THE INFLUENCE OF RELIGION IN THE UPTAKE OF MALE CIRCUMCISION AS AN HIV PREVENTION STRATEGY IN SWAZILAND

Circumcision has been practised for centuries among various groups of people world-wide, mainly for religious, traditional, hygienic or medical reasons. However, this practice was rare in Swaziland. Following recommendations by the World Health Organisation that circumcision should be added as an additional strategy for HIV prevention, the country embarked on mass male circumcision campaigns, aimed at scaling up the practice nationwide. Apparently the turnup for the procedure is below the set targets. Knowledge of factors that influence the uptake of circumcision is necessary in order to maximise the success of the strategy. This study aimed at assessing the influence of religion and/or culture on perception and hence uptake of circumcision in Swaziland. An explorative qualitative research design was used, in which in-depth face-toface interviews were conducted on seventeen participants individually. Results showed thatChristianity and African Traditional Religion are the dominant religions in Swaziland and each of them has both a negative and a positive influence on the perception of, and hence the decision to be, circumcised. This depended on the individuals’ interpretation and understanding of the doctrine of their religion or denomination. It was recommended that the identified positive influences be capitalised on to promote circumcision

The provision of Primary Health Care in two rural districts of the Eastern Cape Province with particular reference to human resources and accessibility - Part 2: The results and recommendations

Part 1 of this article dealt with the introduction, problem statement and the research methods. This article details the results and the recommendations with the aim of improving the provision of primary health care in rural districts of the Eastern Cape Province. This article is dealt with in three phases: phase I gives the results of interviews of community people, phase II deals with the results of the questionnaire administered to professional nurses and phase III entails the recommendations

The provision of Primary Health Care in two rural districts of the Eastern Cape Province with particular reference to human resources and accessibility

The provision of Primary Health Care Services (PHC) is still a problem in developing countries like South Africa. In other countries, one finds enough human resources whilst in other countries there may be enough material resources. A both qualitative and quantitative research was conducted at Mqanduli and part of the Eastern Elliotdale districts in the Eastern Cape Province with the aim of investigating the provision of Primary health Care Services, reference was made to the availability of human resources and accessibility of PHC services

Outcomes of self-induced late pregnancy termination in women presenting to a tertiary hospital in the Eastern Cape Province, South Africa

Background. Little is known about the outcomes of self-induced pregnancy termination after 24 weeks’ gestation, as previous studies have concentrated on outcomes before 24 weeks.Objectives. To investigate the gestational age, misoprostol dosage, source of information on misoprostol, reasons for termination and outcomes of self-induced pregnancy termination after 24 weeks’ gestation.Methods. A quantitative, retrospective case series observational research design was utilised. Paediatric case summaries and the Perinatal Problem Identification Programme were used to collect data. Cases of self-induced pregnancy termination using misoprostol after 24 weeks’ gestation treated at a tertiary hospital in the Eastern Cape Province, South Africa, during the period 1 July 2011 - 1 January 2012 were identified and included in the study. Frequencies and proportions were used to analyse data.Results. Eighteen known cases of self-induced pregnancy termination using misoprostol after 24 weeks’ gestation were treated at the hospital during the 6-month study period. Misoprostol doses ranged from 400 to 1 200 μg. Birth weight was <500 g in 1 case (6%), 500 - 1499 g in 12 (67%), 1 500 - 1 999 g in 2 (11%), >2 500 g in 1 (6%) and unknown in 1 (6%). Eleven of the babies (67%) were born alive and 5 (28%) were stillborn (1 further stillbirth (6%) was classified as an abortion, <500 g). One baby (6%) survived, and in 1 case (6%) the pregnancy continued. Eight of the 10 neonatal deaths were early and 2 were late. The major cause of neonatal death was hyaline membrane disease (n=8, 44%). Other causes were hypoxia (n=2), septicaemia (n=2), necrotising enterocolitis (n=2), pulmonary haemorrhage (n=2) and intraventricular haemorrhage (n=2). More than one cause applied in some cases. The maternal complications were manual removal of the placenta (n=2, 11%), ruptured uterus (n=1, 6%), and anaemia with blood transfusion (n=1, 6%).Conclusions. Self-administration of misoprostol to induce pregnancy termination after 24 weeks’ gestation contributes to preterm births and perinatal morbidity and mortality. The findings of this study show that there is a need to educate women on the perinatal and maternal risks associated with self-induced pregnancy termination at a late stage of gestation, availability of safe options for pregnancy termination, and contraceptive use and adherence. Healthcare workers need to be sensitive to the possibility that cases of apparent spontaneous preterm labour or birth may have been self-induced