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

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Factors affecting antenatal care attendance in Soweto, Johannesburg: The three-delay model. 影响约翰内斯堡索韦托地区产前护理就诊率的因素:三延迟模型
IF 1.2
African Journal of Primary Health Care & Family Medicine Pub Date : 2024-06-14 DOI: 10.4102/phcfm.v16i1.4333
Nellie Myburgh, Thabisile Qwabi, Lunghile Shivambo, Lerato Ntsie, Andile Sokani, Maria Maixenchs, Isaac Choge, Sana Mahtab, Ziyaad Dangor, Shabir Madhi
{"title":"Factors affecting antenatal care attendance in Soweto, Johannesburg: The three-delay model.","authors":"Nellie Myburgh, Thabisile Qwabi, Lunghile Shivambo, Lerato Ntsie, Andile Sokani, Maria Maixenchs, Isaac Choge, Sana Mahtab, Ziyaad Dangor, Shabir Madhi","doi":"10.4102/phcfm.v16i1.4333","DOIUrl":"10.4102/phcfm.v16i1.4333","url":null,"abstract":"<p><strong>Background: </strong> Antenatal care remains critical for identifying and managing complications contributing to maternal and infant mortality, yet attendance among women in South Africa persists as a challenge.</p><p><strong>Aim: </strong> This study aimed to understand the challenges faced by women attending antenatal care in Soweto, Johannesburg, using the three-delay model.</p><p><strong>Setting: </strong> This study was conducted in Soweto, Johannesburg.</p><p><strong>Methods: </strong> An exploratory, descriptive and qualitative research design was used, and in-depth interviews were conducted with 10 pregnant women and four women who had recently given birth.</p><p><strong>Results: </strong> Findings indicate delays in seeking care due to factors such as pregnancy unawareness, waiting for visible signs, and fear of human immunodeficiency virus (HIV) testing. Challenges such as transportation difficulties, distance to clinics, and facility conditions further impeded the initiation of antenatal care. Late initiation often occurred to avoid long waits, inadequate facilities, language barriers and nurse mistreatment.</p><p><strong>Conclusion: </strong> From this study, we learn that challenges such as unawareness of pregnancy, cultural notions of keeping pregnancy a secret, fear of HIV testing, long waiting lines, high cost of transportation fees, clinic demarcation, shortage of essential medicines, broken toilets and verbal abuse from nurses have delayed women from initiating antenatal care early in Soweto, Johannesburg.Contribution: Challenges of women with antenatal care attendance in South Africa must be addressed by implementing community-based health education interventions, institutionalising HIV psycho-social support services and improving quality of antenatal care services in public health facilities.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e9"},"PeriodicalIF":1.2,"publicationDate":"2024-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11220068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471521","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}
引用次数: 0
Corrigendum: Access to healthcare by undocumented Zimbabwean migrants in post-apartheid South Africa. 更正:无证津巴布韦移民在种族隔离后的南非获得医疗保健的情况。
IF 2
African Journal of Primary Health Care & Family Medicine Pub Date : 2024-05-31 DOI: 10.4102/phcfm.v16i1.4625
Takunda J Chirau, Joyce Shirinde, Cheryl McCrindle
{"title":"Corrigendum: Access to healthcare by undocumented Zimbabwean migrants in post-apartheid South Africa.","authors":"Takunda J Chirau, Joyce Shirinde, Cheryl McCrindle","doi":"10.4102/phcfm.v16i1.4625","DOIUrl":"10.4102/phcfm.v16i1.4625","url":null,"abstract":"<p><p>No abstract available.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"4625"},"PeriodicalIF":2.0,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11151349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238477","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}
引用次数: 0
Improving person-centred care for older persons with serious multimorbidity in LMICs. 在低收入和中等收入国家,改善对患有严重多病的老年人以人为本的护理。
IF 2
African Journal of Primary Health Care & Family Medicine Pub Date : 2024-05-31 DOI: 10.4102/phcfm.v16i1.4440
Duncan Kwaitana, Dorothee Van Breevoort, Modai Mnenula, Kennedy Nkhoma, Richard Harding, Maya J Bates
