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Accounting teachers' readiness for e-learning in the Fourth Industrial Revolution: a case of selected high schools in the Eastern Cape, South Africa
No full textThis study sought to explore Accounting teachers’ readiness to implement e-learning in their classrooms during the Fourth Industrial Revolution, specifically in schools in the Eastern Cape province of South Africa. To this end, the authors employed a qualitative approach and a case study research design. Interviews and observation were used to gather data from Accounting teachers with sampling consisting of six educators being purposively and conveniently selected. The findings revealed that Accounting classrooms are not designed in a way that supports e-learning. Another finding was that Accounting teachers do not understand e-learning or the benefit associated with an e-learning classroom. The recommendation made here is that information and communication technology officials at the district level should establish educational platforms at the cluster level to service teachers, advising them on how to use helpful technologies in practice. The Department of Basic Education needs to establish relationships with local universities so that the universities’ specialists might assist teachers in implementing
e-learning in practice.Publisher's versio
Condom sterility in periprosthetic joint infection management at Universitas academic hospital in Bloemfontein 2018
No full textJoint replacement surgery, especially of the hip and knee, is one of the most rewarding operations for both the patient and the orthopaedic surgeon worldwide. Hip replacement has been dubbed the operation of the century. This is because these replacements improve the quality of life for the elderly population crippled with arthritis, and in recent years, due to better implants, also improves quality of life in the younger generation presenting with joint problems. It is, however, not without complications, the most important being periprosthetic joint infections. Other complications include aseptic loosening, periprosthetic fractures and dislocation. Periprosthetic joint infection is the most dreaded of the complications because of its difficulty to manage and association with significant morbidity and bone loss. We therefore began by describing and defining periprosthetic joint infection and investigated the current epidemiological data available. We have reviewed literature and looked at the diagnostic criteria from the different societies and meetings from around the world. Parvizi et al. developed an algorithm and proposed criteria that are based on the latest data and tests. This is explained in detail in the first chapter of this dissertation. The management of periprosthetic joint infection is dependent on the amount of time from the index joint surgery. An outline of the deferent management options are presented, while bearing in mind that two-stage revision surgery is the gold standard of management. Management of periprosthetic joint infection is associated with bone loss, either with the removal of infected implants or removal of the cement spacer in the second surgery of the twostage procedure. A recent unpublished study done locally in our department showed that putting a cement spacer in a condom and then placing the condom-cement spacer in the joint to allow it to set, and then taking out the condom-cement spacer after the cement had set, was associated with no bone loss. The study also showed that female condoms were stronger and more durable compared to the male condoms. The question that needed to be addressed, was whether it is safe to introduce condoms into the joint? Based on the literature, there is a 10% chance that condoms maybe contaminated. We investigated the sterility of condoms from the packaging and how to improve the sterility of the condoms. Sixty government-issued female condoms were used for the study, of which 30 were tested straight from the packaging and the other 30 were first put through hydrogen peroxide gas plasma sterilisation and then tested by means of MC&S. Similar to previously published studies, contamination of the condoms was confirmed, although in our study, the rate of contamination was 60%. We also isolated nonvirulent environmental and implant contaminants. The most important aspect of the results was that we were able to achieve 100% sterility of the condoms with hydrogen peroxide gas plasma. This was significant because we can place condoms for its intended use in the joints without introducing further infection in the joint. Once sterilised, condoms can also be used for other sterile/aseptic medical procedures, such as ultrasound probe covering and temperature probe covers
Modelling groundwater flow in a confined aquifer with dual layers
