African Journal of Primary Health Care & Family Medicine最新文献

{"title":"Awareness, service use and barriers to sexual and reproductive health among adolescents in the Arsi Zone, Oromia, Ethiopia.","authors":"Derese T Demissie, Rose Mmusi-Phetoe","doi":"10.4102/phcfm.v18i1.5500","DOIUrl":"10.4102/phcfm.v18i1.5500","url":null,"abstract":"<p><strong>Background: </strong> Sexual and reproductive health (SRH) services are crucial for adolescents, yet utilisation remains low in the Arsi Zone of Ethiopia. Identifying the factors affecting adolescents' use of SRH services is important to address the problem.</p><p><strong>Aim: </strong> To explore and describe adolescents' awareness and barriers to SRH services in Arsi Zone, Ethiopia, and improve SRH service use, ultimately reducing preventable SRH-related illness and death among adolescents.</p><p><strong>Setting: </strong> The study was conducted at six districts of Arsi Zone, Oromia, Ethiopia.</p><p><strong>Methods: </strong> A school-based cross-sectional study was conducted among 651 randomly selected adolescents aged 15-19 years in Arsi Zone of Ethiopia, from 01 January 2024 to 29 February 2024. Data were collected using a self-administered structured questionnaire. A multivariable logistic regression model was employed to analyse the data. Measures of association were expressed as adjusted odds ratios (AORs) with corresponding 95% confidence intervals (CIs).</p><p><strong>Results: </strong> This study revealed that being involved in SRH discussions with trusted individuals was significantly associated with SRH utilisation, with better odds (AOR = 2.12; 95% CI: 1.22-3.67). Absence of fear when seeking care was significantly associated with higher utilisation of SRH services (AOR = 2.07; 95% CI: 1.12-3.83). The presence of an SRH problem, such as a sexually transmitted infection (STI), was strongly associated with SRH service utilisation (AOR = 4.88; 95% CI: 2.26-10.54). In addition, the perceived convenience of service operating hours was significantly associated with higher SRH service utilisation (AOR = 3.19; 95% CI: 1.57-6.52).</p><p><strong>Conclusion: </strong> The findings highlight a significant gap between awareness and use of SRH services among adolescents. This emphasises the need for targeted interventions to improve awareness and access to SRH services for adolescents.Contribution: The study provides empirical evidence on Ethiopian adolescents' SRH, addressing gaps in service access, structural and sociocultural barriers, and service use. Its findings offer actionable insights for designing, implementing and evaluating adolescent SRH policies and programmes and contribute to the academic literature.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 1","pages":"e1-e8"},"PeriodicalIF":1.7,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is primary care the 'right care' for respiratory medicine in Africa?","authors":"Robert J Mash","doi":"10.4102/phcfm.v18i1.5659","DOIUrl":"10.4102/phcfm.v18i1.5659","url":null,"abstract":"<p><p></p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 1","pages":"e1-e3"},"PeriodicalIF":1.7,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543219/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the effectiveness of the patient referral system in remote Zambia: A case study of Mbala District.","authors":"Austine Dolopo","doi":"10.4102/phcfm.v18i1.5237","DOIUrl":"10.4102/phcfm.v18i1.5237","url":null,"abstract":"<p><strong>Background: </strong> Effective patient referral systems are vital for ensuring timely access to advanced healthcare services, particularly in remote areas. In Zambia's rural districts such as Mbala, the referral system faces critical challenges, including poor road networks, limited ambulance services, unreliable communication infrastructure and a lack of medical personnel at lower-level facilities. These issues contribute to delays, preventable complications, and increased patient morbidity and mortality.</p><p><strong>Aim: </strong> This study aims to assess the effectiveness of the patient referral system in Mbala District by examining logistical, infrastructural and human resource constraints that hinder timely and appropriate patient transfers from rural health facilities to higher-level care.</p><p><strong>Setting: </strong> The study was conducted in Mbala District, a predominantly rural district in Zambia's Northern province, where geographical barriers, limited health infrastructure, and resource constraints present significant challenges to the effectiveness of the patient referral system.</p><p><strong>Methods: </strong> This study employed a descriptive cross-sectional design. Data were collected over 2 weeks using questionnaires from 18 health facility in-charges and community interviews, then analysed using Jeffreys's Amazing Statistics Program (JASP) version 0.19.3 to evaluate referral accessibility, timeliness and effectiveness.