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

{"title":"Lived experiences of motherhood among students in a university in KwaZulu-Natal, South Africa.","authors":"Lungisile Shange, Pranitha Maharaj","doi":"10.4102/phcfm.v17i1.4757","DOIUrl":"https://doi.org/10.4102/phcfm.v17i1.4757","url":null,"abstract":"<p><strong>Background: </strong> Despite ongoing attempts to minimise pregnancies at a young age, early childbearing continues to be one of the world's most pressing social concerns. South Africa is not immune to this problem, with many young females becoming mothers at an early age. Although South Africa's fertility rate has decreased over time, the prevalence of early childbearing remains high.</p><p><strong>Aim: </strong> This study explores the experiences and perspectives of young mothers who are university students.</p><p><strong>Setting: </strong> The study was conducted in KwaZulu-Natal, South Africa.</p><p><strong>Methods: </strong> This was a qualitative study and employed an exploratory research design. In-depth interviews were conducted with 20 African women, aged 18-24 years, to learn about the challenges that young mothers face daily and how this affects their academic careers.</p><p><strong>Results: </strong> The mothers indicated that it was challenging to balance parenthood with their academic pursuits because both are incredibly demanding. As a result, the student mothers' academic performance suffers, reducing their future earning potential. Most young mothers were single and unemployed, so they relied on their parents to care for them and their children. Almost all the mothers reported limited assistance for young mothers at the university.</p><p><strong>Conclusion: </strong> A national education policy should require universities to adopt resources or specifically designed programmes to promote better support for student mothers.Contribution: This study highlights the need for a better understanding of, and continued research into the type of support structures that are available for student mothers.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e9"},"PeriodicalIF":1.2,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054000","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":"Community caregivers' perceptions: Family-centred postnatal care in KwaZulu-Natal, South Africa.","authors":"Nontuthuzelo D Nyasulu, Myra Taylor, Nelisiwe Khuzwayo","doi":"10.4102/phcfm.v17i1.4817","DOIUrl":"https://doi.org/10.4102/phcfm.v17i1.4817","url":null,"abstract":"<p><strong>Background: </strong> The family-centred postnatal care (FCPC) approach highlights the active participation of family members in supporting the care of the mother and newborn. It acknowledges the vital role of social support, practical assistance and emotional encouragement from family members.</p><p><strong>Aim: </strong> The study aimed to explore community caregivers' (CCGs) experiences and perceptions of the FCPC approach.</p><p><strong>Setting: </strong> The study took place in uMgungundlovu municipality, KwaZulu-Natal Province.</p><p><strong>Methods: </strong> A qualitative study design using a grounded theory approach was used. Participants were selected using purposive sampling. Four focus group discussions were held with 23 CCGs from the seven sub-districts. Data were analysed manually following the grounded theory steps.</p><p><strong>Results: </strong> Five themes emerged from the data analysis. These include perceptions of CCGs about the strength of antenatal care in enhancing postnatal care (PNC), experiences of CCGs in FCPC, non-attendance of postnatal visits by mothers and newborns, attitudes of CCGs towards healthcare professionals, and recommended activities for the CCGs in FCPC.</p><p><strong>Conclusion: </strong> The data analysis highlights the vital contributions of CCGs in improving maternal health and neonatal outcomes. These findings underscore the critical areas for improving support and outcomes for mothers and newborns.Contribution: The experiences and perceptions of CCGs on FCPC provide valuable insights into the importance of involving family members in supporting mothers and newborns. Their perspectives highlight practical challenges, opportunities for improved care, and family engagement's critical role in enhancing postnatal outcomes.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e9"},"PeriodicalIF":1.2,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039397","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":"Patients' palliative care needs in rural health and a proposal for palliation services.","authors":"Deidre Pretorius, Lesley G Mahole","doi":"10.4102/phcfm.v17i1.4866","DOIUrl":"https://doi.org/10.4102/phcfm.v17i1.4866","url":null,"abstract":"<p><p>Few patients and their families receive palliative care (PC), and if provided, it is usually in the end stages of the disease. In the past, these services were rendered by non-governmental organisations (NGOs), but after the dedicated South African palliative care policy was released, the responsibility of PC service delivery is at the provincial level. Department of Health's National Policy Framework and Strategy on PC was a major step forward in palliation; however, the services are not yet reaching the rural areas in North West province. This article highlights the need for PC for patients and their families in rural health. A model is suggested to facilitate these services under the leadership of a family physician.