Exploring re-alignment of social welfare services as an enhancement of service delivery at municipal levels: a case study of uMgungundlovu District Municipality.

Masters Degree. University of KwaZulu-Natal, Durban.This study aims at exploring the social workers’ understanding of the re-alignment of social welfare services as an enhancement of service delivery at the local municipal level. The study was undertaken in both rural and urban areas of Midlands, a part of the KwaZulu-Natal Province, under uMgungundlovu District Municipality, specifically at Impendle, Mkhambathini, Msunduzi and Howick service offices. The qualitative approach was applied for its use of the case study design and its descriptive nature. The purposive sampling method was used to select twelve social workers comprising ten females and two males. Data were collected through semi-structured interviews that were audio-recorded. The thematic analysis approach was used to analyse the data transcribed from the interviews. The theoretical framework that guided this study drew from the Structural Social Work Theory. The findings of this study, in relation to the objectives of the study, revealed that the interviewed social workers understood the crises that were created by the Apartheid regime. These involve the segregation of the majority of Black South Africans, depriving them of the basic services and the means of economic production and as such, the establishment of the re-alignment process sought to redress those social imbalances and injustices. The social workers who participated in the study reported the huge success made by the State, with the Department of Social Development responsible for enhancement of the citizenry’s access to social services as well as fostering the community’s awareness of the available services. The participants reported experiencing some challenges concerning supervision, reports demands and shortage of resources. Furthermore, an ineffective communication approach as well as social workers’ exclusion from the decision–making process reportedly posed challenges to the current welfare system in South Africa. Lastly, and on a positive note, the social workers found the pieces of legislation and policies put in place by the State as assisting them to continue adapting to the process of re-alignment. The recommendations regarding the strengthening and enhancement of service delivery at the local municipal level were made

Mixed-methods cross-sectional study of the prevention of vertical HIV transmission program users unaware of male partner’s HIV status, in six South African districts with a high antenatal HIV burden

DATA AVAILABILITY : The dataset is still being analyzed by the primary research team. Anyone needing to access the data should e-mail [email protected] for quantitative data or [email protected] for qualitative data and qualitative methodology. Any data sharing will be by individual request, and in consultation with researchers currently analyzing the data.SUPPLEMENTARY INFORMATION : ADDITIONAL FILE 1: COREQ Checklist for Qualitative Study ADDITIONAL FILE 2: Option B+ FGDs inclusion criteriaBACKGROUND : Elimination of vertical HIV Transmission (VHT) and maternal deaths are global health priorities. Male involvement is one of the most important factors that influences women’s decisions, including the uptake of Prevention of vertical HIV transmission (P-VHT). We sought to understand not knowing a male partner’s HIV status (MPHIVs) amongst women using services to prevent vertical HIV transmission in six South African districts with high antenatal HIV burden. METHODS : A mixed-methods cross-sectional study was conducted in six South African districts, and data collected through face-to-face interviews with women and focus group discussions (FGDs) with women or male partners. The quantitative data were analyzed using STATA SE-17.0 and an inductive approach was used for qualitative data analysis. RESULTS : Overall, 28.7% of women were unaware of their MPHIVs, while 25.3% and 46.0% knew the MPHIVs was positive or negative, respectively. In multivariable logistic regression, single marital status and unplanned pregnancy increased the odds of not knowing a MPHIVs while a woman’s disclosure of her HIV status to the male partner reduced the odds. FDGs highlighted complexities around MPHIVs disclosure, e.g., reluctance to test for HIV and potential interventions including healthcare worker (HCW) assisted HIV disclosure. CONCLUSION : User-informed interventions to address MPHIVs non-disclosure amongst women of child-bearing age, particularly those at risk of unstable sexual partners and unplanned pregnancies, should be strengthened.The President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention (CDC); a Ford Foundation Fellowship, administered by the National Academies of Sciences, Engineering, and Medicine, a PEO Scholar Award from the PEO Sisterhood, and NIMH R36MH127838.https://bmcpublichealth.biomedcentral.comam2024Paediatrics and Child HealthSDG-03:Good heatlh and well-bein

Additional file 1 of Mixed-methods cross-sectional study of the prevention of vertical HIV transmission program users unaware of male partner’s HIV status, in six South African districts with a high antenatal HIV burden

Additional file 1: COREQ Checklist for Qualitative Stud

Safety, uptake, and use of a dapivirine vaginal ring for HIV-1 prevention in African women (HOPE): an open-label, extension study

BackgroundTwo phase 3 clinical trials showed that use of a monthly vaginal ring containing 25 mg dapivirine was well tolerated and reduced HIV-1 incidence in women by approximately 30% compared with placebo. We aimed to evaluate use and safety of the dapivirine vaginal ring (DVR) in open-label settings with high background rates of HIV-1 infection, an important step for future implementation.MethodsWe did a phase 3B open-label extension trial of the DVR (MTN-025/HIV Open-label Prevention Extension [HOPE]). Women who were HIV-1-negative and had participated in the MTN-020/ASPIRE phase 3 trial were offered 12 months of access to the DVR at 14 clinical research centres in Malawi, South Africa, Uganda, and Zimbabwe. At each visit (monthly for 3 months, then once every 3 months), women chose whether or not to accept the offer of the ring. Used, returned rings were tested for residual amounts of dapivirine as a surrogate marker for adherence. HIV-1 serological testing was done at each visit. Dapivirine amounts in returned rings and HIV-1 incidence were compared with data from the ASPIRE trial, and safety was assessed. This study is registered with ClinicalTrials.gov, NCT02858037.FindingsBetween July 16, 2016, and Oct 10, 2018, of 1756 women assessed for eligibility, 1456 were enrolled and participated in the study. Median age was 31 years (IQR 27-37). At baseline, 1342 (92·2%) women chose to take the DVR; ring acceptance was more than 79% at each visit up until 12 months and 936 (73·2%) of 1279 chose to take the ring at all visits. 12 530 (89·3%) of 14 034 returned rings had residual dapivirine amounts consistent with some use during the previous month (>0·9 mg released) and the mean dapivirine amount released was greater than in the ASPIRE trial (by 0·21 mg; p<0·0001). HIV-1 incidence was 2·7 per 100 person-years (95% CI 1·9-3·8, 35 infections), compared with an expected incidence of 4·4 per 100 person-years (3·2-5·8) among a population matched on age, site, and presence of a sexually transmitted infection from the placebo group of ASPIRE. No serious adverse events or grade 3 or higher adverse events observed were assessed as related to the DVR.InterpretationHigh uptake and persistent use in this open-label extension study support the DVR as an HIV-1 prevention option for women. With an increasing number of HIV-1 prophylaxis choices on the horizon, these results suggest that the DVR will be an acceptable and practical option for women in Africa.FundingThe Microbicide Trials Network and the National Institute of Allergy and Infectious Diseases, The Eunice Kennedy Shriver National Institute of Child Health and Human Development, and the National Institute of Mental Health, all components of the US National Institutes of Health