{"title":"Gender discrimination in the emergency services: Female paramedic experiences in South Africa.","authors":"Andrew W Makkink, Busisiwe E Nkhoma","doi":"10.4102/phcfm.v17i1.4945","DOIUrl":"10.4102/phcfm.v17i1.4945","url":null,"abstract":"<p><strong>Background: </strong> Gender discrimination (GD), particularly that against women, remains a challenge in the workplace and paramedicine is no exception. Discrimination against women persists despite, in many cases, their being more qualified than their male counterparts.</p><p><strong>Aim: </strong> The aim of this study was to explore GD in paramedicine using the perceptions and experiences of South African female emergency care practitioners (ECPs).</p><p><strong>Setting: </strong> The study setting was within the Johannesburg area in South Africa, and targeted female ECPs.</p><p><strong>Methods: </strong> This study used a qualitative description design to gather data using online or face-to-face interviews from seven participants. Interviews were transcribed verbatim, read vertically and horizontally, coded using ATLAS.ti version 22 software and analysed for categories and themes.</p><p><strong>Results: </strong> There were six dominant themes that emerged from the data: (1) GD remains prevalent in emergency medical services (EMS); (2) female ECPs were undermined in the workplace; (3) there were race factors related to GD; (4) gender stereotypes were based on physical capabilities; (5) the negative effects of GD in the workplace; and (6) maternal wall bias.</p><p><strong>Conclusion: </strong> Gender discrimination against women in EMS persists with females being stereotyped, undermined and subject to maternal wall bias. Effects of GD on participants included psychological stress, feelings of inadequacy, isolation, sadness and self-doubt. Contribution: There is a paucity of research on GD in African EMS. The findings of this study provide valuable insights into GD in the EMS workplace and contribute to the growing body of knowledge related to GD worldwide.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e11"},"PeriodicalIF":1.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12506810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024509","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}
Simphiwe Mabizela, Elmari Deacon, Esme Van Rensburg, Christiaan I Bekker
{"title":"Protective factors in resilient South African youth with type 1 diabetes: A qualitative study.","authors":"Simphiwe Mabizela, Elmari Deacon, Esme Van Rensburg, Christiaan I Bekker","doi":"10.4102/phcfm.v17i1.4935","DOIUrl":"10.4102/phcfm.v17i1.4935","url":null,"abstract":"<p><strong>Background: </strong> Self-managing type 1 diabetes (T1D) can be challenging, especially for adolescents in a critical developmental stage. Some adolescents struggle to successfully self-manage T1D and struggle to keep it well-controlled into adulthood. Despite this concern, there is a notable lack of evidence-based research on protective factors and/or resources to support adolescents living with T1D in South Africa.</p><p><strong>Aim: </strong> This study aimed to explore and describe the protective factors of resilience among South African adolescents living with well-controlled T1D.</p><p><strong>Setting: </strong> The study was conducted at the Centre for Diabetes and Endocrinology (CDE) in Parktown, Gauteng, South Africa, a specialised facility offering comprehensive, multidisciplinary care for adolescents with T1D.</p><p><strong>Methods: </strong> A qualitative descriptive research design was used, and seven semi-structured interviews were conducted, transcribed and thematically analysed.</p><p><strong>Results: </strong> Four themes emerged from the data: Just do it: Commit to the diabetes care plan; It takes a village to raise a child living with diabetes; The silver lining of developing positive characteristics and It's a process of continuously learning about T1D.</p><p><strong>Conclusion: </strong> Internal abilities (planning, taking responsibility, perseverance and determinism) and external resources (parents, family members, school, mentors) foster positive outcomes and adjustment for adolescents with well-controlled T1D. The potential for adolescents with T1D to use available internal abilities and external resources in managing their diabetes could be beneficial to the successful management of T1D.Contribution: The study addressed a gap in understanding protective factors involved in the successful self-management of adolescents living with well-controlled T1D in South Africa.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e8"},"PeriodicalIF":1.7,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12506827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024496","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}
Justin Engelbrecht, Chandbi Tajeer, Cara O'Connor, Kate Rees
