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

{"title":"Maternal health literacy and its associated factors among pregnant women in Western Cape antenatal clinics.","authors":"Thabani M Noncungu, Talitha Crowley, Jennifer A N Chipps","doi":"10.4102/phcfm.v18i1.5436","DOIUrl":"10.4102/phcfm.v18i1.5436","url":null,"abstract":"<p><strong>Background: </strong> Maternal health literacy influences how pregnant women access, understand and use healthcare services for themselves and their children. Limited maternal health literacy is associated with poor maternal and foetal outcomes.</p><p><strong>Aim: </strong> To assess maternal health literacy and its associated factors among pregnant women attending antenatal clinics in the Western Cape.</p><p><strong>Setting: </strong> The study was conducted in antenatal clinics of the Western Cape.</p><p><strong>Methods: </strong> A cross-sectional survey was conducted among 248 pregnant women using the Maternal Health Literacy Inventory in Pregnancy (MHELIP), together with measures of socio-demographics, depression and functional health literacy (reading and understanding). Data were analysed using the Statistical Package for Social Sciences (SPSS) version 29. Descriptive statistics summarised participant characteristics and maternal health literacy domains, while non-parametric tests and logistic regression identified predictors of maternal health literacy.</p><p><strong>Results: </strong> Participants had a mean age of 27.4 years (± 7.53; range: 18-45), and 60.5% (n = 150) reported more than two pregnancies. Most respondents (80.0%, n = 196) had limited maternal health literacy, with a mean MHELIP score of 57.8 out of 100 (standard deviation [s.d.]: 10.8; range: 21-87). Adequate maternal health literacy was significantly associated with higher reading, understanding, and decision-making scores, while women with no risk of depression scored higher in assessing maternal health information (p  0.05). Reading and understanding significantly predicted maternal health literacy (odds ratio [OR]: 1.20), explaining 10.0% of the variance.</p><p><strong>Conclusion: </strong> Most pregnant women had limited maternal health literacy, underscoring the need for tailored antenatal education.Contribution: The findings inform the development of maternal health literacy programmes to support informed decision-making among pregnant women 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":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876059","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":"Environmental prescribing for asthma and chronic obstructive pulmonary disease.","authors":"Robert Mash, Helen Twohig","doi":"10.4102/phcfm.v18i1.5510","DOIUrl":"10.4102/phcfm.v18i1.5510","url":null,"abstract":"<p><p>No asbtract available.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 1","pages":"e1-e5"},"PeriodicalIF":1.7,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875849","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":"Experiences of medical interns of emotionally charged workplace encounters: A qualitative exploration of their rural rotation.","authors":"Madeleine Muller, Oladele V Adeniyi, Susan Van Schalkwyk","doi":"10.4102/phcfm.v18i1.5435","DOIUrl":"10.4102/phcfm.v18i1.5435","url":null,"abstract":"<p><strong>Background: </strong>Junior doctors experience high-pressure emotional interactions, often with limited support during their rural hospital rotation. Little is known about the effect of such encounters on the emotions and behaviour of clinicians.</p><p><strong>Aim: </strong> This study explores the experiences of interns during emotionally charged encounters in the workplace with clinical supervisors, colleagues and patients.</p><p><strong>Setting: </strong> The study was conducted in a one regional and three rural district hospitals.</p><p><strong>Methods: </strong> A qualitative exploratory study was conducted using semi-structured interviews with 12 interns undergoing training in the Eastern Cape, South Africa, between May 2024 and August 2024. A purposive sample of second-year medical interns who had completed a 2-month rotation in a rural district hospital setting was interviewed. Data were coded and subsequently analysed thematically.</p><p><strong>Results: </strong> Three themes emerged: 'being a doctor in an emotionally charged clinical environment', 'the emotionally competent doctor' and 'the emotional support needs of junior doctors'. Emotionally charged clinical encounters elicited strong, distressing emotions in interns, including anxiety, frustration, and feelings of helplessness, which affected their well-being, service delivery, and clinical performance. Unregulated emotions resulted in counterproductive behaviours, such as abruptness, avoidance, or reluctance to seek guidance. Participants expressed a need for structured emotional competence (EC) training and additional emotional support.</p><p><strong>Conclusion: </strong> Junior doctors face emotionally charged encounters in their clinical practice. Unregulated emotions may drive counterproductive behaviours, affecting service delivery and patient care. Effective educational activities need to be developed to support the development of EC in undergraduate medical education. A programme targeting the emotional well-being of doctors, especially junior doctors, could provide additional support.Contribution: Identifies a need for EC training of doctors.