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

{"title":"Retention of clients in HIV oral pre-exposure prophylaxis care in Engela, Namibia.","authors":"Kristiana Kosmas, Enos Moyo, Mbuzeleni Hlongwa, Perseverance Moyo, Tafadzwa Dzinamarira, Anna Shilunga","doi":"10.4102/phcfm.v17i1.4806","DOIUrl":"10.4102/phcfm.v17i1.4806","url":null,"abstract":"<p><strong>Background: </strong> Namibia has made tremendous progress in controlling the HIV epidemic. The progress has resulted in significant incidence and AIDS-related mortality reductions. However, new infections continue to persist.</p><p><strong>Aim: </strong> The study aimed to measure the clients' retention rate in pre-exposure prophylaxis (PrEP) care and associated factors.</p><p><strong>Setting: </strong> Engela District, in Namibia's Ohangwena region.</p><p><strong>Methods: </strong> We chose an analytical cross-sectional study design for this study. We selected 275 participants using a proportional stratified random sampling method. We used a self-administered questionnaire to collect data. We employed Chi-square tests and logistic regression for data analysis.</p><p><strong>Results: </strong> Participants' retention rate in PrEP care at 3 months was 35.6%, 95% CI (35.2% - 36.0%). Binomial logistic regression showed that men and the unemployed were less likely to be retained in PrEP, crude odds ratio (OR) = 0.52, 95% CI (0.30-0.91), and OR = 0.27, 95% CI (0.15-0.49), respectively. Participants who were divorced or in a relationship were also less likely to be retained in PrEP care, OR = 0.41, 95% CI (0.18-0.96), and OR = 0.43 95% CI (0.23 - 0.80), respectively. Furthermore, participants at Engela District Hospital were less likely to be retained in PrEP care, OR = 0.52, 95% CI (0.29 -0.93).</p><p><strong>Conclusion: </strong> Addressing the specific challenges unemployed individuals face in continuing on PrEP is crucial. Strategies should include decentralising PrEP services in the district and employing community-based models.Contribution: In addition, comprehensive PrEP education targeting men should be provided in diverse settings to improve their PrEP knowledge.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e8"},"PeriodicalIF":1.2,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545399","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":"Challenges and solutions to nurse-delivered integrated primary health care in Nelson Mandela Bay.","authors":"Zubrina Baartman, Cornelle Young, Justine C Baron","doi":"10.4102/phcfm.v17i1.4873","DOIUrl":"10.4102/phcfm.v17i1.4873","url":null,"abstract":"<p><strong>Background: </strong> Delivery of a comprehensive and integrated primary health care service to increase healthcare access, quality, equity and efficiency requires an effective working environment.</p><p><strong>Aim: </strong> To explore perceptions of primary health care nurses in the Eastern Cape, South Africa, regarding the adequacy of their working environment for integrated primary health care service delivery.</p><p><strong>Setting: </strong> Selected public primary health care clinics in a subdistrict of the Nelson Mandela Bay metropole, Eastern Cape, South Africa.</p><p><strong>Methods: </strong> A qualitative descriptive explorative design was used. Semi-structured interviews were conducted with nine nurses working in the selected facilities. Data were thematically analysed.</p><p><strong>Results: </strong> Availability of members of the multidisciplinary primary health care team, nurse competency, responsiveness and productivity levels compromise integrated primary health care. Service delivery is further negatively impacted by a lack of resources and non-optimal collaboration among members of the primary health care team.</p><p><strong>Conclusion: </strong> Challenges to rendering an effective integrated primary health care service exist within the primary health care working environment. To significantly increase comprehensive and integrated primary health care service delivery as a quality component of South African healthcare, these challenges need to be addressed.Contribution: An evidence-based description of aspects of primary health care workspaces that compromise integrated primary health care delivery is provided. This information can be used to improve integrated primary health care services. Integrated services are a prerequisite for the Ideal Clinic Initiative, which is a foundation of the implementation of the National Health Insurance (NHI) scheme for South Africa.