{"title":"Differentiated antiretroviral distribution: Implementation in five South African districts.","authors":"Justin Engelbrecht, Chandbi Tajeer, Cara O'Connor, Kate Rees","doi":"10.4102/phcfm.v17i1.4974","DOIUrl":"10.4102/phcfm.v17i1.4974","url":null,"abstract":"<p><strong>Background: </strong> The National Department of Health introduced Differentiated Service Delivery (DSD) models to improve retention in care and decongest healthcare facilities. Anova Health Institute supported the implementation of DSD guidelines in five districts of South Africa.</p><p><strong>Aim: </strong> The study aimed to describe how the models contained in DSD policies are operationalised.</p><p><strong>Setting: </strong> Five districts of South Africa - two metropolitan, two mixed and one rural.</p><p><strong>Methods: </strong> We used a mixed-methods approach, incorporating a 2-day participatory workshop in 2023 and a retrospective review of routine programmatic data. A mapping exercise was used to understand all models of chronic medication provision in the five study districts and to describe differences in operationalisation. We also report on the number of options per facility and healthcare provider perspectives of benefits and limitations.</p><p><strong>Results: </strong> External and facility pick-up points were the most commonly implemented models. Three key themes were: the trade-off between convenience and additional support, the trade-off between controlling client care and outsourcing tasks and the distribution of work between cadres of staff. Sedibeng District provided the most options per facility, with 57% of facilities having three possible options. Cape Town provided the fewest, with 50% of facilities offering only one option.</p><p><strong>Conclusion: </strong> Health and environmental contexts guide the choice of DSD modalities offered. It is possible to offer clients options in South African settings.Contribution: This study highlights the context-specific nature of DSD model implementation and the importance of client choice. Further research into availability and options from a client perspective would be useful.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e9"},"PeriodicalIF":1.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024348","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}
Samantha Dladla, Klaus B Von Pressentin, Tasleem Ras
{"title":"The perceived impact of family medicine leadership training on practice: A qualitative study.","authors":"Samantha Dladla, Klaus B Von Pressentin, Tasleem Ras","doi":"10.4102/phcfm.v17i1.4954","DOIUrl":"10.4102/phcfm.v17i1.4954","url":null,"abstract":"<p><strong>Background: </strong> Family physicians (FPs) play a crucial role in clinical governance within South Africa's District Health System, necessitating strong leadership skills.</p><p><strong>Aim: </strong> To understand how the postgraduate Leadership and Governance module at the University of Cape Town (UCT) helped prepare qualified FPs working in the Western Cape province public sector for their leadership role.</p><p><strong>Setting: </strong> The UCT offers a 4-month Leadership and Governance module as part of its 4-year Master of Medicine in Family Medicine programme, aiming to prepare registrars for leadership roles.</p><p><strong>Methods: </strong> An exploratory qualitative study design was used. A total of 10 UCT alumni working in senior public sector roles were purposively sampled for online semi-structured interviews. Interviews were recorded, transcribed and analysed using the framework method. Data were coded deductively into themes, with new themes created for cohesive uncategorised data.</p><p><strong>Results: </strong> Findings revealed that FPs shared similar early experiences as clinical leaders and faced a transitional phase after completing their registrarship. While key leadership qualities aligned with existing literature, participants emphasised the importance of context-specific training and the value of community practice resources.</p><p><strong>Conclusion: </strong> The module itself was not considered particularly helpful in preparing FPs for real-world leadership and governance challenges.Contribution: The study highlights gaps between theoretical training and practical leadership demands, indicating that the module must better address the realities faced by newly qualified FPs. This research contributes to understanding the limitations of current leadership training and underscores the need for more practical, contextually relevant education for FPs in leadership roles.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e10"},"PeriodicalIF":1.7,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024491","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":"Malaria signs, symptoms, prevention knowledge and its associated factors among rural Ethiopians.","authors":"Kemal A Kuti, Sibusiso M Zuma","doi":"10.4102/phcfm.v17i1.4885","DOIUrl":"10.4102/phcfm.v17i1.4885","url":null,"abstract":"<p><strong>Background: </strong> Malaria is a leading cause of morbidity, mortality and socio-economic burden in Ethiopia. Although the country set a goal to eradicate malaria by 2030, a resurgence has been reported recently.