No full textGroundwater flow occurring in a confined aquifer has been modelled in the past using deterministic mathematical models such as the Theis (1935) equation providing fundamental solutions. However, for this model to be applicable, certain assumptions must be taken into consideration which sometimes leads to the misinterpretation of the real-life scenarios. Because of the limitations arising from this model, flow in a confined aquifer layer cannot be accurately modelled by this equation as it is too simplified. Therefore, the main aim of this study is to model flow in a confined aquifer with a dual layers using non-conventional differential operators and integral operators. Due to the complexity of the geological formation within which the flow is taking place, classical calculus operators are not suitable mathematical operators to be used. Further, research was done on appropriate mathematical operators in order to find the one to be used in this study and the application of the combination of fractal-fractional operators were adopted. Fractal-fractional derivatives are used to solve a complex physical problem and were found to be effective in modelling anomalous diffusion. In order to include into mathematical formulation some complexities of the geological formation, the concept of fractal-fractional differential and integral operators were used. These new differential operators are able to depict scenarios that combine behaviours following the power-law together with self-similarities, or fading memory with self-similarities or crossover behaviours with self-similarities that are observed when the geological formation is equipped with fractures with a self-similar feature. In this study, the Theis groundwater flow model was extended, where the classical differentiation was replaced by three different types of fractal-fractional operators. The modified models were solved numerically using the newly introduced numerical scheme. For each case, a detailed analysis of stability and convergence was presented. The obtained numerical solutions were used to depict numerical simulations showing different values of fractional order and fractal dimension. Obtained figures present a new class of flow different from the normal flow. The fractal dimension has brought new flow trends that can be observed in fractured rock aquifers. The application of these differential operators will open a new way to capture heterogeneity associated with the geological formation.Old Mutual Scholarship Foundatio
A risk assessment profile and Diet Quality Index for inadequate choline intake in pregnant women in Bloemfontein, South Africa
No full textPregnancy is a period of rapid tissue development. These metabolic processes require additional nutrients to ultimately support the normal growth and development of the foetus. A specific nutrient that is the focus of recent investigations, especially related to the functions thereof for optimal foetal development, is choline. Choline is required in higher amounts during pregnancy. Adequate choline intake contributes to a higher diet quality in general and in turn, a high-quality diet can contribute to optimal short- and long-term pregnancy outcomes. The main aim of the study was to determine choline intake and related factors and to compile a risk assessment profile and diet quality index (DQI) for inadequate choline intake in pregnant women in Bloemfontein, South Africa. In order to reach the aim of the study, the following information was collected from 682 pregnant women (median age of 31.8 years; median gestational age of 32.0 weeks) attending the high-risk antenatal clinic at Pelonomi Regional Hospital: socio-demographic and household information; reported health and lifestyle; dietary intake; pregnancy history; anthropometry and household food security. Choline intake was quantified by matching choline intake from foods included in the quantified food frequency questionnaire (QFFQ) to foods in the USDA Database for the Choline Content of Common Foods (Release 2), after which individual choline intake of each participant was calculated. Median daily choline intake was 275.0 mg (interquartile range 184.7 mg – 386.7 mg). Most participants (84.7%) consumed less than the adequate intake level of 450 mg/day for choline. Lower egg and dairy intakes were significantly associated with inadequate choline intake (p<0.0001 and p=0.0002 respectively). Out of the 247 participants who did not consume any eggs, only five (2.0%) consumed an adequate amount of choline. No participant who did not consume any dairy products managed to consume an adequate amount of choline. Regarding socio-demographic variables and household food security, more than half of participants were unmarried (56.5%) and unemployed (52.5%). Sociodemographic indicators that were univariately significantly associated with an inadequate choline intake included a higher household density ratio (p=0.0485), no access to own flush toilet at home (p=0.0059), not owning a refrigerator (p=0.0483) or microwave (p=0.0225), as well as a lower level of education (p=0.0449). One-third of participants were severely food insecure (29.9%), and although not statistically significant, choline intake decreased with higher levels of food insecurity. Logistic regression analysis showed that the odds ratio for having inadequate choline intake was 0.55 for participants who owned a microwave compared to participants who did not. Participants with primary school education versus tertiary education had a higher odds of an inadequate choline intake (odds ratio 4.09); those having a school grade 8-10 versus tertiary education had higher odds of inadequate choline intake (odds ratio 2.12); and those having a grade 11-12 versus tertiary education had higher odds of inadequate choline intake (odds ratio 1.37). Regarding reported health and