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

{"title":"Integration of Ubuntu philosophy in maternity care units of Limpopo province, South Africa: Perceived experiences of women.","authors":"Seani A Mulondo, Sonto M Maputle","doi":"10.4102/phcfm.v18i1.5240","DOIUrl":"10.4102/phcfm.v18i1.5240","url":null,"abstract":"<p><strong>Background: </strong> In South Africa, midwives should integrate the Ubuntu philosophy in maternity care services to promote utilisation of maternal and child healthcare services. Women expect to be treated with respect, love, dignity and mutual caring during childbirth. However, women experience obstetric violence, such as physical and verbal abuse during labour, which is associated with poor integration of the Ubuntu philosophy in maternity care units.</p><p><strong>Aim: </strong> The study aimed to explore and describe the perceived experiences of women during labour regarding the integration of Ubuntu in maternity services.</p><p><strong>Setting: </strong> The study was conducted in the six community healthcare centres that were purposively selected in Limpopo province.</p><p><strong>Methods: </strong> A qualitative, exploratory descriptive design was used. A non-probability, purposive and convenience sampling method was used to select participants. Data were generated from 24 women using individual face-to-face interviews. Trustworthiness and ethical standards were considered and adhered to. Data were analysed using thematic analysis.</p><p><strong>Results: </strong> The findings revealed three themes associated with a lack of integration of Ubuntu when rendering maternity care services, and two sub-themes emerged from themes one and two; three sub-themes emerged from sub-theme three. First theme: the personal conduct of midwives as perceived by women during labour. Attitude of midwives towards women in labour and midwives' lack of commitment emerged as sub-themes. Second theme: interpersonal relations as perceived by women during labour. Poor midwife-woman relationship and communication, and abusive conduct by midwives emerged as sub-themes. Third theme: the support system needed by women during labour. Poor support from midwives, the use of traditional remedies versus Western medicine, and a lack of sufficient resources that deprive women of quality midwifery care services emerged as sub-themes. Verbal and physical abuse, poor midwife-women relationships, use of traditional remedies and lack of support could lead to inadequate utilisation of maternity care services by pregnant women for childbirth.</p><p><strong>Conclusion: </strong> Integrating Ubuntu principles into maternity care can improve maternal and neonatal outcomes by promoting compassionate, respectful, and patient-centered care.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 1","pages":"e1-e11"},"PeriodicalIF":1.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13149632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reframing Emergency Medical Service in the context of chronic non-communicable disease and palliative care.","authors":"Linley A Holmes, Elizabeth Gwyther, Shannon Odell","doi":"10.4102/phcfm.v18i1.5206","DOIUrl":"10.4102/phcfm.v18i1.5206","url":null,"abstract":"<p><strong>Background: </strong> Emergency Medical Service (EMS) is often the initial primary contact for patients with non-communicable disease (NCD) with symptom exacerbation. EMS personnel are not trained to manage patients requiring this type of care, or recognise the need for palliative care or expert consultation.</p><p><strong>Aim: </strong> To describe how EMS' are often responsible for managing patients with NCDs and symptom exacerbation and to assess whether palliative care and support by EMS in the out-of-hospital sector should be considered.</p><p><strong>Setting: </strong> The study took place in the southern peninsula of Cape Town, including urban, suburban and rural communities, including the informal housing community.</p><p><strong>Methods: </strong> This was a retrospective descriptive analysis of de-identified patient report forms of adult patients (over 18 years old) attended to by a private EMS between January 2019 and April 2019. The patients included in the research met the inclusion criteria, identifying them as possibly requiring palliative care assistance because of the symptom exacerbation of their NCDs.</p><p><strong>Results: </strong> Of the 283 patients many had more than one NCD, and more than one of the primary symptoms of pain, shortness of breath, cognitive changes, nausea and vomiting simultaneously. The majority of these patients were likely to go to the hospital with ambulance transport, and frequently, there was no appropriate clinical intervention by paramedics. Clinical advice was seldom sought by paramedics for patients with symptom exacerbation related to their NCDs, with the data indicating that palliative care access for patients was minimal.</p><p><strong>Conclusion: </strong> Palliative care is a necessary approach to patient-centred care, with EMS being an available resource to assist with this approach. There is a necessity for improved communication and support between palliative care resources and EMS to mitigate inappropriate transport of these patients to already over-burdened emergency departments, and to improve home care by EMS.Contribution: This study highlights the need for appropriate palliative care support by EMS for patients with chronic disease and symptom exacerbation.