{"title":"Improving person-centred care for older persons with serious multimorbidity in LMICs.","authors":"Duncan Kwaitana, Dorothee Van Breevoort, Modai Mnenula, Kennedy Nkhoma, Richard Harding, Maya J Bates","doi":"10.4102/phcfm.v16i1.4440","DOIUrl":"10.4102/phcfm.v16i1.4440","url":null,"abstract":"<p><strong>Background: </strong> Few interventions are documented to meet person-centred needs of older people with serious multimorbidity in low- and middle-income countries where access to palliative care is limited. Most of the care in these settings is delivered by primary care health workers.</p><p><strong>Aim: </strong> This study reports the development and acceptability testing of a communication skills training and mentorship intervention for primary health care workers in Malawi.</p><p><strong>Setting: </strong> This study was conducted at Mangochi District Hospital in the south-eastern region of Malawi.</p><p><strong>Methods: </strong> Twelve primary health care workers (four clinical officers and eight nurses) working in the primary care clinics received the intervention. The intervention was designed using modified nominal group technique, informed by stakeholder interviews and a theory of change workshop. Acceptability is reported from thematic analysis of a focus group discussion with primary health care workers who received the intervention using NVivo version 14.</p><p><strong>Results: </strong> Older persons with serious multi-morbidity and their caregivers identified a need for enhanced communication with their healthcare providers. This helped to inform the development of a communication training skills and mentorship intervention package based on the local best practice six-step Ask-Ask-Tell-Ask-Ask-Plan framework. Primary health care workers reported that the intervention supported person-centred communication and improved the quality of holistic assessments, although space, workload and availability of medication limited the implementation of person-centred communication.</p><p><strong>Conclusion: </strong> The Ask-Ask-Tell-Ask-Ask-Plan framework, supported person-centered communication and improved the quality of holistic assessment.Contribution: This intervention offers an affordable, local model for integrating person-centered palliative care in resource-limited primary healthcare settings.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e9"},"PeriodicalIF":2.0,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11151358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238494","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}
引用次数: 0
Determinants of sub-optimal glycemic control among patients enrolled in a medicine dispensing programme in KwaZulu-Natal: A cohort study, 2018-2021. 夸祖鲁-纳塔尔省参加配药计划的患者血糖控制未达理想状态的决定因素:2018-2021 年队列研究。
IF 2
African Journal of Primary Health Care & Family Medicine Pub Date : 2024-05-31 DOI: 10.4102/phcfm.v16i1.4336
Leigh C Johnston, Patrick Ngassa Piotie, Innocent Maposa, Sandhya Singh, Lazarus Kuonza, Alex De Voux
{"title":"Determinants of sub-optimal glycemic control among patients enrolled in a medicine dispensing programme in KwaZulu-Natal: A cohort study, 2018-2021.","authors":"Leigh C Johnston, Patrick Ngassa Piotie, Innocent Maposa, Sandhya Singh, Lazarus Kuonza, Alex De Voux","doi":"10.4102/phcfm.v16i1.4336","DOIUrl":"10.4102/phcfm.v16i1.4336","url":null,"abstract":"<p><strong>Background: </strong> The Central Chronic Medicines Dispensing and Distribution (CCMDD) programme facilitates clinically stable patients to collect their chronic medication from community-based pick-up points.</p><p><strong>Aim: </strong> We determined baseline glycaemic control and rates and predictors of becoming sub-optimally controlled for type 2 diabetes mellitus (T2DM) CCMDD-enrolled patients.</p><p><strong>Setting: </strong> The setting of the study was eThekwini, KwaZulu-Natal, South Africa.</p><p><strong>Methods: </strong> We performed a cohort study (April 2018- December 2021). We linked T2DM CCMDD-enrolled patients to glycated haemoglobin (HbA1c) data from the National Health Laboratory Service. We selected patients optimally controlled at their baseline HbA1c, with ≥ 1 repeat-test available. We used Kaplan-Meier analysis to assess survival rates and extended Cox regression to determine associations between time to sub-optimal control (HbA1c 7%) and predictors. Adjusted hazard ratios (aHRs), 95% confidence interval (CI), and p-values are reported.