Background: Inadequate access to healthcare in rural areas worsens the burden of disease, leading to increased morbidity and mortality rates. This study aims to explore the multifaceted barriers that hinder access to chronic disease management at selected rural facilities of the Eastern Cape Province. Methods: An exploratory descriptive qualitative design was used to collect data from a sample size of 32 participants (23 patients and 9 health professionals) between November and December 2024. A convenient sampling technique was used to select participants for the study. Semi-structured interviews were audio-recorded; transcribed; and analyzed using thematic analysis. The interview tool was piloted in one of the primary healthcare facilities in the Eastern Cape, which was not used in the actual study. Ethical principles were adhered to throughout the study. The study adhered to the Access to Healthcare conceptual framework. Results: The study identified three themes: barriers of access to healthcare services, experiences and perspectives, and existing strategies or interventions. Conclusions: Addressing systemic issues like workforce shortages, infrastructure deficits, and socioeconomic challenges in rural Eastern Cape requires a multifaceted approach, including strengthening community-based services and ensuring equitable resource distribution.

Introduction: Clinical governance outlines duties and responsibilities as well as indicators of the actions towards best possible patient outcomes. However, evidence of outcomes on clinical governance interventions is limited in South Africa. This study determined knowledge of clinical staff about the existence of clinical governance protocols/tools that are utilised in selected South African hospitals. Methods: A cross-sectional study conducted among randomly sampled clinical staff at Nelson Mandela Academic (NMAH), St Elizabeth in the Eastern Cape Province and, Rob Ferreira (RFH) and Themba Hospitals in the Mpumalanga Province of South Africa. A self-administered survey questionnaire was used to collect demographic information and quality improvement protocols/tools in existence at the hospitals. Data were captured in Excel spreadsheet and analysed with STATA. Knowledge was generated based on the staff member’s score for the 12 questions assessed. Results: A total of 720 participants were recruited of which 377 gave consent to participate. Overall, 8.5% (32/377) of the participants got none or only one correct out of the 12 protocols/tools; and 65.5% (247/377) got between two and five correct. The median knowledge scores were 41.7% (interquartile range (IQR) = 16.7%) in three of the hospitals and 33.3% (IQR = 16.7%) at NMAH (p-value = 0.002). Factors associated with good knowledge included more than five years of experience, being a professional nurse compared to other nurses, not working at NMAH as well as being a medical doctor or pharmacist compared to other staff. Overall, 74.0% (279/377) of the respondents scored below 50%; this was 84.4% (92/109) at NMAH and 66.3% (55/83) at RFH and this difference was statistically significant (p-value = 0.017). Conclusion: Despite clinical governance implementation, there was low knowledge of clinical governance protocols/tools among clinical staff. Therefore, providing more effective, relevant training workshops with an emphasis on importance of local ownership of the concept of clinical governance, by both management and clinical staff is of great importance.

Illegal abortion remains a significant public health challenge globally, particularly among adolescent girls who often lack adequate reproductive health information, access to healthcare services, and social support. Despite South Africa’s progressive abortion legislation, teenage girls in rural communities like Lusikisiki still face barriers to accessing safe reproductive health services due to socio-cultural stigma, misinformation, and limited youth-friendly services, increasing the risk of unsafe abortion and related health complications. This paper outlines a protocol for a proposed qualitative case study that aims to assess the awareness of teenage girls in Lusikisiki regarding the health risks associated with illegal abortion, explore their sources of information, identify factors influencing their awareness, and propose strategies to reduce unsafe abortion. A qualitative case study design guided by an interpretive paradigm will be used to explore the perceptions and experiences of teenage girls. A purposive sample of 25 participants aged 13–19 years will be recruited from Village Clinic, Bambisana Hospital, and St Elizabeth Regional Hospital. Data will be collected through semi-structured interviews and analysed using thematic analysis supported by NVivo software. The anticipated findings are expected to provide context-specific insights to support improved reproductive health education and adolescent-friendly healthcare services in rural communities.