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 1","pages":"e1-e8"},"PeriodicalIF":1.7,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595451","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":"Capacity development of researchers involved in guideline development in Malawi, Nigeria and South Africa: A mixed-methods study.","authors":"Retsedisitsoe P Mazibuko, Willem Odendaal, Sara Cooper, Tamara Kredo, Michael McCaul, Anke Rohwer","doi":"10.4102/phcfm.v18i1.5193","DOIUrl":"10.4102/phcfm.v18i1.5193","url":null,"abstract":"<p><strong>Background: </strong> The Global Evidence, Local Adaptation (GELA) project aimed to build capacity for rigorous clinical practice guideline (CPG) development and evidence-informed decision-making (EDIM) in Malawi, South Africa and Nigeria.</p><p><strong>Aim: </strong> This study aimed to explore and assess whether and how participating in GELA project activities developed the capacity of GELA researchers in evidence synthesis, guideline development, project management and interpersonal skills.</p><p><strong>Setting: </strong> GELA researchers were based at academic and research institutions in South Africa, Malawi, Nigeria and Norway.</p><p><strong>Methods: </strong> We conducted a nested mixed-method study of GELA researchers comprising an online survey and semi-structured interviews. Quantitative data were analysed descriptively, while qualitative data were analysed through framework analysis.</p><p><strong>Results: </strong> Survey respondents indicated that their confidence in technical skills, as well as project management and interpersonal skills, improved during GELA. Interview results highlighted the importance of both skill sets. Collaboration emerged as a key facilitator of capacity development, while the tension between meeting deliverables and dedicating enough time to capacity development was a key challenge.</p><p><strong>Conclusion: </strong> The GELA project enabled capacity development in technical, project management and interpersonal skills in novice as well as experienced researchers. The collaborative nature of the project facilitated this iterative process. Planning of capacity development for researchers within a project such as GELA is essential for the success of both capacity development and project deliverables.Contribution: Our evaluation sheds light on the challenges and facilitators of building capacity of researchers within the context of a multinational project on CPG development.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 1","pages":"e1-e10"},"PeriodicalIF":1.7,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595394","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":"Stopping antidepressants safely.","authors":"Mark Horowitz, Thomas L Perry","doi":"10.4102/phcfm.v18i1.5431","DOIUrl":"10.4102/phcfm.v18i1.5431","url":null,"abstract":"<p><p>Long-term antidepressant pharmacotherapy is frequently continued beyond guideline-recommended durations. This occurs particularly among women, despite limited evidence of ongoing benefit for many people treated for mild-to-moderate depression and an increasing burden of adverse effects over time. In randomised trials, average symptom improvement over placebo is small (approximately 2 points on the 52-point Hamilton Depression Rating Scale), with an estimated number needed to treat of about 7-10 for a clinically meaningful benefit, underscoring the importance of planning for discontinuation once treatment is initiated. Antidepressant withdrawal is common yet under-recognised: at least half of people experience withdrawal symptoms when stopping, with risk and severity increasing with higher doses, longer duration of use and prior withdrawal experiences. This Therapeutic Letter outlines a practical, patient-centred approach to deprescribing that tailors tapering to individual risk, uses clinical response to guide the pace of reduction and emphasises careful differentiation of withdrawal symptoms from relapse. To minimise harms, abrupt discontinuation should be avoided; higher-risk patients may require very gradual tapering over months or years, often using hyperbolic dose reductions enabled by liquid formulations or dissolving tablets, with close follow-up every 2-4 weeks and the option to pause or reverse tapering if symptoms emerge. The guidance also highlights strategies for challenging presentations, including withdrawal-associated akathisia and protracted withdrawal, alongside patient education, shared decision-making and informed consent to support safer discontinuation and improved outcomes.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 1","pages":"e1-e6"},"PeriodicalIF":1.7,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Operationalising palliative care integration: Experiences of implementers in South Africa.","authors":"Juanita O Arendse, Virginia Zweigenthal, Liz Gwyther","doi":"10.4102/phcfm.v18i1.5221","DOIUrl":"10.4102/phcfm.v18i1.5221","url":null,"abstract":"<p><strong>Background: </strong> South Africa's 2017 National Policy Framework and Strategy for Palliative Care mandated the integration of palliative care (PC) into the public health system using existing resources.</p><p><strong>Aim: </strong> To explore PC implementers' (1) experiences at least 1 year after implementation; (2) implementers' capability in providing PC; (3) approaches to PC integration at selected sites and (4) perceived enablers and obstacles requiring managerial support.</p><p><strong>Setting: </strong> Healthcare facilities in the Cape Metro District (CMD) of South Africa.