</p><p><strong>Results: </strong> Of the 41145 T2DM patients enrolled in the CCMDD programme, 7960 (19%) had a HbA1c result available. Twenty-seven percent (2147/7960) were optimally controlled at their baseline HbA1c. Of those controlled at baseline, 695 (32%) patients had a repeat test available, with 35% (242/695) changing to sub-optimal status. The HbA1c testing frequency as per national guidelines was associated with a lower hazard of sub-optimal glycaemic control (aHR: 0.46; 95% CI: 0.24-0.91; p-value = 0.024). Patients prescribed dual-therapy had a higher hazard of sub-optimal glycaemic control (aHR: 1.50; 95% CI: 1.16-1.95; p-value = 0.002) versus monotherapy.</p><p><strong>Conclusions: </strong> The HbA1c monitoring, in-line with testing frequency guidelines, is needed to alert the CCMDD programme of patients who become ineligible for enrolment. Patients receiving dual-therapy require special consideration.Contribution: Addressing identified shortfalls can assist programme implementation.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e12"},"PeriodicalIF":2.0,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11151363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238488","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}
引用次数: 0
Development and validation of a job aid: Tool to reduce infections in home-based stroke. 开发和验证工作辅助工具:减少居家卒中感染的工具。
IF 2
African Journal of Primary Health Care & Family Medicine Pub Date : 2024-05-06 DOI: 10.4102/phcfm.v16i1.4221
Violet K Chikanya, Sindiwe James
{"title":"Development and validation of a job aid: Tool to reduce infections in home-based stroke.","authors":"Violet K Chikanya, Sindiwe James","doi":"10.4102/phcfm.v16i1.4221","DOIUrl":"10.4102/phcfm.v16i1.4221","url":null,"abstract":"<p><strong>Background: </strong> Stroke patients who are discharged from hospital because of limited access to rehabilitation facilities are cared for by lay caregivers who at times have limited knowledge of infection prevention and control (IPC). User-friendly educational interventions can help bridge this knowledge gap and enhance safe care of these persons.</p><p><strong>Aim: </strong> To describe the development and validation of educational interventions for home-based stroke patients. The validation process enhanced the reliability and validity of the job aid resulting in standardised quality patient care of stroke patients.</p><p><strong>Setting: </strong> Mutasa district, Manicaland province, Zimbabwe.</p><p><strong>Methods: </strong> The systematic six steps in quality intervention development guided the development of the job aid. Graphic designers assisted with development of diagrams and annotations. A purposively selected eight-member panel of IPC expert reviewers was invited to validate the job aid using a standardised validation tool.</p><p><strong>Results: </strong> The panel agreed that the job aid's title, target group and media of instruction were adequately explained, and the background could be easily understood during practice. The content was approved with some modifications on the description of instructions to caregivers. Seven reviewers agreed that the materials used ensured understandability, acceptability, practicability and usability of the educational interventions by caregivers, and one reviewer was neutral in commenting effectiveness of the job aid.</p><p><strong>Conclusion: </strong> The developed job aid addressed knowledge barriers in IPC for caregivers, and the reviewers confirmed that the developed job aid was adequate for effective use by lay home-based caregivers.Contribution: Utilisation of this intervention standardises patient care practices.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e9"},"PeriodicalIF":2.0,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11151429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862677","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}
引用次数: 0
A psychological insight of Moroccan adults' immunisation behaviour towards emergency vaccines. 摩洛哥成年人对紧急疫苗免疫行为的心理分析。
IF 2
African Journal of Primary Health Care & Family Medicine Pub Date : 2024-05-03 DOI: 10.4102/phcfm.v16i1.4353
Nour El Houda Benkaddour, Hind Khalil, Asmae Lekfif, Naima Abda, Bouchra Oneib, Yassamine Bentata