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e4"},"PeriodicalIF":1.2,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054104","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":"Exploring stakeholders' experiences on implementing family medicine in urban South Africa.","authors":"John M Musonda, Shabir Moosa","doi":"10.4102/phcfm.v17i1.4675","DOIUrl":"https://doi.org/10.4102/phcfm.v17i1.4675","url":null,"abstract":"<p><strong>Background: </strong> South Africa recognised family medicine as a medical speciality in 2007. The discipline plays a significant role in strengthening primary health care. However, the experiences of family physicians, private general practitioners and other stakeholders on implementing family medicine in urban South Africa remain unexplored.</p><p><strong>Aim: </strong> To explore stakeholders' experiences in urban South Africa on implementing family medicine.</p><p><strong>Setting: </strong> All participants were from Gauteng province, South Africa.</p><p><strong>Methods: </strong> The evaluated lived experiences of implementing family medicine as a clinical discipline. A descriptive, explorative qualitative study was undertaken using semi-structured, in-depth interviews with purposively selected individuals from October 2019 to December 2020. Thematic data analysis used MAXQDA version 2020.</p><p><strong>Results: </strong> Four major themes emerged. Most participants felt a disparity between private and public primary care services, with the latter having optimistic views about health reforms. Further, private general practitioners' clinical skills and competencies needed strengthening, and mixed staffing for primary care teams was envisioned. Many participants had ill-defined ideas about family medicine's impact and prospects but agreed that more resources were needed to improve it.</p><p><strong>Conclusion: </strong> The study highlights the participants' first-hand involvement in implementing family medicine. The findings may enhance knowledge of primary care services, clinical skills and staff composition. Further research is recommended.Contribution: The study provides insight into recognising family medicine, which preceded the government's efforts to introduce Universal Health Coverage to be funded through the National Health Insurance.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e8"},"PeriodicalIF":1.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067543/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056182","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":"Optimising neonatal bubble continuous positive airway pressure: A Somaliland quality initiative.","authors":"Hawa D Mahmoud, Sarah C Kent, Fatima E Ibrahim, Najma Mohamed, Fatima A Abdulahi, Meagan N O'Neal, Priya Kanajam, Ellen K Diego","doi":"10.4102/phcfm.v17i1.4742","DOIUrl":"https://doi.org/10.4102/phcfm.v17i1.4742","url":null,"abstract":"<p><strong>Background: </strong> Continuous positive airway pressure (CPAP) therapy is the standard of care for neonatal respiratory distress and improves survival when implemented in low-resource settings. Clinical audits at the Borama Regional Hospital (BRH) Neonatal Intensive Care Unit (NICU) revealed multiple barriers to effective CPAP, including insufficient pressure, a lack of neonatal-sized nasal prongs, and patient interface challenges.</p><p><strong>Aim: </strong> Improve respiratory distress by increasing effective CPAP delivery for neonates 30 days of age from 52% to 90% in 6 months.</p><p><strong>Setting: </strong> Single-centre referral hospital in the Awdal region of Somaliland.</p><p><strong>Methods: </strong> Quality improvement (QI) initiative with outcomes displayed using statistical process control (SPC) charts.</p><p><strong>Results: </strong> Eleven residents, three medical interns and seven NICU nurses completed the educational training. Forty-five patients were initiated on the locally designed bubble CPAP (bCPAP) device with a 47% (122/261) CPAP safety checklist completion rate for the three daily nursing shifts. We achieved our study aim by increasing the adherence rate to the 7-item bCPAP device set up from a baseline of 52% to 91%. The rate of infants weaned or discontinued from bCPAP for improved respiratory severity score (RSS) increased from 0% to 18% but did not demonstrate process change. There was no increase in adverse event rates (air leak, nasal columella breakdown and nasal irritation).</p><p><strong>Conclusion: </strong> We demonstrated increased effective bCPAP delivery and decreased respiratory distress.Contribution: This study outlines low-cost, customisable QI strategies to address commonly encountered gaps for effective bCPAP delivery in low-resource settings without access to commercially available CPAP devices or speciality-trained providers.