Last mile cold chain distribution challenges for privately-owned and retail pharmacies in Auckland Park and surrounding areas, Johannesburg

Abstract: Research objective: The primary research objective was to determine the challenges prevailing in the last mile distribution of cold chain medication to privately-owned and retail pharmacies in Auckland Park and surrounding areas. Methodology: A positivist research philosophy guided a descriptive quantitative survey design. Structured questionnaires were hand-delivered to all 43 privately-owned and retail pharmacies in the Auckland Park and surrounding areas. Findings: Some discrepancies were found in the cold chain distribution process that could compromise the quality of the cold chain medication. Although these pharmacies mostly used the correct storage systems for cold chain medication within the specified temperature range, the appropriate mode of transportation for delivery to the pharmacy is questionable..

Midwives’ perceptions of skin-to-skin contact between the mother and baby after birth in selected rural primary healthcare facilities in Schoonoord, Limpopo province, South Africa

The implementation of skin-to-skin contact between the mother and baby immediately after birth is associated with the successful initiation of exclusive breastfeeding. Midwives have the responsibility to promote and support breastfeeding and ensure that the mother and baby are in a satisfactory condition. The purpose of the study was to explore and describe the perceptions of midwives regarding the implementation of skin-to-skin contact between the mother and baby after birth in selected primary health care facilities in Schoonoord, Makhuduthamaga Sub-district of the Limpopo province, South Africa. This study employed a qualitative, exploratory and descriptive approach to understand the perceptions of midwives with regards to implementation of skin-to-skin contact between the mother and baby after birth. Face-to-face individual interviews were used to collect data and Tesch’s method of data analysis was applied to analyse data. Three themes emanated from the study, namely: awareness about skin-to-skin benefits, facilitating factors for successful implementation of skin-to-skin and perceived barriers to the practice of skin-to-skin during birth. This study recommends that on-going education and unitbased in-service training for mother-baby friendly practices should be established and strengthened. Furthermore, a model of support for mother-friendly care amongst midwives in primary healthcare facilities should be developed.http://journals.co.za/content/journal/ajpherd1am2019Nursing Scienc

Nurses’ attitudes towards the implementation of the Mother-Baby Friendly Initiative in selected primary healthcare facilities at Makhuduthamaga Municipality, Limpopo province

Background: The implementation of the Mother-Baby Friendly Initiative (MBFI) strategy demonstrated its capabilities to improve global children’s health and maternal survival. However, its implementation in primary healthcare (PHC) facilities remains a challenge as many nurses are reluctant to adopt it for the improvement of child and maternal healthcare services in their respective clinics. Objectives: The primary objective of this study was to determine the attitudes of nurses towards the implementation of the MBFI in selected PHC facilities in the Makhuduthamaga Municipality, Limpopo province. Method: This study used a quantitative, descriptive design, and all respondents were conveniently sampled. A self-administered questionnaire was used to collect data. One-hundred and seventy-seven questionnaires were distributed, and 153 nurses responded and completed the questionnaire. The Statistical Package for Social Sciences version 23 was used to analyse data. Results: Results show that the majority of nurses (professional nurses [PNs] = 65, 78%; enrolled nurses [ENs] = 18, 72%; enrolled nursing auxiliaries [ENAs] = 23, 51%) had a positive attitude towards the MBFI strategy implementation as they agreed that it increased breastfeeding rates. Most PNs (n = 58, 70%) and ENs (n = 15, 60%) showed positive attitudes towards exclusive breastfeeding (EBF) as they agreed that it was the ideal feeding option for any child, and most ENAs (n = 38, 84%) showed a negative attitude as they disagreed that EBF was the ideal feeding option for any child. Conclusion: In this study, most PNs and ENs had a positive attitude in all the aspects that determined their attitudes towards MBFI strategy implementation. A concern is the fact that most ENAs showed negative attitudes in almost all the statements that were in line with the principles of MBFI, as they disagreed in most aspects. Therefore, this study recommends that on-going orientation and trainings should be offered to all nurses including ENAs to equip them with information that can assist in changing their attitudes towards MBFI implementation in PHC facilities

Sentinel seroprevalence of SARS-CoV-2 in Gauteng Province, South Africa, August - October 2020

Background. Estimates of prevalence of anti-SARS-CoV-2 antibody positivity (seroprevalence) for tracking the COVID-19 epidemic are lacking for most African countries.Objectives. To determine the prevalence of antibodies against SARS-CoV-2 in a sentinel cohort of patient samples received for routine testing at tertiary laboratories in Johannesburg, South Africa.Methods. This sentinel study was conducted using remnant serum samples received at three National Health Laboratory Service laboratories in the City of Johannesburg (CoJ) district. Collection was from 1 August to 31 October 2020. We extracted accompanying laboratory results for glycated haemoglobin (HbA1c), creatinine, HIV, viral load and CD4 T-cell count. An anti-SARS-CoV-2 targeting the nucleocapsid (N) protein of the coronavirus with higher affinity for IgM and IgG antibodies was used. We reported crude as well as population-weighted and test-adjusted seroprevalence. Multivariate logistic regression analysis was used to determine whether age, sex, HIV and diabetic status were associated with increased risk for seropositivity.Results. A total of 6 477 samples were analysed, the majority (n=5 290) from the CoJ region. After excluding samples with no age or sex stated, the model population-weighted and test-adjusted seroprevalence for the CoJ (n=4 393) was 27.0% (95% confidence interval (CI) 25.4 - 28.6). Seroprevalence was highest in those aged 45 - 49 years (29.8%; 95% CI 25.5 - 35.0) and in those from the most densely populated areas of the CoJ. Risk for seropositivity was highest in those aged 18 - 49 years (adjusted odds ratio (aOR) 1.52; 95% CI 1.13 - 2.13; p=0.0005) and in samples from diabetics (aOR 1.36; 95% CI 1.13 - 1.63; p=0.001).Conclusions. Our study conducted between the first and second waves of the pandemic shows high levels of current infection among patients attending public health facilities in Gauteng Province