{"title":"A psychological insight of Moroccan adults' immunisation behaviour towards emergency vaccines.","authors":"Nour El Houda Benkaddour, Hind Khalil, Asmae Lekfif, Naima Abda, Bouchra Oneib, Yassamine Bentata","doi":"10.4102/phcfm.v16i1.4353","DOIUrl":"10.4102/phcfm.v16i1.4353","url":null,"abstract":"<p><strong>Background: </strong>The psychology of vaccination behaviour explains how thoughts and feelings influence people's willingness to receive vaccines. Understanding vaccination behaviour is crucial to successfully managing vaccination campaigns.</p><p><strong>Aim: </strong>Investigating factors associated with immunisation stress among students at Mohammed First University.</p><p><strong>Setting: </strong>This study was conducted on students at Mohammed First University institutions.</p><p><strong>Methods: </strong>This study is a descriptive and analytical cross-sectional study. It was conducted on 305 students at Mohammed First University institutions using a 90-item questionnaire.</p><p><strong>Results: </strong>Three hundred and five participants have been included in this survey. Overall, 65.5% of the students in our sample had a positive perception towards COVID-19 vaccines. Nevertheless, 34.5% had a negative opinion regarding immunisation. According to the analysis of perceived stress scale, 40% (n = 122) of students expressed moderate to high stress regarding vaccination. Students with a negative perception of vaccine showed a higher level of stress than those with a positive one. Stressed students tended to be older than others, coming from other institutions, other than the medical faculty, and were renting alone. Vaccine accessibility was the less significant reason associated with stress regarding vaccination. Moreover, participants with high levels of confidence in social media, exhibited higher stress. Nevertheless, those who believed in scientific journals were significantly less stressed.</p><p><strong>Conclusion: </strong>These results reflect a positive perception and acceptance of vaccines, with a considerable level of stress regarding vaccination.Contribution: This study suggests emphasising the mental health of Moroccan young adults, to better sensitise and inform them about immunisation.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e10"},"PeriodicalIF":2.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11151418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872633","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}
引用次数: 0
Determinants of self-reported chronic disease diagnoses among older persons in South Africa. 南非老年人自我报告慢性病诊断的决定因素。
IF 2
African Journal of Primary Health Care & Family Medicine Pub Date : 2024-04-30 DOI: 10.4102/phcfm.v16i1.4425
Maatla D Temane, Stephina K Mbele, Mluleki Tsawe
{"title":"Determinants of self-reported chronic disease diagnoses among older persons in South Africa.","authors":"Maatla D Temane, Stephina K Mbele, Mluleki Tsawe","doi":"10.4102/phcfm.v16i1.4425","DOIUrl":"10.4102/phcfm.v16i1.4425","url":null,"abstract":"<p><strong>Background: </strong> Chronic diseases tend to affect the quality of life for older persons worldwide, especially in resource-constrained developing countries. Chronic diseases contribute to a large number of deaths among the population of South Africa.</p><p><strong>Aim: </strong> This study examines the determinants of self-reported chronic disease diagnoses among older persons in South Africa.</p><p><strong>Setting: </strong> The study setting was South Africa.</p><p><strong>Methods: </strong> Cross-sectional data from the 2019 South Africa General Household Survey were analysed (n [weighted] = 4 887 334). We fitted a binary logistic regression model to determine the relationship between socio-demographic factors and being diagnosed with self-reported chronic diseases.</p><p><strong>Results: </strong> We found that at least 5 in 10 older persons were diagnosed with self-reported chronic disease. The bivariate findings showed that age, population group, sex, marital status, level of education, disability status, household composition and province were significantly associated with self-reported chronic disease diagnoses. At the multivariate level, we found that age, sex, population group, marital status, educational level, disability status, household wealth status, household composition and province were key predictors of self-reported chronic disease diagnoses.