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 1","pages":"e1-e8"},"PeriodicalIF":1.7,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875881","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":"Perceived reward adequacy as a key mechanism for retaining medical doctors in health systems: A structural equation modelling study.","authors":"Seth Fenyi, Solomon Keelson","doi":"10.4102/phcfm.v18i1.5381","DOIUrl":"10.4102/phcfm.v18i1.5381","url":null,"abstract":"<p><strong>Background: </strong> Retaining medical doctors remains a major challenge for health systems, particularly in low- and middle-income countries (LMICs), where workforce instability undermines continuity of care and service delivery. Although total rewards are widely used to improve retention, it remains unclear whether doctors stay because rewards are available or because they perceive them as fair and adequate.</p><p><strong>Aim: </strong> To examine whether reward adequacy and reward expectation mediate the relationship between total rewards and medical doctor retention.</p><p><strong>Setting: </strong>The study was conducted in public healthcare facilities in Ghana.</p><p><strong>Methods: </strong> A quantitative cross-sectional survey was conducted among 400 medical doctors recruited through stratified facility-level sampling. Data were collected using a structured questionnaire and analysed using Statistical Package for the Social Sciences (SPSS) version 26 and SmartPLS version 4. Partial least squares structural equation modelling assessed measurement validity and bootstrapped direct and indirect effects.</p><p><strong>Results: </strong> Total rewards had no significant direct effect on retention intention (β = 0.048, p = 0.507). Total rewards positively influenced reward adequacy (β = 0.689, p  0.001), and reward adequacy positively influenced retention intention (β = 0.623, p  0.001). Reward adequacy significantly mediated the total rewards-retention relationship (β = 0.429, p  0.001), whereas reward expectation did not.</p><p><strong>Conclusion: </strong> The retention value of total rewards depends primarily on doctors' perceptions of adequacy, fairness and sufficiency. Health systems should prioritise transparent and equitable reward structures rather than relying solely on financial and non-financial incentives.Contribution: The study identifies reward adequacy as the principal mechanism through which total rewards influence medical doctor retention in an LMIC primary healthcare context.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 1","pages":"e1-e8"},"PeriodicalIF":1.7,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876085","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":"A conducive clinical learning environment in primary care as a wicked problem: A scoping review of enablers, obstacles, and strategies.","authors":"Owen Eales, Hanneke Brits, Irene Lubbe, Maureen Moyo-Chilufya, Marietjie Van Rooyen","doi":"10.4102/phcfm.v18i1.5246","DOIUrl":"10.4102/phcfm.v18i1.5246","url":null,"abstract":"<p><strong>Background: </strong> The clinical learning environment (CLE) in primary care is increasingly recognised as critical to undergraduate medical education. However, its design and implementation are shaped by multiple interdependent factors, such as mentorship, autonomy, relationships and logistics, which make it a complex challenge.</p><p><strong>Aim: </strong> This study aimed to map the literature on the contributing factors to conducive CLE for medical students in primary care settings, identify enablers and obstacles and strategies for improvement.</p><p><strong>Setting: </strong> Primary care clinical learning environments, including community health centres, primary healthcare clinics, general practices, and district hospitals involved in undergraduate medical education.</p><p><strong>Methods: </strong> A scoping review was conducted using the Joanna Briggs Institute methodology and the PRISMA-ScR (Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews) checklist. Four databases were searched with no language or date restrictions. Articles were screened independently by two reviewers. Data were charted using Gruppen's conceptual framework and thematically synthesised.</p><p><strong>Results: </strong> A total of 34 articles were included. Common enablers included effective mentorship, student autonomy, positive interpersonal relationships, organisational alignment and supportive infrastructure. Obstacles included inadequate space, transport constraints, authoritarian teaching styles and a lack of student agency. Few articles proposed solutions, and many challenges were systemic and persistent. The CLE in primary care emerged as a wicked problem - a complex, context-sensitive issue involving multiple stakeholders without a definitive solution.</p><p><strong>Conclusion: </strong> A conducive CLE in primary care requires coordinated, multilevel strategies that address both human and structural domains. Isolated interventions are unlikely to produce lasting change.Contribution: This review highlights the CLE in primary care as a wicked problem and provides a framework for developing systemic, adaptive responses to support medical education in diverse contexts.