</p><p><strong>Aim: </strong> This study was conducted to assess the signs of malaria, its symptoms and knowledge regarding prevention and its associated factors among rural Ethiopians.</p><p><strong>Setting: </strong> Three malaria-endemic rural districts in the Bale Zone, Ethiopia, constituted the setting for the study. The study respondents were household members aged 18 and older, predominantly the heads of households.</p><p><strong>Methods: </strong> A community-based cross-sectional study design was employed. Data were collected from a randomly selected 634 individuals using a pre-tested structured questionnaire. Descriptive and inferential statistics were computed using SPSS version 28.</p><p><strong>Results: </strong> Less than half of the respondents (44.2%) demonstrated a good overall understanding of the signs, symptoms and prevention of malaria, while some participants wrongly attributed malaria transmission to staying long in the sun, lack of rest and drinking alcohol. The most commonly recognised malaria symptoms include fever, headache and uncoordinated speech. Preventive measures that were widely known included eliminating mosquito breeding sites, sleeping under insecticide-treated nets and indoor residual spraying. Factors such as education, religion, marital status, family size and the presence of children and pregnant women in the household were associated with a better understanding of malaria.</p><p><strong>Conclusions: </strong> Malaria-related knowledge is low in the current study area. Some socio-demographic factors were known to have influenced malaria-related knowledge. Contribution: The study provides data on malaria-related knowledge among rural communities. The findings can be used to develop a knowledge-transfer strategy to improve communities' knowledge and accelerate malaria elimination.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e10"},"PeriodicalIF":1.7,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024503","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}
Elizabeth K Ndakukamo, Roshwitha Mahalie, Panduleni Hailonga-van Dijk
{"title":"Health system constraints in cervical cancer prevention in rural Namibia: A qualitative study.","authors":"Elizabeth K Ndakukamo, Roshwitha Mahalie, Panduleni Hailonga-van Dijk","doi":"10.4102/phcfm.v17i1.4976","DOIUrl":"10.4102/phcfm.v17i1.4976","url":null,"abstract":"<p><strong>Background: </strong> Cervical cancer remains a pressing public health concern in Namibia, with significant barriers to prevention, particularly in rural areas.</p><p><strong>Aim: </strong> This study explored health system's challenges and their impact on cervical cancer prevention efforts.</p><p><strong>Setting: </strong> This study was conducted in the Ohangwena and Kavango West regions of Namibia.</p><p><strong>Methods: </strong> A qualitative exploratory design was employed, focusing on healthcare workers directly involved in cervical cancer prevention. In-depth interviews were utilised to collect data from 11 participants from four district hospitals. Thematic analysis, guided by the World Health Organisation's six health system framework pillars, was used.</p><p><strong>Results: </strong> Key service gaps were identified across critical areas of cervical cancer prevention, including a lack of awareness, a lack of human papillomavirus vaccines and referral screening equipment that limited local outreach services. Other significant findings included the shortage of trained personnel and the manual data systems, which resulted in deficiencies in decision-making. Financial constraints, including reliance on non-governmental organisation funding and weak community engagement, exacerbated by cultural stigma, presented leadership challenges.</p><p><strong>Conclusion: </strong> Investing in human resources for health, decentralising budget trends and enhancing data systems are critical for cervical cancer prevention in rural Namibia. Equally important is the active involvement of the community in these efforts. Contribution: This study highlights key health system constraints in the Ohangwena and Kavango West regions.