Journal of Medicine, Nursing and Public health

Lived Experiences of Patients with End-Stage Kidney Disease on Dialysis at Scottish Livingstone Hospital, Kweneng District, Botswana

2025-12-16T15:44:47+00:00

End-Stage Kidney Disease (ESKD) is a public health problem with increasing prevalence in Botswana. There is limited evidence on ESKD patients' experience in managing the condition. Therefore, this research investigated the lived experiences of ESKD patients undergoing dialysis in Botswana. This study adopted an interpretative phenomenological research design. The research used 16 ESKD patients undergoing dialysis at the Scottish Livingstone Hospital. Semi-structured, audiotaped interviews were used for data collection. Collected data was transcribed and analysed thematically to identify shared patterns related to the participants lived experiences. Thematic analysis yielded themes and sub-themes representing the participants’ experiences with ESKD. The themes included: Dialysis as demanding (subthemes: Time Burden, disrupted daily routines, Long Dialysis hours); Dialysis experiences (subthemes: predialysis anxiety, Mixed feelings during dialysis, Post dialysis Exhaustion) and Physical Symptoms (subthemes: Persistent fatigue and weakness, Pain and swelling, Respiratory and Systemic distress) In summary, this study showed ESKD and dialysis to be considerably demanding for the patients. Patients had mixed experiences before, during, and after dialysis. ESKD patients have to battle dialysis symptoms daily, which affect their well-being and quality of life. Based on the findings this study advocates for dialysis centres in Botswana to be increased to enhance treatment access and lower disease burden, more healthcare providers to be trained on renal care that include Patient-centred care to address healthcare disparities and increase treatment access, for ESKD patient support programs to be implemented to help them cope with predialysis anxiety, mixed feelings during dialysis and post dialysis exhaustion also to strengthen and support ESKD social programs. Policies and strategies that lessen ESKD disease burden and improve the quality of life for ESKD patients should be adopted.

Exposure Levels to Dust in Grain Storage and Milling among the Selected Mill Workers in Greater Gaborone District, Botswana

2025-12-16T15:57:40+00:00

The different processes of grain milling generate dust, which can be inhaled as respirable or inhalable dust, may contain hazardous substances that can cause eye or skin irritation, acute and chronic health effects on the respiratory system, or impaired lung function leading to worker disability. There is currently limited literature on exposure levels to dust among mill workers in Botswana. The study’s aim was to assess the exposure levels to dust in grain storage and milling among mill workers in the Greater Gaborone District. A cross-sectional analytical study was conducted among 176 mill workers in eight (8) grain mills. Data was collected through a modified standardized British Medical Research Council (BMRC)Structured questionnaire, Key Informant Interviews, and an observation checklist. A particulate matter counter, JD3003, was also used to collect dust samples from three fixed points, i.e., milling, packaging, and storage, to measure exposure levels for PM2.5 and PM10. SPSS v29 and Stata 14 were used for data analysis. This study recorded high arithmetic mean dust concentrations of 39.0µg/m³ for PM2.5 and 127.7 µg/m³ for PM10. These concentrations exceeded the World Health Organization Air Quality limits of PM2.5, 5µg/m^3, and PM10, 15µg/m³. The highest dust concentrations were recorded in milling sections, followed by packaging areas in all the mills. Prolonged work shifts (> 8 hours) were linked to 18.4% higher PM2.5 and 44.2% higher PM₁₀ dust exposure levels. A proportion of workers presented with chronic respiratory symptoms (39.2%), skin problems or irritation (4.6%), and itching or tearing eyes (8%), indicating health implications of exposure to high grain dust concentrations. Safety training and PPE use were associated with increased exposure to dust. These findings underscore the need to strengthen preventive safety measures and policy enforcement to address non-adherence to safety protocols.

Factors Influencing the Uptake of Sexual and Reproductive Health Services Among Adolescent Girls in Humanitarian Crises: A Case Study of Bor County, South Sudan

2025-12-16T15:26:51+00:00

Humanitarian crises in South Sudan, characterized by conflict, displacement, and disrupted health systems, severely limit adolescent girls' access to SRH services. The study employed a mixed-methods design. This study aimed to examine factors influencing the uptake of SRH services among adolescent girls aged 15-19 in Bor County, South Sudan. The target population included adolescent girls aged 15-19, with a sample size of 225 participants selected through purposive sampling. Data was collected via semi-structured questionnaires for quantitative insights and Key Informant Interviews (KIIs) for qualitative perspectives. Quantitative data were analyzed using descriptive statistics (means, standard deviations, and regression analysis) with SPSS Version 25.0, and results were presented in tables, pie charts, and graphs. Qualitative data were analyzed thematically using NVivo software to identify key patterns and themes. The study found that accessibility was the most significant barrier (Beta = 0.311, p = 0.021), with long distances to clinics, poor transportation, and lack of youth-friendly services limiting uptake. Awareness and knowledge (Beta = 0.219, p = 0.032) were constrained by inadequate school-based SRH education. Psychosocial factors (Beta = 0.201, p = 0.001), including stigma and trauma, significantly deterred service utilization. Socio-cultural and economic factors (Beta = 0.156, p = 0.002), such as cultural taboos and poverty, had a notable but lesser impact. This study enriches the literature by providing context-specific insights into SRH service uptake in humanitarian settings, emphasizing the unique challenges faced by adolescent girls in Bor County. It recommends youth-friendly mobile clinics, comprehensive sexuality education, and community-based stigma reduction programs to align with South Sudan’s adolescent health policies and global humanitarian SRH standards.