</p><p><strong>Results: </strong> Statistical analyses show that communication reliability is the strongest predictor of referral success and satisfaction (β = 0.63, p = 0.002), also reducing delays by 1.89 h (β = -1.89, p = 0.007). Distance negatively affects referrals (r = -0.52), with over 70% of facilities beyond 25 km. Grid-powered facilities face 16-h daily power outages. A chi-square test found no significant link between community awareness and satisfaction (χ2 = 1.68, p = 0.1951).</p><p><strong>Conclusion: </strong> The referral system in Mbala District is significantly constrained by logistical and structural barriers. Targeted interventions, including improved transport logistics, communication infrastructure and staff training, are necessary to enhance patient outcomes in rural settings.Contribution: This study contributes empirical evidence on referral barriers in rural Zambia, highlighting communication, transport, distance, infrastructure and staffing as critical determinants of timely and effective patient referrals.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 1","pages":"e1-e6"},"PeriodicalIF":1.7,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543218/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875789","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiometabolic risk profile and associated factors among adults with type 2 diabetes in a primary health care clinics in North Central Nigeria.","authors":"Innocent N Okonkwo, Maryanna Idoh, Ezra O Agbo, Edwin N Okafor","doi":"10.4102/phcfm.v18i1.5461","DOIUrl":"10.4102/phcfm.v18i1.5461","url":null,"abstract":"<p><strong>Background: </strong> Cardiometabolic abnormalities substantially increase morbidity among individuals with type 2 diabetes mellitus (T2DM), particularly in primary health care (PHC) settings. In Nigeria, evidence on comprehensive metabolic risk profiling beyond glycaemic control remains limited.</p><p><strong>Aim: </strong> To determine the cardiometabolic risk profile and identify factors associated with adverse cardiometabolic outcomes among adults with T2DM.</p><p><strong>Setting: </strong>The study took place at government-owned PHC facilities in Makurdi, Benue State, Nigeria.</p><p><strong>Methods: </strong> This facility-based analytical cross-sectional study systematically recruited 120 eligible adults aged ≥ 30 years with T2DM. Socio-demographic and clinical data were obtained using structured questionnaires and medical records. Laboratory analyses assessed glycaemic status, lipid profile and renal function. Renal impairment was determined using estimated glomerular filtration rate (eGFR) based on standard clinical thresholds. Cardiometabolic abnormality was defined as the presence of at least one abnormal component: poor glycaemic control, dyslipidaemia or renal impairment. Data were analysed using descriptive statistics and logistic regression.</p><p><strong>Results: </strong> The mean age was 56 ± 10.8 years, with females comprising 61.7%. The mean diabetes duration was 4 ± 3.2 years. Overall, 84.8% had at least one cardiometabolic abnormality. Poor glycaemic control, dyslipidaemia and renal impairment occurred in 65.8%, 65.0% and 29.2%, respectively. The mean cardiometabolic risk score was 1.87 ± 1.05. Longer diabetes duration independently predicted poor glycaemic control (p  0.05).</p><p><strong>Conclusion: </strong> Adults with T2DM attending PHC clinic had a high burden of cardiometabolic abnormalities, highlighting the need for integrated diabetes management strategies.Contribution: The study provides context-specific evidence to support routine lipid and renal function assessment in resource-limited settings.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 1","pages":"e1-e8"},"PeriodicalIF":1.7,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating ChatGPT to support children and adolescents with diabetes mellitus in South African healthcare: Perspectives of healthcare professionals and academics.","authors":"Kabelo G Chuma, Philangani T Sibiya","doi":"10.4102/phcfm.v18i1.5433","DOIUrl":"10.4102/phcfm.v18i1.5433","url":null,"abstract":"<p><strong>Background: </strong> The increasing prevalence of diabetes mellitus among children and adolescents in South Africa presents a major public health challenge, compounded by limited resources, inadequate infrastructure and poor disease management. Given these challenges, innovative solutions such as ChatGPT are essential to offer immediate, personalised education and social support to children and adolescents with diabetes.</p><p><strong>Aim: </strong> The study explored the integration of ChatGPT to support children and adolescents with diabetes in South African healthcare.</p><p><strong>Setting: </strong> This study was conducted with experts working in various organisations and institutions across Gauteng province of South Africa.