disease and the attitudes and beliefs of health care professionals about CFS/ME. It will provide a background for the full systematic review in Part C. This review will detail what is known about CFS/ME as a disease, report on potential causal mechanisms for CFS/ME as a disease and report on the scope of the disease in epidemiological terms. Part C is the full systematic review. It follows the previous section in the description of the background as well as outlining the methodology followed. The results of the search are then reviewed and discussed in detail.