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e10"},"PeriodicalIF":1.2,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223976/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144545395","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":"Understanding implementation research.","authors":"Robert Mash, Juliet Nyasulu, Zelra Malan, Lisa Hirschhorn","doi":"10.4102/phcfm.v17i2.4934","DOIUrl":"10.4102/phcfm.v17i2.4934","url":null,"abstract":"<p><p>Implementation research (IR) focuses on understanding and closing the gap between evidence-based interventions and practice. Key elements to evaluate include the design of the intervention itself, contextual barriers and enablers to implementation, the use of implementation strategies as well as the achievement of implementation outcomes. This article gives an overview of IR for doctoral-level researchers in the fields of family medicine and primary care. The consolidated framework for IR and socioecological model are considered for making sense of the contextual factors. A typology of implementation strategies is also described to make conceptualisation, reporting and sharing of findings easier. Standard implementation outcomes are described, such as coverage or reach, acceptability, adoption, appropriateness, feasibility, fidelity, costs and sustainability. The RE-AIM framework for implementation outcomes is described. Finally, different study designs are discussed, including hybrid effectiveness-implementation designs and approaches to reporting using the IR logic model.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 2","pages":"e1-e7"},"PeriodicalIF":1.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223990/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209898","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":"Barriers and facilitators of incorporating Ubuntu principles in the integrated management of childhood illness.","authors":"Felicia O Meno, Fhumulani M Mulaudzi, Nombulelo V Sepeng","doi":"10.4102/phcfm.v17i1.4802","DOIUrl":"10.4102/phcfm.v17i1.4802","url":null,"abstract":"<p><strong>Background: </strong> Success in incorporating Ubuntu principles in the integrated management of childhood illness (IMCI) requires collaboration between health professionals and families and assistance from their communities. Despite this, the literature reviewed is silent about exploring caregivers' perspectives regarding the barriers and facilitators of incorporating Ubuntu principles in managing childhood illness.</p><p><strong>Aim: </strong> The study explored and described the barriers and facilitators of incorporating Ubuntu principles in managing childhood illness.</p><p><strong>Setting: </strong> The study was conducted in selected primary healthcare settings, community health centres and clinics in the Mafikeng sub-district of the North West province.</p><p><strong>Methods: </strong> The study was conducted using exploratory descriptive contextual, qualitative design. The 36 participants were selected using purposeful sampling. Data were collected through focus group discussions, and thematic analysis was used to analyse the data.</p><p><strong>Results: </strong> The study revealed three themes: the negative attitude of professional nurses, communication barriers and facilitators enhancing the incorporation of Ubuntu into IMCI. The findings indicated that health education of caregivers is crucial, the right allocation of nurses will facilitate the inclusion of Ubuntu into IMCI and the unannounced visit of government authorities will also facilitate the incorporation.</p><p><strong>Conclusion: </strong> The study illustrated that caregivers face several barriers hindering the incorporation of Ubuntu in IMCI. These findings support the need for healthcare providers to prioritise the incorporation of Ubuntu principles for better management of childhood illness for children under the age of five.Contribution: This is the first study to report the barriers and facilitators of incorporating Ubuntu principles into IMCI.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e8"},"PeriodicalIF":1.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12223842/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209872","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":"Effect of a structured teaching programme on mothers' knowledge and utilisation of oral rehydration solution.","authors":"Stephen Nanbur, Clement K Dongurum, Godwin Achema, Emmanuel Andy, Sopen Chunuan, Kumzhi P Ringkat, Kenai A Nanchak, Nanvyat Nannim","doi":"10.4102/phcfm.v17i1.4717","DOIUrl":"10.4102/phcfm.v17i1.4717","url":null,"abstract":"<p><strong>Background: </strong> Childhood diarrhoea is a major health problem in developing countries.</p><p><strong>Aim: </strong> The aim of this study was to evaluate the impact of a structured teaching programme on mothers' knowledge and use of oral rehydration solution in the treatment of diarrhoea in children under 5 years of age.</p><p><strong>Setting: </strong> The study was conducted at Life-changing Eudaimonia Hospital, Jos, Nigeria.</p><p><strong>Methods: </strong> A quasi-experimental research design was used, based on a pre- and post-test with one group. Seventy mothers of children under 5 years of age suffering from diarrhoea were recruited as subjects. However, two withdrew, resulting in a response rate of 97.1%. Data were collected by administering a pretest to the respondents and a post-test after a 3-h structured teaching programme on the preparation and utilisation of oral rehydration solution in the treatment of diarrhoea.