lifestyle, the majority of participants were either overweight or obese (69.3%). Almost one in ten participants (9.0%) consumed alcohol and 6.2% smoked while pregnant. Hypertension (23.0%) and sexually transmitted diseases (18.5%) were among the most common current diagnoses. Univariate analysis showed that participants without hypertension and those using anti-retroviral medications (thus HIV-infected), were more likely to consume inadequate amounts of choline (p=0.0424 and p=0.0112 respectively). When an established diet quality index, the Diet Quality Index Adapted for Pregnant Women (IQDAG), was applied to the sample, the median final IQDAG score was found to be 69 out of a maximum of 100 points (interquartile range of 63 – 74 points) (N = 680). Almost all participants (94.9%) in the first tertile of IQDAG score consumed below adequate levels (AI) of choline, compared to 78.3% of participants in the second tertile and 80.2% of participants in the third tertile. Differences in the choline intake between the tertiles of final IQDAG scores were significant (P<0.0001). In order to compile the risk assessment profile for inadequate choline intake, logistic regression with backward selection (p < 0.05) was used to select significant independent factors associated with choline intake from those identified in theme-specific logistic regressions. In this sample the odds ratio of inadequate choline intake was 43.61 for participants with no egg intake compared to participants who consumed ≥ 5 eggs per week. The odds ratio for having inadequate choline intake was 2.73 for participants with a daily dairy intake of < 250 g compared to participants who consumed ≥ 250 g. The odds of consuming an inadequate choline intake were lower for participants that were not using ART compared to those using antiretroviral therapy (ART) (thus HIV-infected) with an odds ratio of 0.51. The odds ratio of consuming inadequate choline was 3.38 for participants with the lowest tertile diet quality scores compared to participants with the highest tertile diet quality scores. In order to develop a DQI for use in pregnancy among South African women, a systematic review of the literature was performed to identify currently available DQIs used in pregnancy. The methodology of development and use of components were summarised to provide an overview of identified DQIs. The review identified nine DQIs, of which none were developed using dietary guidelines or data from African countries. Additionally, none of the DQIs specifically included choline or foods that are very high in choline (e.g., eggs and liver) as components. Using the South African Food Based Dietary Guidelines, the Guidelines for Maternity Care in South Africa and other international dietary guidelines and recommendations, the South African Diet Quality Index for Pregnant Women in South Africa (SA-DQI-P) was developed. Egg and dairy intake were incorporated as separate components; thus this tool can be used as an estimate of diet quality, while simultaneously providing an indication of choline intake in pregnant South African women
The architecture of preserving memories: 'an odyssey of spice'
No full textThe Bo-Kaap has been a hub for cultural celebration for the people of the Cape Malay community over time. The urban fabric of the Bo-Kaap has become an exhibition for outsiders to view the insiders as objects living within a functionalist paradigm. This area has become more and more of a social ''exuberant experience for tourists to have an experiential journey denoted to the daily lives of the insiders. With the notion of globalization, the Bo-Kaap runs the risk of becoming a stagnant community within an ever-growing society and world. Extracting the outsiders into a common experiential node to subsequently preserve the memories and rituals of the insiders through architectural intervention will be the ultimate goal of this dissertation. This dissertation will explore the notion of preserving elements of a cultural experience by pursuing a structuralist paradigm in architectural poiesis. The project questions how architecture could surpass the stagnation of an area, through public intervention, and instil innovative incremental growth to expand cultural hardware, for years to come. Consequently, aligning the incremental development of the Bo-Kaap with an evolving world's constructs; the preservation of the urban fragment's history will be impending. Proposing a Bo-Kaap Cultural Centre, in the form of a spice market, will provide a platform for outsiders to experience culture in a vacuum, insiders to have a shrine of reminiscence and an intervention exploring the possibility of structuralist living. Furthermore, this would ensue the preservation of the community in terms of tourism and history by becoming an existential foothold of Cape Malay living. The investigation will relate culture and history to the built environment and eventually discover ways of harmoniously merging history with the inevitable growth of society, in whichever capacity it may be presented on the forefront. Ultimately, exploring new theoretical paradigms for urban living; a pre-emptive paradigm becomes a necessity to support the incremental development of urbanism with creativity and innovation - 'a new approach in sustainable evolution that forbears cultural and creative stagnation ...