</p><p><strong>Methods: </strong> A qualitative research design was used, with semi-structured interviews conducted with paediatric endocrinologists, diabetologists, diabetes educators and senior academics through purposive and snowball sampling. Data were analysed using thematic analysis and ATLAS.ti version 23.</p><p><strong>Results: </strong> The findings of the study revealed four key themes: perceptions of ChatGPT (both positive and negative); ethical concerns related to data security, reliability and technology overreliance; factors influencing acceptance, including usability, trust and accuracy; and obstacles to integration, such as technological, social and financial barriers.</p><p><strong>Conclusion: </strong> The study underscores the critical need for policy and regulatory frameworks, infrastructure development and government support in facilitating ChatGPT integration in South African healthcare to improve diabetes care.Contribution: This study contributes to the broader discourse on digital health innovations and their role in enhancing chronic disease management among vulnerable populations in South Africa.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 1","pages":"e1-e11"},"PeriodicalIF":1.7,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delivering diabetes care in underserved communities in South Africa: Insights from the 2025 Diabetes Summit Workshop.","authors":"Khutso G Phalane, Wyvine A Bapolisi, Nelisiwe Mkize, Rivoningo Gonani, Kibachio J Mwangi, Melanie Pienaar, Patrick Ngassa Piotie","doi":"10.4102/phcfm.v18i2.5579","DOIUrl":"10.4102/phcfm.v18i2.5579","url":null,"abstract":"","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 2","pages":"e1-e3"},"PeriodicalIF":1.7,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543278/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distributed leadership as an enabler of community participation in primary health care in Malawi.","authors":"Tony M Majo, Martha K Makwero","doi":"10.4102/phcfm.v18i1.5400","DOIUrl":"10.4102/phcfm.v18i1.5400","url":null,"abstract":"<p><p>Community participation is a foundational principle of primary health care (PHC), yet its meaningful implementation remains limited in many low- and middle-income countries (LMICs), including Malawi. Although formal community governance structures such as Health Advisory Committees (HACs), Village Development Committees (VDCs) and Area Development Committees (ADCs) are recognised in policy, their influence on facility-level decision-making is often constrained by hierarchical leadership arrangements, weak coordination and persistent power asymmetries between health professionals and community representatives. This article examines community participation in Malawi's PHC system through a distributed leadership (DL) lens and explores how leadership practices can be strengthened to enhance facility-community governance. A narrative review and policy analysis were conducted using National Health Policy documents and relevant literature on PHC governance, community participation and DL in Malawi. Community structures play an important role in representing community interests and monitoring service delivery but largely function in advisory capacities. Leadership authority remains concentrated at facility and district levels, limiting shared ownership. Coordination among health workers, community committees and local government structures is weak, resulting in fragmented leadership and limited accountability for service improvement. The article argues that challenges in community participation are fundamentally leadership challenges. Distributed leadership provides a practical framework for strengthening PHC by promoting shared responsibility, collaboration and accountability across community and facility levels.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 1","pages":"e1-e4"},"PeriodicalIF":1.7,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543226/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875906","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reframing diabetes mellitus care in South Africa through lived experience, peer support and advocacy: Lessons from the 2025 Diabetes Summit.","authors":"Melanie A Pienaar, Alexandra Van Essche, Sandhya Singh, Patrick Ngassa Piotie, Kibachio J Mwangi","doi":"10.4102/phcfm.v18i2.5578","DOIUrl":"10.4102/phcfm.v18i2.5578","url":null,"abstract":"<p><p>No abstract available.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 2","pages":"e1-e4"},"PeriodicalIF":1.7,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dietary patterns and associated cardiometabolic risk factors among teachers in Makhado Municipality, South Africa.","authors":"Zelda L Ratshilivha, Takalani C Muluvhu, Suzanne Jacobs, Tjale C Mahopo","doi":"10.4102/phcfm.v18i1.5292","DOIUrl":"10.4102/phcfm.v18i1.5292","url":null,"abstract":"<p><strong>Background: </strong> Cardiometabolic diseases such as obesity, hypertension, dyslipidaemia and type 2 diabetes are major contributors to morbidity and mortality. Diet is a modifiable risk factor, yet limited evidence exists on its influence on cardiometabolic outcomes among South African teachers.