</p><p><strong>Results: </strong> The t-test analysis revealed that the mean knowledge and utilisation of oral rehydration solution in the treatment of diarrhoea significantly increased, with paired t-values of 3.528 (p = 0.001) and 20.382 (p  0.001) respectively.</p><p><strong>Conclusion: </strong> We concluded that the structured teaching programme significantly improved mothers' knowledge and utilisation of oral rehydration solution in the management of diarrhoea in children under 5 years of age at Life-changing Eudaimonia Hospital, Jos.Contribution: Based on the findings of this study, we suggest that policy makers should develop programmes that support education campaigns on oral rehydration therapy among family caregivers, especially in rural areas with poor access to health care.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e5"},"PeriodicalIF":1.2,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135766/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209874","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":"Use of integrated services in antenatal care: A case study of Mabvuku Polyclinic, Zimbabwe.","authors":"Gamuchirai P Gwaza, Danai T Zhou, Annette Plüddemann, Carl Heneghan","doi":"10.4102/phcfm.v17i1.4847","DOIUrl":"10.4102/phcfm.v17i1.4847","url":null,"abstract":"<p><strong>Background: </strong> The integration of diagnostic services presents a critical opportunity to improve health outcomes in low- and middle-income countries (LMICs), potentially averting up to 1 million premature deaths annually. Antenatal care provides a critical platform for diagnosing multiple diseases in an integrated manner.</p><p><strong>Aim: </strong> This study explored the experiences of healthcare providers and pregnant women using integrated diagnostic services at a primary care facility in Zimbabwe.</p><p><strong>Setting: </strong> A qualitative case study was conducted at Mabvuku Polyclinic in Harare, Zimbabwe.</p><p><strong>Methods: </strong> Using purposive sampling, 14 healthcare workers and 22 pregnant women participated in interviews. Observations and semi-structured interviews were recorded, transcribed and analysed using NVivo software. Thematic analysis was applied to identify key themes related to access, patient-provider interactions and systemic barriers.</p><p><strong>Results: </strong> According to the interviewees' reports, challenges such as limited resources, medical equipment and staff hinder efforts to integrate diagnostic services. The women strongly preferred integrated diagnosis, even if it meant enduring long waiting times, and valued the convenience of receiving all necessary services in a single visit. The study highlighted the hidden socio-economic barriers to 'free' healthcare and underscored the importance of addressing systemic inefficiencies.</p><p><strong>Conclusion: </strong> The insights gained from this study are transferable and contribute to the understanding of integrated diagnostic services in maternal healthcare contexts.Contribution: They offer practical recommendations for improving service delivery and health outcomes in similar settings.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e13"},"PeriodicalIF":1.2,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209896","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":"Factors influencing late antenatal booking in Tshwane District: Pregnant women's perceptions.","authors":"Kagiso P Tukisi, Vuyo D Dlakude, Sakhile I Hlatshwayo, Fezeka Dlamini","doi":"10.4102/phcfm.v17i1.4870","DOIUrl":"10.4102/phcfm.v17i1.4870","url":null,"abstract":"<p><strong>Background: </strong> Antenatal care (ANC) is a branch of primary health care service universally accessible for promoting positive maternal and neonatal outcomes globally. Pregnant women are encouraged to initiate ANC as soon as pregnancy is diagnosed. Early ANC allows a series of diagnostic procedures and investigations to exclude early, potential and actual pregnancy risks. However, the rate of late initiation of ANC remains high.</p><p><strong>Aim: </strong> To explore and describe factors influencing late antenatal booking based on pregnant women's perceptions in selected antenatal clinics in the Tshwane district.</p><p><strong>Setting: </strong> The study took place at the two selected facilities rendering ANC to the public in Tshwane district.</p><p><strong>Methods: </strong> A qualitative, explorative, descriptive and contextual research design was followed, and 10 purposively sampled pregnant women attended semi-structured interviews. Collaizi's descriptive method was used to analyse and organise data into themes and categories.</p><p><strong>Results: </strong> Although the participants had some awareness of ANC and the benefits attached, there were hindrances to the early seeking of ANC. The participants brought to light the factors that hinder early seeking of ANC under three themes: Theme 1 listed the patient-related factors; Theme 2 detailed ANC routine factors; and lastly, Theme 3 described midwives-related factors.