The distribution of Babesia bigemina and Babesia bovis transmitted by Rhipicephalus spp. on a farm in the Eastern Cape
No full textRhipicephalus (Boophilus) microplus, the Asiatic blue tick, was introduced from Madagascar to South Africa during 1896, after a rinderpest epidemic. Displacement of Rhipicephalus (Boophilus) decoloratus, the African blue tick, by R. (B.) microplus has been reported in the Eastern Cape and Limpopo provinces. These two tick species are known vectors for protozoan bovine blood parasites. With the introduction of R. (B.) microplus, Babesia bovis, one of these parasites, was also introduced into South Africa. Babesia bovis is more virulent than B. bigemina, the native species. Control of the disease, babesiosis, caused by these blood parasites, is mainly accomplished by control of the tick vector with chemicals. This however is becoming less effective due to emerging resistance of both tick species to these chemicals. Methods for detecting B. bigemina and B. bovis are therefore becoming all the more important to be able to detect outbreaks early, as well to determine new areas where both the vectors and blood parasites are present. The aim of this study was to confirm the presence of both vector species, R. (B.) decoloratus and R. (B.) microplus, on an Eastern Cape farm after reports of possible B. bovis infections. Larvae, collected by field drags, and adult ticks, collected from cattle, were identified morphologically by using a dissection microscopes. The presence of the protozoan parasites B. bigemina and B. bovis in the blood of cattle hosts was further investigated through Giemsa-stained blood smears from blood samples, collected from 10% of the cattle on the farm. DNA extractions and PCR were performed on the progeny of adult ticks and blood collected from cattle hosts, to scan for Babesia infections. Morphological identification of larval and adult ticks indicated that both R. (B.) decoloratus and R. (B.) microplus were present on the test farm. Over the study period, R. (B.) microplus was found in all camps investigated but R. (B.) decoloratus was present in significantly higher numbers than R. (B.) microplus with 97% (P = 0.0000402) of the larvae and 98% (P = 0.000041) of the adults collected, identified as R. (B.) decoloratus. Displacement of R. (B.) decoloratus by R. (B.) microplus thus did not take place since the first discovery of R. (B.) microplus on the farm during 2014. By means of Polymerase chain reactions the presence of B. bigemina was found in two adult ticks and B. bovis in one. The blood smears yielded one positive B. bovis identification in the blood of one host animal that was confirmed with PCR. DNA extracted and PCR performed on a second blood sample showed one animal host with a double infection of both B. bigemina and B. bovis. The presence of both parasite species, although at a low frequency of 1.85% for B. bovis and 1.08% for B. bigemina, was also confirmed for this farm. It was however only identified from three camps of the 11 camps tested. This study confirmed the prevalence of both of the tick vector species well as the pathogens they transmit on this commercial farm. The presence of R. (B.) microplus and B. bovis, currently still present in low numbers, should be monitored for potential further distribution of this parasite to prevent unexpected outbreaks of babesiosis and the financial implication it can cause
Extraction, characterisation and application of betalains from cactus pear, beetroot and amaranth
No full textAccording to Europe, Middle East, and Africa (EMEA) Mintel Food and Drink Trends
in 2018, consumers require explicit disclosure on food and drink labels. The
requirements go hand in hand with the preference for nutritionally-dense foods that
are pleasing to the eye and prepared under safe conditions (Gengatharan et al., 2015;
Martins et al., 2016). The preference for explicit disclosure includes information on
how, as well as where, products are grown and produced, and could result in
interactive, reliable relationships between customers and the food industry.
