Browsing by Author "Kader, Rehana"

Now showing 1 - 4 of 4
  • Thumbnail Image
    Item
    Identifying perceived barriers to monitoring service quality among substance abuse treatment providers in South Africa
    (BioMed Central, 2014-02-05) Myers, Bronwyn; Petersen, Zainonisa; Kader, Rehana; Koch, J. Randy; Manderscheid, Ron; Govender, Rajen; Parry, Charles D. H.
    Background: A performance measurement system is planned for South African substance abuse treatment services. Provider-level barriers to implementing these systems have been identified in the United States, but little is known about the nature of these barriers in South Africa. This study explored the willingness of South African substance abuse treatment providers’ to adopt a performance measurement system and perceived barriers to monitoring service quality that would need to be addressed during system development. Methods: Three focus group discussions were held with treatment providers from two of the nine provinces in South Africa. These providers represented the diverse spread of substance abuse treatment services available in the country. The final sample comprised 21 representatives from 12 treatment facilities: eight treatment centres in the Western Cape and four in KwaZulu-Natal. Content analysis was used to extract core themes from these discussions. Results: Participants identified barriers to the monitoring of service quality that included outdated modes of collecting data, personnel who were already burdened by paperwork, lack of time to collect data, and limited skills to analyse and interpret data. Participants recommended that developers engage with service providers in a participatory manner to ensure that service providers are invested in the proposed performance measurement system. Conclusion: Findings show that substance abuse treatment providers are willing to adopt a performance measurement system and highlight several barriers that need to be addressed during system development in order to enhance the likelihood that this system will be successfully implemented.
  • Thumbnail Image
    Item
    Moving beyond access : towards a quality-orientated substance abuse treatment system in South Africa
    (Health and Medical Publishing Group (HMPG), 2012-08) Myers, Bronwyn J.; Petersen, Zaino; Kader, Rehana; Parry, Charles D. H.
    There is growing concern about the increased demand for and limited access to substance abuse treatment in South Africa.1 The government has responded by allocating more money to the delivery of substance abuse treatment, expanding the number of state-funded treatment slots, and training additional health and social workers to deliver these services, particularly in provinces where the prevalence of substance-related problems is high, such as the Western Cape.
  • Thumbnail Image
    Item
    The relationship between substance abuse, health status and health behaviours of patients attending HIV clinics
    (Stellenbosch : Stellenbosch University, 2013-03) Kader, Rehana; Seedat, Soraya; Parry, Charles; Koch, Randy; Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Psychiatry.
    ENGLISH ABSTRACT: HIV infection, substance abuse, and psychiatric disorders are major public health issues in South Africa. Psychiatric disorders and substance-use disorders together have a negative impact on the health outcomes of people living with HIV and AIDS (PLWHA), such as poor adherence to anti-retrovirals (ARVs), HIV disease progression, lower CD4 counts, vulnerability to opportunistic infections, high viral loads, possible drug resistance, and an earlier onset of death. The overall aim of this study was to investigate the relationship between substance abuse practices and the health status and health behaviour of patients attending HIV clinics in the Cape Metropole. The study used a cross-sectional study design for collecting data on hazardous or harmful use of alcohol and problematic drug use, demographic information and health status among patients attending eight HIV clinics in the Cape Metropole. A sub-sample of patients were assessed on the following domains: depression, psychological distress, psychopathology, post-traumatic stress disorder (PTSD), risky sexual behaviour, adherence to ARVs, levels of resilience, levels of social support and patient’s work, family and social functioning. Of the 608, 10% of consecutively selected patients completed an additional psychiatric diagnostic interview (Mini International Neuropsychiatric Interview). The main findings to emerge from this study are: 1. Patients reporting hazardous or harmful use of alcohol and/or drug use are significantly more likely to be non-adherent to ARVs and have lower CD4 counts than their non-substance abusing counterparts 2. Hazardous or harmful use of alcohol has a direct influence on CD4 count resulting in lower CD4 counts and participants being less likely to be on ARVs. 3. Hazardous or harmful use of alcohol has a direct relationship in predicting tuberculosis (TB). 4. Hazardous or harmful users of alcohol and/or problematic drug users are more likely to report psychological distress (anxiety and depression), depression and low levels of family support than their non-using counterparts. 5. Participants who met the criteria for major depression are significantly more likely to be non-adherent to ARVs. 6. Gender, depression, psychological distress, and PTSD were found to be significant determinants of hazardous or harmful use of alcohol. 7. Psychological distress (anxiety and depression) is significant in directly predicting ARV non-adherence. 8. Male participants and those who stopped taking their ARVs were more likely to have lower CD4 counts than female participants and those who did not stop. 9. PTSD was found to predict psychological distress indicating that participants who experienced trauma were more likely to suffer from psychological distress (anxiety and depression) compared to those who did not experience any PTSD. Participants with lower levels of family support were more likely to suffer from psychological distress than those with high levels of family support.
  • Thumbnail Image
    Item
    Understanding the impact of hazardous and harmful use of alcohol and/or other drugs on ARV adherence and disease progression
    (Public Library of Science, 2015-05) Kader, Rehana; Govender, Rajen; Seedat, Soraya; Koch, John Randy; Parry, Charles
    The objective of this study was to understand the impact of hazardous and harmful use of alcohol and/or other drugs on ARV adherence and disease progression among HIV patients. A cross-sectional study design was used. A total of 1503 patients attending HIV clinics in Cape Town, South Africa were screened for problematic substance use. A sub-sample of 607 patients (303 patients who screened positive for problematic substance use and 304 who did not) participated in this study. Hazardous or harmful alcohol use and problematic drug use predicted missing and stopping ARVs which, in turn, was associated with a decrease in CD4 counts and more rapid HIV-disease progression and poorer health outcomes in people living with HIV/AIDS (PLWHA). The findings of this study underscore the need for an integrated approach to managing substance-use disorders in PLWHA.