</p><p><strong>Methods: </strong>A qualitative, exploratory design was employed in five primary healthcare facilities classified as higher- or lower-morphine-usage sites based on dispensing trends. Purposive sampling identified 29 stakeholders: 22 implementers (clinical and support staff) and seven operations managers. Data were collected in four virtual focus group discussions and one in-depth interview with implementers and one in-depth interview with managers.</p><p><strong>Results: </strong> Three main themes emerged: (1) Provider capability: implementers reported variable confidence in clinical skills and in providing psychosocial support; (2) health systems response: participants cited insufficient staffing and time, limited training opportunities and inconsistent multidisciplinary team functionality and (3) provision of patient-centred PC: stakeholders emphasised the need for clear referral pathways, interprofessional communication and supportive leadership to ensure continuity of care.</p><p><strong>Conclusion: </strong> Palliative care implementers' engagement in policy design and resource allocation is essential for sustainable implementation. Strengthening multidisciplinary teamwork, embedding PC content in undergraduate curricula and providing ongoing managerial support will enhance equitable access to quality palliative services.Contribution: Understanding how frontline stakeholders operationalise PC integration is essential for refining policy and practice in low-resource settings.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 1","pages":"e1-e12"},"PeriodicalIF":1.7,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058540/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595415","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 affecting the enrolment of men into a community adherence group in Kavango East Region, Namibia.","authors":"Andreas Nampola, Daniel O Ashipala, Epafras Anyolo","doi":"10.4102/phcfm.v18i1.5115","DOIUrl":"10.4102/phcfm.v18i1.5115","url":null,"abstract":"<p><strong>Background: </strong> Community adherence groups (CAGs) are an acceptable and effective strategy to provide social support for people living with human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS), as well as for receiving their antiretroviral therapy (ART). However, in Namibia, it is estimated that 30% - 50% of men living with HIV are reluctant to access treatment through these groups, and little research exists on the factors affecting their enrolment.</p><p><strong>Aim: </strong> This study aimed to explore and describe factors affecting the enrolment of men in CAGs in Rundu District, Kavango East Region, Namibia.</p><p><strong>Setting: </strong> This study was carried out in the Kavango-East region, one of the 14 regions of Namibia.</p><p><strong>Methods: </strong> This study followed a qualitative approach that utilised exploratory, descriptive, and contextual strategies. The researcher conducted semi-structured, face-to-face interviews with 15 men between 22 years and 56 years of age in Rundu in September 2024 and October 2024. The participants were purposively selected and the data were analysed thematically.</p><p><strong>Results: </strong> Participants described numerous barriers hindering men from enrolling in CAGs, including stigma, a lack of information, few perceived benefits, and poor continuity of care. Additionally, participants recommended that men-only groups would improve enrolment.</p><p><strong>Conclusion: </strong> The study's findings demonstrate that overcoming barriers to men's enrolment in CAGs is vital for improving access to HIV treatment. Strategies such as anti-stigma campaigns, increased awareness, incentives, and men-only groups are essential for fostering inclusive and effective HIV care for men.Contribution: This study highlights the barriers to enrolment in CAGs for men living with HIV, particularly stigma and lack of information, while recommending anti-stigma campaigns, increased awareness, incentives, and men-only groups for improved enrolment.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 1","pages":"e1-e10"},"PeriodicalIF":1.7,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595455","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":"Dr Zelra Malan (13 November 1963 - 22 November 2025).","authors":"Felicia Christians","doi":"10.4102/phcfm.v18i1.5408","DOIUrl":"https://doi.org/10.4102/phcfm.v18i1.5408","url":null,"abstract":"","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 1","pages":"5408"},"PeriodicalIF":1.7,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147844262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dr Zelra Malan (13 November 1963 - 22 November 2025).","authors":"Felicia Christians","doi":"10.4102/phcfm.v18i1.5408","DOIUrl":"https://doi.org/10.4102/phcfm.v18i1.5408","url":null,"abstract":"","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 1","pages":"5408"},"PeriodicalIF":1.7,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dr Zelra Malan (13 November 1963 - 22 November 2025).","authors":"Felicia Christians","doi":"10.4102/phcfm.v18i1.5408","DOIUrl":"10.4102/phcfm.v18i1.5408","url":null,"abstract":"","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 1","pages":"5408"},"PeriodicalIF":1.7,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13058500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148875876","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":"Dr Zelra Malan (13 November 1963 - 22 November 2025).","authors":"Felicia Christians","doi":"10.4102/phcfm.v18i1.5408","DOIUrl":"https://doi.org/10.4102/phcfm.v18i1.5408","url":null,"abstract":"","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"18 1","pages":"5408"},"PeriodicalIF":1.7,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}