The food industry is, therefore, presented with an opportunity to conduct research on
various colourants that are available in the market, the countries that consume them,
their healthful and detrimental effects, as well as which ones can be used in the food
industry going forward. This chapter gives an understanding of consumer perceptions,
some of the different colourants that exist, their characterisation, as well as application
in foods. It further shows the need for the industry to shift to natural colourants by
drawing particular attention to the benefits of natural plant pigments, primarily
betalains.Agricultural Research Council (ARC
A model of transformational leadership and organisational performance in state-owned enterprises in Zimbabwe
No full textA lack of leadership skills was cited as one of the reasons for poor performance in
Zimbabwe’s state-owned enterprises (SOEs). In response to the highlighted
leadership skills gap and poor performance in the state-owned enterprises, the present
study sought to address this by developing a transformational leadership and
organisational performance model. In pursuit of this aim, specific objectives set at the
onset are: to develop a conceptual leadership and an organisational performance
model for state-owned enterprises in Zimbabwe, to theoretically explain the
relationships between variables in the proposed transformational leadership and
organisational performance model using previous literature, and to determine the
predictive validity of the proposed transformational leadership and organisational
performance model in State-Owned Enterprises in Zimbabwe.
A quantitative research approach was selected, with predictive research design being
adopted. The study made use of four standard questionnaires, namely the Multifactor
Leadership Questionnaire-5X (MLQ-5X) to assess transformational leadership, the
Influence Behaviour Questionnaire (IBQ-G) to assess proactive influence tactics; the
Leader-Member-Exchange Questionnaire (LMX-7) to assess the quality of leader
follower relationships; and finally the Competing Values Questionnaire (CVQ) to
assess organisational performance. The data was collected from managerial and nonmanagerial staff members representing 12 State Owned Enterprises (SOEs), as well
as government officials from line Ministries in Zimbabwe using these questionnaires.
A total of 302 respondents participated in the study, representing a 78% response
rate. All four instruments used in the study demonstrated good reliability and validity.
In the analysis of the data, descriptive statistics and inferential statistics are provided
from SPSS and SmartPLS. The analysis was in the form of correlations, stepwise
multiple regression and structural equation modelling. An observation from the findings
is that only two of the independent variables are direct significant predictors of
organisational performance; these are transformational leadership and soft proactive
influence tactics. Transformational leadership explained 40% of the variance in
organisational performance, while soft proactive influence tactics contributed 3.5% of
organisational performance.
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Meanwhile, the relationship between transformational leadership and organisational
performance proved to be a complex one, beyond the direct relationship. In this
regard, transformational leadership demonstrated that it could influence organisational
performance through soft proactive influence tactics and the quality of leader follower
relationships. Overall, the combined independent variables in the theoretical model
explained 47% of the variance in organisational performance, a variance above that
of individual independent variables on organisational performance. As anticipated, the
findings of the study mostly concurred with previous studies, except for the path
transformational leadership → quality of leader follower relationships that was
statistically non-significant. Since the relationship between transformational leaders
and the quality of leader follower relationships was not significant, it might be argued
that soft proactive influence tactics probably mediated this relationship. In other words,
a transformational leader could not directly influence the quality of leader follower
relationships, but only through soft proactive influence tactics. Factoring good
reliability and validity of instruments into the study, the statistically significant paths
between independent variables and organisational performance, and the resultant
contribution of 47% in organisational performance demonstrated the predictive validity
of the theoretical model.
