Journal of Medicine, Nursing and Public health

System Factors Influencing Fire Emergency Preparedness Among Healthcare Workers in Selected Hospitals in Botswana

2026-04-06T11:49:49+00:00

Hospitals are among the most complicated building structures, and their infrastructure can easily contribute to hazardous and sometimes fatal incidents if strict fire safety procedures are not in place. Despite global efforts to improve hospital safety, thousands of fire incidents happen every year, putting patients and healthcare workers at risk. With an emphasis on understanding the system factors influencing preparedness, this study assessed healthcare workers' fire emergency preparedness in selected hospitals in Botswana. Safety, Health, and Environment officers from seven hospitals participated in key informant interviews, while semi-structured questionnaires and observational checklists were used as part of an analytical cross-sectional design. The association between the variable was assessed using binary logistic regression. The results showed that hospital systems significantly influence preparedness levels. Only 34.3% of healthcare workers had received fire safety training, and only 18.5% had taken part in fire drills in the previous year, indicating significant gaps in institutional initiatives. Gaps were noted between system-provided resources and actual operational competence, 79.5% of healthcare workers knew the location of fire extinguishers, while 40.5% understood how to use them correctly. Inadequate funding for fire safety implementation was cited by 75.1% of respondents, and institutional compliance with safety standards varied greatly among Hospitals (47.2%–100%), indicating system-level weaknesses. Binary logistic regression analysis showed that organizational culture barriers and budget adequacy (aOR= 0.400, p=0.025; aOR=0.411, p=0.030, respectively) were system determinants of fire preparedness, with both characteristics reducing rather than increasing the odds of preparedness. Overall, only 27% of healthcare workers were adequately prepared, and 87.7% were unsure of their emergency responsibilities, highlighting systematic gaps in policy enforcement, communication, and training. These results demonstrate that system factors, specifically resource allocation, organized training programs, regular drills, and institutional policy oversight, are essential determinants of fire emergency preparedness in Botswana's hospitals.

Utilization of Peritoneal Dialysis among End-Stage Renal Disease Patients in Greater Gaborone, Botswana

2026-04-06T12:15:08+00:00

Peritoneal dialysis offers better health outcomes and improved quality of life compared to hemodialysis, yet it remains underutilized globally, especially in Asia and Africa, including Botswana. This study identified factors associated with utilization of PD among End-Stage Renal Disease patients, and explored experiences of those who transitioned from PD to HD as well as those who never utilized PD in greater Gaborone, Botswana. A convergent mixed methods design was used. Quantitative strand utilized a cross-sectional analytical approach with semi-structured questionnaires (N=170), while the qualitative strand used a descriptive phenomenological approach with semi-structured embedded open-ended survey questions (n=108) and interviews (n=16). Quantitative data were analyzed using SPSS V26, while qualitative data were analyzed thematically using NVivo. Findings were integrated for deeper insight. Prevalence of PD was 36(22.5%) compared to 124(77.5%) HD. Majority of participants were male 100(63%), aged >35years 144(90%) and had not married 99(61.9%). More than half of the participants had completed secondary school or higher, 112 (70%). The most prevalent comorbidity was hypertension, 135(84.1%). Logistic regression: negative association of hypertension and PD utilization (OR 0.36[(95% CI 0.15, 091), p=0.026]), while awareness strongly predicted PD utilization (aOR 82.1 [(95% CI 20.6, 584.7), p <0.001]). Integrated findings highlighted misconceptions, mistrust, and mixed effects of higher education on PD uptake. Barriers to PD utilization in Botswana include patients’ concerns about PD side effects, complications, and comorbidities, as well as missed PD opportunities due to late presentation to facilities. Addressing these in Botswana requires targeted patient education alongside system-level support.

Patient-Related Factors Influencing Kidney Transplantation Uptake among Hemodialysis Patients in Gaborone, Botswana

2026-04-13T19:59:05+00:00

Chronic kidney disease (CKD) is a growing public health burden globally, with a disproportionately high impact in low- and middle-income countries such as Botswana. Although hemodialysis (HD) remains the most widely used renal replacement therapy, kidney transplantation (KT) is the preferred treatment option due to improved survival, better quality of life, and long-term cost-effectiveness. Despite Botswana’s subsidized renal services, KT uptake among HD patients remains low. This study examined patient factors as determinants of KT uptake among HD patients in Gaborone, Botswana. An analytical cross-sectional study was conducted among 163 adult HD patients proportionally sampled from three dialysis centres in Gaborone. Data were collected using structured questionnaires that captured socio-demographic characteristics and patient-related factors, including knowledge, attitudes, comorbidities, and perceptions of KT. Descriptive statistics were used to summarize participant characteristics, while chi-square tests were applied to identify patient-level predictors of KT uptake. Only 17.2% of participants had initiated the KT process, indicating low uptake. Bivariate analysis showed significant associations between KT uptake and selected patient demographic factors, particularly age, gender, and education level. However, most patient-related attributes, including knowledge, attitudes, comorbidities, and cultural or religious beliefs, were not significantly associated with KT uptake. The most commonly reported patient-related barriers were a lack of a suitable donor and inadequate information, suggesting that perceived donor limitations remain a key challenge for patients. Kidney transplantation uptake among HD patients in Gaborone remains low despite the availability of subsidized services. Findings suggest that while demographic characteristics such as age influence uptake, most patient-related factors play a limited role, with donor-related constraints emerging as the dominant barrier from the patient perspective. Strengthening patient counseling, improving access to transplant information, and supporting family-based donor engagement may improve transplantation uptake.

Determinants of Willingness to Donate Kidneys Among Relatives of Haemodialysis Patients in Gaborone, Botswana

2026-04-13T20:27:49+00:00

Willingness to donate kidneys among relatives of hemodialysis patients is a critical issue, particularly in low-resource settings like Gaborone, Botswana, where kidney disease is a growing public health concern. This study aimed to examine the willingness of relatives of hemodialysis patients to donate kidneys and to identify health status factors that influence this willingness. A descriptive cross-sectional approach was adopted, using a standardized questionnaire to collect information from 131 family members of patients undergoing hemodialysis at selected health institutions in Gaborone. Both descriptive and inferential statistical techniques were applied to detect trends and associations among the study variables. The study revealed that 67.2% of relatives of hemodialysis patients in Gaborone expressed willingness to donate a kidney, while 32.8% were unwilling. Logistic regression showed that willingness to donate kidneys was significantly associated with perceived medical compatibility (AOR = 3.63). This study emphasizes the important influence of prior family experience with organ donation or transplantation on individuals’ willingness to donate kidneys. Public health strategies should leverage the influence of prior familial experiences with organ donation to enhance willingness to donate kidneys. Educational programs and counseling sessions can incorporate personal stories and testimonials from families who have participated in donation or transplantation, helping to reduce fear, build familiarity, and motivate potential donors. Healthcare providers should offer tailored guidance that reassures potential donors about the process, risks, and outcomes, while highlighting relatable experiences that encourage positive attitudes.