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 1","pages":"e1-e10"},"PeriodicalIF":1.7,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543242/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875812","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":"Transforming diabetes prevention and care in South Africa: Proceedings and outcomes of the 2025 Diabetes Summit.","authors":"Patrick Ngassa Piotie, Ndinda Makina-Zimalirana, Alexandra Van Essche, Penelope Modipane, Herbert M Makgopa, Mariam Hassen, Asanda Mbewu-Hlobo, Kibachio Joseph Mwangi, Melanie Pienaar","doi":"10.4102/phcfm.v18i2.5577","DOIUrl":"10.4102/phcfm.v18i2.5577","url":null,"abstract":"","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 2","pages":"e1-e4"},"PeriodicalIF":1.7,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148876162","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":"Sociocultural beliefs and palliative care needs among older adults in low- and middle-income countries: A narrative review.","authors":"Hussaini M Yusuf, Felix Archibong, Monica N Adekoya, Ekanem A Edet, Abdulgafar L Olawumi, Attahiru Muhammad, Muhammad H Dauda","doi":"10.4102/phcfm.v18i1.5434","DOIUrl":"10.4102/phcfm.v18i1.5434","url":null,"abstract":"<p><p>Palliative care is an integral component of comprehensive primary health care and is particularly relevant for older adults living with chronic and progressive illnesses. In low- and middle-income countries (LMICs), including many African settings, access to palliative care remains limited despite substantial need. Sociocultural beliefs shape perceptions of ageing, illness, suffering and death, and influence how palliative care needs are recognised and addressed within primary care and family medicine contexts. To synthesise existing evidence on how sociocultural beliefs influence palliative care needs and utilisation among older adults in LMICs, with implications for primary care and family practice. A narrative literature review was conducted using published qualitative, quantitative and mixed-methods studies identified through searches of major electronic databases and relevant grey literature. Evidence was synthesised thematically, focusing on sociocultural influences relevant to primary care settings. Key themes identified included cultural constructions of ageing and suffering, family-centred decision-making, religious and spiritual interpretations of illness, and misconceptions surrounding palliative care. These factors influence symptom reporting, care-seeking behaviour, referral patterns and utilisation of palliative care services at the primary care level. Sociocultural beliefs are fundamental to understanding palliative care needs among older adults in LMICs. To improve access and quality of care, culturally sensitive palliative care models that involve families, recognise spiritual concerns and dispel myths are crucial. More empirical research from under-represented LMIC regions is required to inform contextually appropriate policy and practice.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 1","pages":"e1-e5"},"PeriodicalIF":1.7,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13543283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670855","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":"Strengthening diabetes education and peer support in South Africa: Insights from a national stakeholder convening ahead of the 2025 Diabetes Summit.","authors":"Lorrein S P Muhwava, Patrick Ngassa Piotie, Kibachio J Mwangi, Melanie Pienaar","doi":"10.4102/phcfm.v18i2.5572","DOIUrl":"10.4102/phcfm.v18i2.5572","url":null,"abstract":"","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 2","pages":"e1-e4"},"PeriodicalIF":1.7,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13444150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670889","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":"Building a type 1 diabetes registry in South Africa: Insights from a national multi-stakeholder workshop.","authors":"Patrick Ngassa Piotie, Penelope Modipane, Michelle Carrihill, Michelle Kruger, Marina Lazaridis, Adriaan Kruger, Luke Shankland, Elsabe Klinck, Camille Castelyn, Joseph Kibachio Mwangi, Melanie Pienaar, Mazvita Muchengeti","doi":"10.4102/phcfm.v18i2.5580","DOIUrl":"10.4102/phcfm.v18i2.5580","url":null,"abstract":"","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 2","pages":"e1-e4"},"PeriodicalIF":1.7,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13444176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670825","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":"Scaling up and institutionalising multisectoral collaboration and policy action for non-communicable diseases and mental health in South Africa: Lessons, gaps and insights from the 2025 Diabetes Summit.","authors":"Kibachio J Mwangi, Patrick Ngassa Piote, Melanie Pienaar, Masindi Mashapha, Nkateko Mkhondo, Mikkel Pape Dysted","doi":"10.4102/phcfm.v18i2.5573","DOIUrl":"10.4102/phcfm.v18i2.5573","url":null,"abstract":"","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 2","pages":"e1-e4"},"PeriodicalIF":1.7,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13444069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670873","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}