</p><p><strong>Conclusion: </strong> We found that various factors were key determinants of being diagnosed with self-reported chronic diseases. This study offers important insights into the main correlations between older adults and self-reported chronic illness diagnoses. More study is required on the health of the elderly as it will help direct policy discussions and improve the development of health policies about the elderly.Contribution: This study highlights the need for a better understanding of, and continued research into, the determinants health among older populations to guide future healthcare strategies.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e9"},"PeriodicalIF":2.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11079353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865706","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}
引用次数: 0
Young women's social support networks during pregnancy in Soweto, South Africa. 南非索韦托年轻女性怀孕期间的社会支持网络。
IF 2
African Journal of Primary Health Care & Family Medicine Pub Date : 2024-04-29 DOI: 10.4102/phcfm.v16i1.4146
Khuthala Mabetha, Larske M Soepnel, Sonja Klingberg, Gugulethu Mabena, Molebogeng Motlhatlhedi, Shane A Norris, Catherine E Draper
{"title":"Young women's social support networks during pregnancy in Soweto, South Africa.","authors":"Khuthala Mabetha, Larske M Soepnel, Sonja Klingberg, Gugulethu Mabena, Molebogeng Motlhatlhedi, Shane A Norris, Catherine E Draper","doi":"10.4102/phcfm.v16i1.4146","DOIUrl":"10.4102/phcfm.v16i1.4146","url":null,"abstract":"<p><strong>Background: </strong>Although studies from high-income countries have examined social support during pregnancy, it remains unclear what type of support is received by expectant mothers from low- and middle-income country settings.</p><p><strong>Aim: </strong>To explore young women's social support networks during pregnancy in Soweto, South Africa.</p><p><strong>Setting: </strong>This study was undertaken in an academic hospital based in the Southwestern Townships (Soweto), Johannesburg, in Gauteng province, South Africa.</p><p><strong>Methods: </strong>An exploratory descriptive qualitative approach was employed. Eighteen (18) young pregnant women were recruited using a purposive sampling approach. In-depth interviews were conducted, and data were analysed using inductive thematic analysis.</p><p><strong>Results: </strong>Analysis of the data resulted in the development of two superordinate themes namely; (1) relationships during pregnancy and (2) network involvement. Involvement of the various social networks contributed greatly to the young women having a greater sense of potential parental efficacy and increased acceptance of their pregnancies. Pregnant women who receive sufficient social support from immediate networks have increased potential to embrace and give attention to pregnancy-related changes.</p><p><strong>Conclusion: </strong>Focusing on less-examined characteristics that could enhance pregnant women's health could help in the reduction of deaths that arise because of pregnancy complications and contribute in globally accelerating increased accessibility to adequate reproductive health.Contribution: This study's findings emphasise the necessity for policymakers and healthcare providers to educate the broader community about the importance of partner, family and peer support to minimise risks that may affect pregnancy care and wellbeing of mothers.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e11"},"PeriodicalIF":2.0,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11079395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869746","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}
引用次数: 0
Strengthening caesarean birth: Sub-Saharan Africa health system evaluation: Scoping review. 加强剖腹产:撒哈拉以南非洲卫生系统评估:范围界定审查。
IF 1.2
African Journal of Primary Health Care & Family Medicine Pub Date : 2024-04-29 DOI: 10.4102/phcfm.v16i1.4128
Patrick Minani, Andrew Ross