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e14"},"PeriodicalIF":1.2,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050160","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":"Psychological insulin resistance among patients with diabetes mellitus in Botswana.","authors":"Engemadzo Bitsang, Billy M Tsima, Keneilwe Motlhatlhedi","doi":"10.4102/phcfm.v17i1.4752","DOIUrl":"https://doi.org/10.4102/phcfm.v17i1.4752","url":null,"abstract":"<p><strong>Background: </strong> Timely initiation of insulin therapy is vital in patients with type 2 diabetes mellitus. However, insulin initiation may be delayed because of psychological insulin resistance (PIR).</p><p><strong>Aim: </strong> This study aims to determine the prevalence of PIR and factors that contribute to PIR in adults with type 2 diabetes mellitus at a diabetes clinic in Botswana.</p><p><strong>Setting: </strong> The study was conducted in a diabetes clinic, one of the two large centres in the country that manage diabetes mellitus. It is situated on the south eastern part of Botswana.</p><p><strong>Methods: </strong> This was a cross-sectional study among patients with type 2 diabetes mellitus. We included participants aged between 18 and 80 years old and diagnosed with type 2 diabetes mellitus for more than 1 year. Patients' attitudes towards insulin therapy were assessed using the Insulin Treatment Appraisal Scale (ITAS).</p><p><strong>Results: </strong> The prevalence of PIR was 82.9% (95% confidence interval [CI]: 78.0 - 87.8) out of the 228 respondents. Factors significantly associated with PIR were gender (odds ratio [OR] adjusted 0.44; 95% confidence interval 0.211 - 0.921; p = 0.029) and treatment type (OR adjusted 1.58; 95% confidence interval 1.067 - 2.341; p = 0.023).</p><p><strong>Conclusion: </strong> Significant factors associated with psychological insulin resistance were patient and health system-related. It is therefore pivotal to improve patient and healthcare provider communication and to ensure that patient education is thoroughly performed at the diagnosis of disease.Contribution: This study highlights the importance of patient education at diagnosis and during treatment continuum of diabetes mellitus.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e7"},"PeriodicalIF":1.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057458","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":"Prevalence of hypertension in community members in a low-income community in Windhoek, Namibia.","authors":"Zelda Janse van Rensburg, Craig Vincent-Lambert","doi":"10.4102/phcfm.v17i1.4735","DOIUrl":"https://doi.org/10.4102/phcfm.v17i1.4735","url":null,"abstract":"<p><strong>Background: </strong> Hypertension remains a significant risk factor for the development of several non-communicable diseases such as stroke, myocardial infarction and renal failure. In many African countries, undiagnosed and unmanaged hypertension within the population remains a challenge. Proactive screening and health education therefore become important interventions.</p><p><strong>Aim: </strong> This study aimed to investigate the prevalence of hypertension among community members in a low-income, peri-urban community.</p><p><strong>Setting: </strong> The study was conducted in Otjomuise township, Windhoek, Namibia.</p><p><strong>Methods: </strong> A quantitative, cross-sectional design with a survey method was followed. A pre-validated health screening instrument was used to record the presence of hypertension in a sample of 358 community members who presented for screening over 2 days. A purposive sampling method was employed. Systolic and diastolic blood pressure reading were recorded, analysed and categorised using the American Heart Association classification scale. Blood pressures were classified as being either normal, elevated, hypertension stage 1 or hypertension stage 2. The data were analysed by a statistician using SPSS version 27 statistical software program and presented in tables.</p><p><strong>Results: </strong> A total of 210/358 (59%) of participants were found to have blood pressures within normal limits. Moreover, 57/358 (16%) had elevated blood pressures, 52/358 (14%) were in hypertension stage 1 and 39/358 (11%) were in hypertension stage 2.</p><p><strong>Conclusion: </strong> The 41% prevalence of abnormally elevated blood pressures found in our study is in line with the findings of other studies and confirms that hypertension in the Namibian population remains an ongoing public health concern. Larger scale and more regular screening exercises with appropriate referral are recommended.Contribution: Our study give insight on the prevalence of hypertension in a community in Namibia.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e6"},"PeriodicalIF":1.2,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067533/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044789","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":"Lower back pain prevalence and experiences in civil service workers, Botswana.","authors":"David Damba, Sonti I Pilusa","doi":"10.4102/phcfm.v17i1.4629","DOIUrl":"https://doi.org/10.4102/phcfm.v17i1.4629","url":null,"abstract":"<p><strong>Background: </strong> Lower back pain (LBP) is a global problem contributing to both disability and an increased demand for rehabilitation services. Studies on the prevalence and impact on work performance in Botswana are scarce.</p><p><strong>Aim: </strong> We investigated the prevalence of LBP among civil workers in Botswana and their experiences.</p><p><strong>Setting: </strong> The study setting comprised physiotherapy practice, Gaborone, Botswana.