Background Burnout among nurses is a growing public health concern, particularly in resource-constrained healthcare systems across Africa. Nurses working in public hospitals are frequently exposed to high workloads, staffing shortages, and limited organisational support, all of which contribute to chronic occupational stress. Objectives This scoping review aimed to map and synthesise evidence on factors contributing to burnout among nurses working in public hospitals in Africa. Methods The review followed Arksey and O′Malley’s framework, enhanced by Levac et al., and was guided by PRISMA-ScR reporting standards. A comprehensive search of PubMed, CINAHL, Scopus, and Web of Science identified studies published between 2020 and 2026. Eligibility criteria were defined using the Population Concept Context (PCC) framework. A total of 990 English-language records were identified, and 11 studies were included after screening. Data were extracted and analysed thematically. Results Five key themes were identified: (1) excessive workload leading to emotional and physical exhaustion; (2) poor management support and communication gaps; (3) inadequate resources and infrastructure; (4) unfavourable work environments and staffing conditions; and (5) limited access to wellness and professional development programmes. These factors were consistently associated with reduced job satisfaction, increased turnover intention, and compromised patient care. Conclusion Burnout among nurses in African public hospitals is driven by interconnected organisational and systemic challenges. Addressing these factors requires a multifaceted approach, including improved staffing, stronger leadership, enhanced resource allocation, and implementation of wellness and support programmes. Contribution This review contributes to the literature by providing a comprehensive synthesis of evidence on nurse burnout in African public hospital settings, identifying key systemic drivers, and highlighting gaps to guide future research and policy development.

Background: Cancer is a rising public health concern in South Africa, with varying incidence and prevalence trends between provinces. Objectives: This study aimed to investigate the approach to estimating and ranking common cancers in South Africa’s Eastern Cape and Mpumalanga provinces through a patient survey in three referral hospitals. Methods: A quantitative cross-sectional design was employed from 1 April 2022 to 31 July 2022. A total of 425 patients were recruited to participate in this study. Patients were purposively sampled. Pretests were conducted to determine the reliability and validity of the instruments. Data were coded in Microsoft Excel and Stata; version 18 was used for data analysis. Ethical principles were observed and ensured throughout the study. Results: The results show the highest prevalence as breast cancer with 37.65% representing 160 cases, followed by cervical cancer with 19.06% (81 cases), and prostate cancer with 12.00% (51 cases). Conclusions: This study provided valuable insights into the prevalence and distribution of common cancers in the Eastern Cape and Mpumalanga provinces of South Africa based on data collected from patients across three referral hospitals.

Background/Objectives: Prostate cancer is a major public health concern and a leading cause of cancer-related morbidity and mortality among men worldwide, with disproportionately high mortality rates in sub-Saharan Africa. Late diagnosis, limited access to screening services, low health-seeking behaviour, and sociocultural barriers contribute to poor outcomes, particularly in rural settings. However, evidence on effective and context-appropriate strategies for prostate cancer prevention and early detection in African countries remains fragmented. Objective: This scoping review protocol aims to map and synthesize existing evidence on strategies implemented to reduce the burden of prostate cancer in Africa, with a focus on prevention, screening, community engagement approaches, and their acceptability. Methods: This scoping review protocol will be conducted in accordance with established methodological frameworks and reported following the PRISMA-ScR guidelines. A comprehensive search will be undertaken in PubMed (MEDLINE), EBSCOhost, ScienceDirect, CINAHL, and ProQuest. Studies conducted in African countries and published in English, French, or Portuguese will be included. Study selection and data extraction will be managed using Covidence, and findings will be summarized descriptively and thematically. Expected Results: This review is expected to identify and categorize existing prostate cancer prevention and early detection strategies implemented across African settings. Gaps in evidence, differences in implementation, and reported levels of acceptability among men are anticipated to be highlighted. Conclusions: The completed scoping review is expected to provide a comprehensive overview of prostate cancer prevention and early detection strategies implemented in Africa and to identify gaps in evidence. The evidence will inform the development of culturally responsive and context-specific interventions, with particular relevance for rural South African settings. This manuscript presents a protocol for a scoping review; no review findings are reported.