{"title":"Strengthening caesarean birth: Sub-Saharan Africa health system evaluation: Scoping review.","authors":"Patrick Minani, Andrew Ross","doi":"10.4102/phcfm.v16i1.4128","DOIUrl":"10.4102/phcfm.v16i1.4128","url":null,"abstract":"<p><strong>Background: </strong> Promoting safe caesarean birth (CB) is a challenge in sub-Saharan Africa (SSA) where maternal and neonatal mortality rates are high due to inadequate maternal health services. Although the CB rate in SSA is lower than the World Health Organization (WHO) recommendation, it is often associated with high maternal and neonatal mortality.</p><p><strong>Aim: </strong> The aim of this scoping review was to report on the extent to which SSA health systems deliver safe CB.</p><p><strong>Methods: </strong> A systematic search across various databases identified 53 relevant studies, comprising 30 quantitative, 10 qualitative and 16 mixed methods studies.</p><p><strong>Results: </strong> These studies focused on clinical protocols, training, availability, accreditation, staff credentialing, hospital supervision, support infrastructure, risk factors, surgical interventions and complications related to maternal mortality and stillbirth. CB rates in SSA varied significantly, ranging from less than 1% to a high rate of 29.7%. Both very low as well as high rates contributed to significant maternal and neonatal morbidity. Factors influencing maternal and perinatal mortality include poor referral systems, inadequate healthcare facilities, poor quality of CBs, inequalities in access to maternity care and affordable CB intervention.</p><p><strong>Conclusion: </strong> The inadequate distribution of healthcare facilities, and limited access to emergency obstetric care impacted the quality of CBs. Early access to quality maternity services with skilled providers is recommended to improve CB safety.Contributions: This scoping review contributes to the body of knowledge motivating for the prioritization of maternal service across SSA.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e11"},"PeriodicalIF":1.2,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11079335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867718","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}
引用次数: 0
Longitudinal integrated clerkships from start to finish: A medical curriculum innovation. 自始至终的纵向综合实习:医学课程创新。
IF 2
African Journal of Primary Health Care & Family Medicine Pub Date : 2024-04-27 DOI: 10.4102/phcfm.v16i1.4401
Julia Blitz, Ian Couper, Maryke Geldenhuys, Marina Klocke, Maria Van Zyl
{"title":"Longitudinal integrated clerkships from start to finish: A medical curriculum innovation.","authors":"Julia Blitz, Ian Couper, Maryke Geldenhuys, Marina Klocke, Maria Van Zyl","doi":"10.4102/phcfm.v16i1.4401","DOIUrl":"10.4102/phcfm.v16i1.4401","url":null,"abstract":"<p><p>Stellenbosch University embarked on a renewal of its MBChB programme guided by an updated set of core values developed by the multidisciplinary curriculum task team. These values acknowledged the important role of (among others) context and generalism in the development of our graduates as doctors of the future for South Africa. This report describes the overall direction of the renewed curriculum focusing on two of the innovative educational methods for Family Medicine and Primary Health Care training that enabled us to respond to these considerations. These innovations provide students with both early longitudinal clinical experience (now approximately 72 h per year for each of the first 3 years) and a final longitudinal capstone experience (36 weeks) outside the central tertiary teaching hospital. While the final year experience will run for the first time in 2027 (the first year launched in 2022), the initial experience has got off to a good start with students expressing the value that it brings to their integrated, holistic learning and their identity formation aligned with the mission statement of this renewed curriculum. These two curricular innovations were designed on sound educational principles, utilising contextually appropriate research and by aligning with the goals of the healthcare system in which our students would be trained. The first has created opportunities for students to develop a professional identity that is informed by a substantial and longitudinal primary healthcare experience.Contribution: The intention is to consolidate this in their final district-based experience under the supervision of specialist family physicians and generalist doctors.</p>","PeriodicalId":47037,"journal":{"name":"African Journal of Primary Health Care & Family Medicine","volume":"16 1","pages":"e1-e5"},"PeriodicalIF":2.0,"publicationDate":"2024-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11079352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872947","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}
引用次数: 0
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