</p><p><strong>Methods: </strong> Concurrent explanatory mixed methods were employed. A total of 339 medical files for civil service workers were reviewed to identify the prevalence of LBP and associated risk factors such as age, gender, body mass index, working duration and type of work. Descriptive statistics were performed. In addition, 20 civil service workers were interviewed. The interviews were transcribed verbatim and coded inductively.</p><p><strong>Results: </strong> A total of 339 files were reviewed and the prevalence of LBP was 49%. There was no association between the risk factors and LBP (p  0.05). The experience of LBP was expressed in terms of the characteristics of LBP; the effects of LBP on all life domains and how LBP was managed. Our findings were that LBP affected work life and work performance.</p><p><strong>Conclusion: </strong> The high prevalence of LBP in civil service workers is concerning because it affects all the domains of life including work performance. Workplace health and wellness interventions are recommended.Contribution: Workplace health and wellness interventions are recommended.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e6"},"PeriodicalIF":1.2,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053049","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":"Maximising contributions of midwives in Africa towards achieving MNH targets: Lessons learned.","authors":"Doreen K Kaura, Jemima A Dennis-Antwi, Frances D Ganges, Sarah N Ngoma","doi":"10.4102/phcfm.v17i1.4851","DOIUrl":"https://doi.org/10.4102/phcfm.v17i1.4851","url":null,"abstract":"<p><p>African midwives are pivotal in enhancing continuity and care coordination throughout healthcare systems. They are a critical human resource in mitigating near misses, morbidities and mortality in Maternal and Neonatal Health (MNH). Thus, achieving the sustainable development goals (SDGs) necessitates robust midwifery policies and system strengthening across Africa. Given the critical role of midwives, this report reflects on the need for a coordinated regional approach to unify midwifery across the continent as a strategy towards impactful SDG achievements. The reflections are based on insights from a Ghana meeting aimed at unifying African midwives. Globalisation and Africanisation are both crucial for developing a harmonised sexual, reproductive, maternal, newborn and adolescent health system that improves the quality of life for African women and their families. Despite significant healthcare improvements, Africa faces challenges such as a shortage of skilled birth attendants, leading to high maternal and neonatal mortality rates. Achieving SDGs requires local solutions and fully integrating midwives into health systems. It also requires that midwives are purposefully and regularly engaged in global, regional and local policy discussions and decisions. To support this goal, the authors present an approach to ensure midwives in Africa are not only represented in these forums but also actively engaged in shaping, advocating for, and advancing relevant actions. We therefore recommend establishing a regional midwifery body to lead and coordinate these efforts.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e3"},"PeriodicalIF":1.2,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143988010","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":"What is the role of family medicine in providing palliative care in Africa?","authors":"Jennie Morgan, Maggie De Swardt, Nuhamin T Gebre, Mohja K Marhoom, Edwina B Opare-Lokko, Liz Gwyther","doi":"10.4102/phcfm.v17i1.4879","DOIUrl":"https://doi.org/10.4102/phcfm.v17i1.4879","url":null,"abstract":"<p><p>Although palliative care is known to effectively relieve serious health-related suffering (SHS), it is not yet widely available, particularly in Africa. Primary health care has been recognised as an effective means to enhance access to palliative care and achieve universal health coverage. As family physicians play an important role in the delivery of primary health care, this article seeks to illustrate how the family medicine speciality is contributing to efforts to ensure palliative care services are provided throughout the African continent. The World Health Organization recommends three tiers of training for healthcare providers to enhance competencies in palliative care. This training has played out differently in various African countries. This article focuses on the countries represented by the authors, namely South Africa, Ethiopia, Sudan and Ghana. In providing continuous, coordinated, holistic care to patients along the life course, family physicians can anticipate and relieve suffering in a timely manner in ways that no other specialities have been trained to do. We propose that all family physicians' training programmes in Africa prioritise palliative care training along with other leading clinical areas, to ensure that the significant numbers of people dying from SHS receive holistic care and die with dignity.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"17 1","pages":"e1-e3"},"PeriodicalIF":1.2,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12067638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004307","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}