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e9"},"PeriodicalIF":1.7,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024458","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":"Advocacy for family medicine in sub-Saharan Africa.","authors":"Robert J Mash","doi":"10.4102/phcfm.v17i1.5109","DOIUrl":"10.4102/phcfm.v17i1.5109","url":null,"abstract":"","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e3"},"PeriodicalIF":1.7,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12421777/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145024356","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":"Usage of traditional medicine during pregnancy and the associated factors among Basotho women.","authors":"Lisemelo L Chesetsi, Andrew Ross","doi":"10.4102/phcfm.v17i1.4936","DOIUrl":"10.4102/phcfm.v17i1.4936","url":null,"abstract":"<p><strong>Background: </strong> Many women persist in using traditional medicine despite the evidence that traditional medicines have the potential to harm both the unborn baby and the mother. Data on the extent of use of traditional medicine by women in Lesotho during pregnancy are largely unavailable.</p><p><strong>Aim: </strong> This study aimed to determine the prevalence of traditional medicine use during pregnancy among Basotho women and identify the associated factors.</p><p><strong>Setting: </strong> The study took place in Ha-Shalabeng, Ha-Molengoane and Ha-Setoko, Lesotho.</p><p><strong>Methods: </strong> A cross-sectional design was adopted, data were collected through a structured questionnaire, coded into Excel, and analysed using SPSS. Frequency distribution tables and graphs were used to describe the data on women. The χ2 test examined the association between categorical dependent and independent variables.</p><p><strong>Results: </strong> The prevalence of traditional medicine use during pregnancy was 40%. The factors significantly influencing traditional medicine use, included age (p 0.01), educational level (p 0.01), location (p 0.01), transport availability (p 0.04), belief in the efficacy of traditional medicine (p 0.01), reasons for the type of care (p 0.01) and recommendations from parents (p 0.03).</p><p><strong>Conclusion: </strong> The utilisation of traditional medicine during pregnancy was found to be high. Therefore, it is crucial to have a policy in Lesotho that regulates the usage and safety of traditional medicine. Contribution: The data would be crucial in informing future research and shaping the development and implementation of traditional medicine policy, thus addressing the existing policy gap regarding traditional medicine in Lesotho.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e7"},"PeriodicalIF":1.7,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12339889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800586","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}
Naseem Cassim, Ernest P Buthelezi, Somayya Sarang, Sadhaseevan Moodly, Lucia Hans, Lindi-Marie Coetzee
{"title":"Assessing laboratory specimen losses for the city of Johannesburg, South Africa.","authors":"Naseem Cassim, Ernest P Buthelezi, Somayya Sarang, Sadhaseevan Moodly, Lucia Hans, Lindi-Marie Coetzee","doi":"10.4102/phcfm.v17i1.4907","DOIUrl":"10.4102/phcfm.v17i1.4907","url":null,"abstract":"<p><strong>Background: </strong> Specimen losses across the pathology value chain (PVC) result in missed diagnostic opportunities. It is difficult to fully assess these due to the current paper-based systems, with tracking of specimens only possible on the laboratory information system (LIS).</p><p><strong>Aim: </strong> This study aimed to assess specimen losses using the paper-based register.</p><p><strong>Setting: </strong> Randomly selected Primary health care (PHC) facilities, City of Johannesburg, South Africa.</p><p><strong>Methods: </strong> The retrospective descriptive study design was used to scan 1,000 barcodes from facilities in sub-districts A to G. Data was limited to barcodes from the request form and excluded surveillance testing. Matching data from the laboratory repository was extracted. PVC losses were assessed by determining the percentage of scanned barcodes that had a registered, tested, reviewed and/or rejected date. The analysis was stratified according to sub-district, health facility type and test code.</p><p><strong>Results: </strong> The dataset analysed included 33 867 barcodes with 121 697 test codes, equating to 3.59 tests per barcode. Matching registered, tested and reviewed dates were detected for 33 107 (97.76%) barcodes. In total, a rejection for one or more test codes was detected for 1,961 barcodes (5.79%). At the sub-district level, between 95.95% (D) and 98.90% (E) of barcodes were reviewed. The rejection rate ranged from 3.27% (F) to 10.93% (D). For community health centres and clinics, 97.37% and 97.97% of the barcodes had a matching reviewed date.</p><p><strong>Conclusion: </strong> PVC losses reported were 4.05%, excluding rejections (5.79%), with slightly higher levels noted at the sub-district level. Contribution: The continuous audit of PVC losses is recommended.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e8"},"PeriodicalIF":1.7,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12339880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800556","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}