These findings imply that theories of transformational leadership, proactive influence
tactics, and the quality of leader follower relationships can be integrated to positively
and significantly influence organisational performance in SOEs in Zimbabwe. This
could be explained by the theoretical links between the variables in the model. In
explaining the direct relationships, transformational leadership encourages followers
and motivates and inspires followers to pursue higher goals, and this helps followers
to improve organisational performance. Soft influence tactics, for example, rational
persuasion, use reason to encourage follower commitment and persuade followers to
carry out tasks. Likewise, inspirational appeals increase follower confidence in
carrying out a task, thereby increasing organisational performance. This is attributable
to the fact that the inspirational appeals ignite enthusiasm in followers by appealing to
values and ideals. In summary, the theoretical explanations supported the direct
relationship between transformational leadership and organisational performance, as
well as the relationship between proactive influence tactics and organisational
performance.
Page vi
Regarding the more complex and indirect relationships; transformational leadership
was also linked to soft proactive influence tactics (sPITS), for instance, inspirational
appeals that include the leader’s requests based on follower values and ideals. These
requests ignite an emotional response from the followers and create follower
enthusiasm to carry out tasks or requests. Meanwhile, transformational leader’s
inspirational motivation is where the leader motivates and inspires followers to reach
towards a common vision and uses emotional persuasion to gain followers’
acceptance and commitment to the organisational goals. Thus, inspirational appeals
resemble transformational leadership’s inspirational motivation, which explains the
predictive relationship between transformational leadership and soft proactive
influence tactics.
The link between soft influence tactics and the quality of leader follower relationships
is explained by considering that with consultation influence tactics, followers
participate in tasks and provide ideas while the leader listens. Such a process helps
in building mutual trust, improving follower commitment, and developing good quality
relationships between the leader and followers. This forms part of the explanation for
the predictive relationship between soft proactive influence tactics and the quality of
leader follower relationships. Furthermore, in high-quality leader follower relationships,
the leaders support followers, provide necessary resources and improve
communication with followers. Consequently, followers experience job satisfaction,
feel empowered, and reciprocate by working hard to achieve set goals and improve
organisational performance. The linkages illustrated above demonstrate how
transformational leadership can influence organisational performance through
proactive influence tactics and the quality of leader follower relationships.
Theoretically, the study added value by providing a new comprehensive framework
beyond dual relationships that exist between variables. Moreover, the present study
has empirical value as it provides critical evidence from the public sector in a
developing South Saharan country. Meanwhile, the practical value includes potential
utilisation of the present model to influence organisational performance in state-owned
enterprises in Zimbabwe positively.
Some of the noted limitations relate to the study being a cross-sectional one. In the
future, longitudinal studies would also help to assess if transformational leaders
Page vii
consistently use sPITS on followers over time. To add on to the limitations, the present
study focused on the public sector only. Future studies could also look at other
organisational settings.
The recommendations focus on the expansion of the present model to include other
variables such as innovation and how this influences organisational performance. In
addition, future research could include studies in other organisations beyond the public
sector such as the private sector and not for profit organisations; the adoption of the
theoretical model for use in state-owned enterprises; designing training programmes
for employees to develop transformational leadership behaviour, identifying
programmes on how to use soft influence tactics and how to build high quality leader
follower relationships; and the application of the Competing Values Framework (CVF)
as a uniform performance measure in state-owned enterprises
The place of socio-economic rights in sovereign debt governance
No full textRecurring sovereign debt crises across the world have consistently pushed indebted countries into ‘obligatory dilemmas’, increasingly putting the socio-economic rights of debtors’ citizens in jeopardy and creating a doctrinal tension between debtors’ contractual and treaty obligations. Even the minimum core obligations of state parties to the International Covenant on Economic, Social and Cultural Rights have been losing their functional significance as a result of the recurring circles of debt crises. Therefore, using doctrinal methodology, this research interrogates the extent to which contractual obligations may be honoured where socio-economic rights of debtor’s citizens face clear danger of non-realisation. Unlike previous studies on the subject, this research examines the place of socio-economic rights in all the critical phases of sovereign debt governance using