</p><p><strong>Conclusion: </strong> The information dissemination methods of reproductive health and childbirth need to be revisited to ensure awareness and increase uptake of the ANC services.Contribution: The study findings have the potential to guide policymakers in addressing the factors that hinder the uptake of ANC as perceived by pregnant women - the primary consumers of the service. Additionally, the uptake of ANC may contribute to a decline in maternal and neonatal mortalities.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e10"},"PeriodicalIF":1.2,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209876","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":"Phenomenology for primary care researchers.","authors":"Robert Mash, Febisola Ajudua, Sebaka Malope, Doreen Kaura","doi":"10.4102/phcfm.v17i2.4946","DOIUrl":"10.4102/phcfm.v17i2.4946","url":null,"abstract":"<p><p>Primary care researchers often turn to qualitative methodologies to explore people's perspectives and experiences. Phenomenology is appropriate when the focus is on lived experiences, rather than ideas, beliefs, opinions or perceptions. Phenomenology has its roots in German philosophy and the social sciences, and doctoral students as well as researchers in the health sciences may struggle to understand the paradigm and apply it practically. This article attempts to make sense of the paradigm and two of its key threads, namely descriptive and interpretive phenomenology. The key principles of both approaches and the practical methodological steps are outlined. In addition, examples are given, and the two approaches are compared. Finally, the article discusses trustworthiness and quality criteria in phenomenology.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 2","pages":"e1-e6"},"PeriodicalIF":1.2,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209897","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":"National Health Insurance - knowledge, attitude and perceptions of speech-language therapists.","authors":"Nomfundo Njilo, Andrew J Ross","doi":"10.4102/phcfm.v17i1.4835","DOIUrl":"10.4102/phcfm.v17i1.4835","url":null,"abstract":"<p><strong>Background: </strong> The South African government signed the National Health Insurance (NHI) Bill into effect on 15th of May 2024 to ensure that all citizens have access to high-quality healthcare, regardless of their financial situation. While this initiative will impact all healthcare professionals, there is limited information on how speech-language therapists (SLTs) perceive its implementation in South Africa.</p><p><strong>Aim: </strong> The study aimed to explore the knowledge, attitudes and perceptions of SLTs in the public and private healthcare sectors related to service provision regarding the implementation of the NHI.</p><p><strong>Setting: </strong> This study was conducted virtually via Zoom (Zoom Video Communication, San Jose, California, United States) and Teams (Microsoft Teams, 2017) with SLTs in their respective settings in South Africa.</p><p><strong>Methods: </strong> The descriptive, qualitative research design involved virtual semi-structured interviews with 10 SLTs. NVivo software (QSR International, Victoria, Australia) was used to analyse the data, as guided by Tesch's content analysis method.</p><p><strong>Results: </strong> Eleven sub-themes emerged related to the three themes of knowledge (4 sub-themes), attitudes (4 sub-themes) and perceived impact (3 sub-themes) of NHI implementation on SLT services.</p><p><strong>Conclusion: </strong> The study highlights SLTs' knowledge, gaps and concerns about the impact of NHI implementation on their profession, emphasising the personal and professional areas that need to be addressed for its successful rollout.Contribution: Understanding SLTs' opinions will help address their concerns during the planning stages of integrating them into the NHI. This will lead to an equitable distribution of sufficient practitioners and ensure that many people benefit from its implementation.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e8"},"PeriodicalIF":1.2,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209894","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":"Thirty-five years of family medicine training and development in Uganda.","authors":"Innocent K Besigye, Brenda Tusubira, Michael Mulowooza, Fred Ndoboli","doi":"10.4102/phcfm.v17i1.4915","DOIUrl":"10.4102/phcfm.v17i1.4915","url":null,"abstract":"<p><p>In Uganda, family medicine training was started in 1989 to train an all-round generalist able to provide comprehensive care at a district hospital. Since then, the training programme has undergone several changes to cater for the needs of communities in a changing world. Very low numbers of applicants and poor understanding of the discipline have been a persistent challenge. Availability of non-family physician champions, family physician role models and collaborative networks are key to development of family medicine.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e3"},"PeriodicalIF":1.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12135734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144209895","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}