</p><p><strong>Aim: </strong> To identify dietary patterns and examine their associations with cardiometabolic risk factors among teachers in Makhado Municipality, Limpopo province.</p><p><strong>Setting: </strong> Rural public schools within Makhado Municipality, Limpopo province, South Africa.</p><p><strong>Methods: </strong> A cross-sectional study was conducted among 201 teachers selected using stratified random sampling. Data included demographic information, blood pressure, fasting glucose (FG), lipid profiles and anthropometry. Dietary intake was assessed using a validated food-frequency questionnaire that reflected habitual intake. Exploratory factor analysis identified dietary patterns. Associations were analysed using nonparametric tests in STATA version 17 (p  0.05).</p><p><strong>Results: </strong> Six dietary patterns emerged: mixed, Western, meat-free, Mediterranean fish-free, animal starch product and low-carbohydrates and Mediterranean. The mixed pattern was associated with systolic blood pressure (p = 0.03). The Western pattern was associated with total cholesterol (p = 0.04) and low-density lipoprotein cholesterol (p = 0.02). Meat-free and Mediterranean fish-free patterns were associated with high-density lipoprotein cholesterol (p = 0.03), while the animal protein fruit pattern was associated with FG (p = 0.02).</p><p><strong>Conclusion: </strong> Distinct dietary patterns were associated with cardiometabolic risk among teachers, highlighting the need for culturally appropriate dietary interventions.Contribution: This study provides context-specific evidence that may inform the development of culturally appropriate nutrition interventions, workplace wellness programmes, and primary health care policies aimed at improving cardiometabolic health and reducing the burden of non-communicable diseases among teachers.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 1","pages":"e1-e8"},"PeriodicalIF":1.7,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543258/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Cost, man. Good quality stuff can get pricey', men's choices regarding HIV services in South Africa.","authors":"Patience Manjengwa, Clarence Yah, Alfred Musekiwa","doi":"10.4102/phcfm.v18i1.5334","DOIUrl":"10.4102/phcfm.v18i1.5334","url":null,"abstract":"<p><strong>Background: </strong> Despite global declines in human immunodeficiency virus (HIV) infections, South African men remain disproportionately affected. Understanding men's HIV service preferences is essential for designing effective interventions.</p><p><strong>Aim: </strong> This qualitative study identified key attributes influencing men's preferences for HIV testing, prevention and treatment services in Gauteng province, South Africa.</p><p><strong>Setting: </strong> Data were collected through focus group discussions and in-depth interviews between November 2023 and March 2024 across sites in Randburg, Soweto, Orange Farm and Pretoria.</p><p><strong>Methods: </strong> A qualitative exploratory design employed focus group discussions with men aged 20-64 years and key informant interviews with HIV programme stakeholders. Stratified purposive sampling ensured demographic diversity. Recordings were transcribed verbatim and independently dual-coded. Framework analysis following Ritchie and Spencer's five-step approach systematically identified themes, which were refined into discrete attributes.</p><p><strong>Results: </strong> Thirty-two focus group participants and 19 interview participants (median age 35 years [interquartile range [IQR] = 28-43], all Black African men, 82% secondary-educated) identified 10 priority HIV service attributes: accessibility, quality of care, cost-efficiency, comprehensive service packages, privacy and confidentiality, cultural sensitivity, technological solutions, community engagement, health awareness and stigma mitigation. Participants emphasised geographic proximity, welcoming nonjudgemental environments, affordability and privacy as critical in service utilisation.</p><p><strong>Conclusion: </strong> Findings emphasise the importance of comprehensive, private, affordable care delivered through welcoming environments with digital health awareness integration.Contribution: Validated attributes will inform a discrete choice experiment to quantify preference structures and guide the development of evidence-based, male HIV service delivery models in South Africa.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 1","pages":"e1-e7"},"PeriodicalIF":1.7,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}