Fostering gender equality and alternatives to violence: perspectives on a gender-transformative community mobilisation programme in rural South Africa

Gender-based violence and violence against children are significant problems in South Africa. Community mobilisation and gender-transformative programming are promising approaches to address and reduce violence. A quantitative evaluation of One Man Can, a gender-transformative community mobilisation programme in South Africa, found mixed results in increasing gender-equitable behaviours and reducing violence. To better understand these findings, we analyse longitudinal qualitative data from community mobilisers, community members and community action teams, exploring individual and community-level factors that facilitate and hinder change. Interviews and focus groups were transcribed and analysed. Participants self-reported changes in their gender-equitable attitudes and use of violence as a result of participation in the programme, although some participants also reported opposition to shifting to a more gender-equitable culture. Facilitators to change included the internalisation of gender-transformative messaging and supportive social networks, which was buoyed by a shared vocabulary in their community generated by One Man Can. Because the programme targeted a critical mass of community members with gender-transformative programming, mobilisers and community action teams were held accountable by community members to model non-violent behaviour. Results reinforce the importance of addressing facilitators and barriers to change at both individual and community levels

Impact of South Africa’s April 2022 floods on women and men’s lives and gender relations in low-income communities: A qualitative study

This is the final version. Available on open access from Elsevier via the DOI in this recordIn 2022, South Africa faced devastating flooding which resulted in the loss of at least 425 lives and widescale destruction of property. Using qualitative methods, we describe the gendered impact of the floods on homes and lives of women and men from very low-income housing areas. We conducted 16 in-depth interviews with women, and eight single-sex narrative group discussions and with 35 women and 15 men from flood-affected areas. The women were research participants in a project that commenced prior to the floods, and the men were recruited for this study. The floods were described by many as ‘heart-breaking’, as neighbouring homes collapsed, children were swept away, and people known to them lost their lives. However, other participants asserted that the floods ‘didn’t affect them much’, before describing considerable, impact on their houses, families, possessions, neighbourhoods, jobs, and other aspects of their lives. After the initial struggle to secure their homes, and rescue family and possessions from the floods, participants were faced with extensive interruption to water supply and electricity, which severely exacerbated stress, especially for women. We describe how the impact of the flooding unfolded and largely followed the contours of gender relations, rather than disrupting them. Most women did not describe violence against women (VAW) as escalating after the floods, but for those who did, the pathway followed the impact of the floods on men’s access to the central tenets of successful masculinity, notably the provider/protector role, and lashing out response. Participants also emphasised that their lives continued much as before once the immediate aftermath of floods was past, and in so doing demonstrated significant resilience, which is not described in existing models of disaster impact on VAW.South African Medical Research Counci

Challenges and opportunities in coproduction: reflections on working with young people to develop an intervention to prevent violence in informal settlements in South Africa

This is the final version. Available on open access from BMJ Publishing Group via the DOI in this recordData availability statement: No data are available. Not applicable.Coproduction is widely recognised as essential to the development of effective and sustainable complex health interventions. Through involving potential end users in the design of interventions, coproduction provides a means of challenging power relations and ensuring the intervention being implemented accurately reflects lived experiences. Yet, how do we ensure that coproduction delivers on this promise? What methods or techniques can we use to challenge power relations and ensure interventions are both more effective and sustainable in the longer term? To answer these questions, we openly reflect on the coproduction process used as part of Siyaphambili Youth (‘Youth Moving Forward’), a 3-year project to create an intervention to address the social contextual factors that create syndemics of health risks for young people living in informal settlements in KwaZulu-Natal province in South Africa. We identify four methods or techniques that may help improve the methodological practice of coproduction: (1) building trust through small group work with similar individuals, opportunities for distance from the research topic and mutual exchanges about lived experiences; (2) strengthening research capacity by involving end users in the interpretation of data and explaining research concepts in a way that is meaningful to them; (3) embracing conflicts that arise between researchers’ perspectives and those of people with lived experiences; and (4) challenging research epistemologies through creating spaces for constant reflection by the research team. These methods are not a magic chalice of codeveloping complex health interventions, but rather an invitation for a wider conversation that moves beyond a set of principles to interrogate what works in coproduction practice. In order to move the conversation forward, we suggest that coproduction needs to be seen as its own complex intervention, with research teams as potential beneficiaries.Medical Research Council (MRC

Men’s perceptions of treatment as prevention in South Africa: Implications for engagement in HIV care and treatment

While South Africa provides universal access to treatment, HIV testing and antiretroviral therapy (ART) uptake remains low, particularly among men. Little is known about community awareness of the effects of treatment on preventing transmission, and how this information might impact HIV service utilization. This qualitative study explored understandings of treatment as prevention (TasP) among rural South African men. Narratives emphasized the known value of ART for individual health, but none were aware of its preventive effects. Many expressed that preventing transmission to partners would incentivize testing, earlier treatment, and adherence in the absence of symptoms, and could reduce the weight of a diagnosis. Doubts about TasP impacts on testing and care included enduring risks of stigma and transmission. TasP information should be integrated into clinic-based counseling for those utilizing services, and community-based education for broader reach. Pairing TasP information with alternative testing options may increase engagement among men reluctant to be seen at clinics