reflexivity of global law as conceived by contemporary transnational legal theorists. It argues that the recurring circles of debt crises are linked to the continuing influence of the dominant private law paradigm in sovereign debt governance. This, the research further argues, could be seen in, first, the creditors’ persistent resistance to a statutory framework on restructuring sovereign debt, the rising trend of creditor litigations, the strengthening of the contractual framework by the creditor-controlled law creating and enforcing institutions, the doctrinal wedge between the public and the private realms and state-centrism under which private entities are largely seen as incapable of bearing socio-economic rights obligations. Second, the creeping effects of the investment treaty regime into the sovereign debt regime demonstrates the penetrating influence of creditordiktat in sovereign debt governance. The research further argues that socio-economic rights can qualify as ‘essential interest’ to ground debt moratorium under customary international law, treaty law and evolving soft laws on sovereign debt. After reviewing relevant cases, the research observes the growing relevance of socio-economic rights jurisprudence in sovereign debt adjudication. It makes a case for the prioritisation of socio-economic rights considerations in debt contracting, restructuring and adjudication through a more concrete recognition of creditors’ socio-economic rights responsibilities. This can be done by recognising the sovereign debt regime as a form of global law which de-emphasises the public-private dichotomy. The research suggests, among others, some statutory reforms to concretely embrace socio-economic rights considerations in contracting and restructuring of sovereign debt and in adjudication of sovereign debt claims by way of a specific treaty, or by taking advantage of both the evolving business and human rights treaty-making process and the incremental soft law development process. In this regard, it suggests a specific recognition of creditors’ standstill obligation to respect socio-economic rights of debtors’ citizens during debt crisis
Exploring registered nurses' compliance to standards for medical male circumcision
No full textMedical Male Circumcision (MMC) is recommended as a Human Immune Virus (HIV) prevention strategy in countries with high HIV prevalence and low MMC prevalence. Lesotho, as the country with the second-highest HIV infection globally, is implementing this strategy. Although MMC services have been accessible to the intended recipients, there is a challenge of poor compliance with WHO standards by Registered Nurses that are providing MMC services in Lesotho. These have been noted during regular quality assessments conducted at MMC sites in Lesotho by supervisors and researcher. The focus group participants had to answer the following research question: What factors can influence the RNs' compliance with quality standards at the MMC sites in Lesotho? The purpose of the study is to explore and describe the factors that influence Registered Nurses' compliance with MMC standards. A qualitative, exploratory, descriptive, and phenomenology research design was used. A purposive sample was utilized. The target population for this study was all the RNs offering MMC services in the five lowlands districts of Lesotho. Explorative interviews were conducted before the main study to determine the questions and pre-empt the problems that might arise in the main study. For the main study, focus group interviews were conducted with 19 registered nurses. The data were analyzed using ATLAS. ti Windows 8 User Manual. The ethical standards regarding the principles of respect for persons, beneficence and justice were adhered throughout the study. The research revealed three key themes: (1) knowledge of quality standards, (2) barriers to compliance, and (3) perceived enabling working environment. This research highlights that system barriers such as poor infrastructure, insufficient staffing, and inadequate supplies make it difficult for RNs to comply with standards. Furthermore, fatigue and burnout were prevalent among MMC providers due to workload. MMC providers have also stated that carelessness in their work brought on by overconfidence in one's skills often led to poor compliance with quality standards. This research's main conclusions show that high workloads and limited resources contribute to poor compliance with quality standards. The studies revealed that a well-established quality improvement framework increases accountability and prevents the risk of intentional errors. It also enhances systems that reduce the recurrence of similar mistakes. Furthermore, the study and literature findings demonstrate that it is possible to address the quality of MMC using a Continuous Quality Improvement (CQI) approach, supportive supervision, and feedback. Key recommendations are as follows: managers should establish programs for continuous professional development and evaluate their clinical practice impact. Performance-based incentives should be linked to appraisals for better quality services, and the strengthening of accountability is recommended. Healthcare institutions should establish and sustain human resources that will meet the population's needs to provide quality services. Managers must be held accountable for the provision of quality health care. Registered nurses should take an active role in quality improvement activities in a healthcare setting and align nursing practice with professional values.University of Free State (UFS