Scielo RSS <![CDATA[African Journal of Primary Health Care & Family Medicine ]]> http://www.scielo.org.za/rss.php?pid=2071-293620210001&lang=pt vol. 13 num. 1 lang. pt <![CDATA[SciELO Logo]]> http://www.scielo.org.za/img/en/fbpelogp.gif http://www.scielo.org.za <![CDATA[<b>Training and assessing undergraduate medical students' research: Learning, engagement and experiences of students and staff</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100001&lng=pt&nrm=iso&tlng=pt BACKGROUND: The development of research skills is an important aspect of undergraduate medical training that facilitates the practice of evidence-based medicine. The inclusion of research training into undergraduate medical curricula can take various formats and is compulsory for all students at the Nelson R. Mandela School of Medicine (NRMSM). The evaluation of this training is important, both to ensure that students obtain the required research skills and to improve the quality of the training. AIM: The aim of this study was to evaluate undergraduate medical students' and staff learning, engagement and experiences in the training and assessment of third-year research projects. SETTING: This research was conducted at NRMSM, South Africa. METHODS: Questionnaires were administered to third-year medical students after they completed their research project poster presentations and to the staff who assessed the presentations. Responses to the learning process, group work, alignment between module outcomes and assessment and the benefits of poster presentations were assessed. RESULTS: A total of 215 students and 10 staff completed the questionnaire. Many students reported having enjoyed learning about research (78%) and that the training activities facilitated their understanding of the research process (84%). The majority of students (86%) and staff (80%) perceived the posters as an effective way to demonstrate students' ability to collect, analyse and interpret data. CONCLUSION: Staff and students viewed the research process positively and reported that the poster presentations were an effective way to assess research. <![CDATA[<b>The value proposition of efficiency discount options: The government employees medical scheme emerald value option case study</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100002&lng=pt&nrm=iso&tlng=pt BACKGROUND: The Government Employees Medical Scheme (GEMS) introduced an EDO named the Emerald Value Option (EVO) in January 2017. The option was introduced to contain the cost of care whilst simultaneously improving the quality of care by championing care coordination. AIM: This study aimed to assess the impact of introducing an EDO such as EVO as a cost-containment strategy using contracted provider networks and coordinated care. SETTING: The study was conducted using aggregated data from GEMS. Government Employees Medical Scheme is a restricted medical scheme available to government employees in South Africa. METHODS: This is a descriptive pairwise comparison study between the Emerald benefit option (the parent option), which does not have embedded care coordination, and its derivative, EVO. RESULTS: Membership and claims data for 2018 were analysed. Expenditure per life per month in 2018 on the EVO amounts to R1357.01. After adjusting for the risk profile of beneficiaries on the EVO, expenditure per life per month would be expected to be R1621.73 (based on the conventional Emerald option). This translates to a savings of 16.3%. Similarly, health outcomes for EVO were more favourable than expected, actual admission rates were lower at 23.2% versus 26.2% expected CONCLUSIONS: The EVO benefit design has succeeded in lowering the cost of care through network provider contracting and care coordination. The EVO has saved approximately R490 million in healthcare costs in 2018. If applied across the medical schemes industry, it is estimated that EVO contracting, and care coordination principles could save R20 billion per annum. <![CDATA[<b>Healthcare professionals' perceptions of community-based rehabilitation in KwaZulu-Natal, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100003&lng=pt&nrm=iso&tlng=pt BACKGROUND: People with disabilities (PWDs) continue to experience challenges with access to healthcare. Community-based rehabilitation (CBR) is an approach that advocates for equal opportunities and social inclusion of PWDs to enhance their quality of daily life. Healthcare professionals are crucial in the implementation of CBR. However, little is known about the perception of healthcare professionals on this approach to rehabilitation in South Africa. AIM: This study sought to explore perceptions of healthcare professionals on CBR in the province of KwaZulu-Natal, South Africa. SETTING: This study was located across four public healthcare facilities spanning districts to tertiary levels care in KwaZulu-Natal, situated in rural and peri-urban areas. METHODS: An explorative qualitative approach using focus group discussions was used to collect data from healthcare professionals employed at these public hospitals in the province. Twenty-five healthcare workers participated in four focus group discussions, with four to eight participants per group. Data were transcribed and analysed using thematic analysis. RESULTS: The findings revealed four dominant themes, namely, the CBR conundrum, CBR enablers, perceived impediments to CBR implementation and a proposal for the implementation of CBR. CONCLUSION: Continual promotion of, as well as education and training on, CBR for healthcare professionals, was understood as an imperative for the development and roll-out of CBR programmes in South African communities. Excellent communication about CBR programmes was described as key to ensuring social inclusion, quality of life and access to services for PWDs. <![CDATA[<b>'It kinda sucks': Illness perception of a group of South African adolescents with type 1 diabetes mellitus</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100004&lng=pt&nrm=iso&tlng=pt BACKGROUND: Living with diabetes is challenging, especially for adolescents at risk of poor glycaemic control. Understanding the illness perceptions of this group is important to be able to develop interventions for this growing population in need. AIM: This study explored the illness perception amongst adolescents living with type 1 diabetes (T1D) and how these perceptions interacted with the management of T1D. SETTING: This study was conducted at a medical centre providing care for adolescents living with T1D in Parktown, South Africa. METHODS: A qualitative, explorative design with semi-structured interviews was followed. A non-random purposive sampling method was utilised. The illness perception amongst eight adolescents, aged 12-18 years, at risk of poor glycaemic control, was analysed through thematic analysis. RESULTS: Two subthemes related to illness perception were generated, namely (1) illness perception of T1D is negative and (2) living with T1D leads to a sense of being different. Furthermore, two subthemes were generated in relation to how illness perceptions interacted with diabetes management, namely (3) management of T1D is challenging and (4) management of T1D is motivated by fear. CONCLUSION: This group of adolescents with at-risk glycaemic control believed that T1D is difficult to manage, leading to a largely negative perception of the disease. This study contributes to the body of literature on adolescents where illness perception may play a role in adhering to diabetes care plans. This research may give additional insights into the awareness of illness perception in designing successful interventions. <![CDATA[<b>Perceptions of strategies to facilitate caring for patients in primary health care clinics</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100005&lng=pt&nrm=iso&tlng=pt BACKGROUND: Caring in nursing helps patients feel better, whilst the absence of caring will affect patients psychologically, emotionally and physically. AIM: The aim of this article was to explore and describe primary health care (PHC) professional nurses' and PHC nurse managers' perceptions of the developed strategies to facilitate effective caring for patients in PHC clinics. SETTING: This study was conducted in two PHC clinics in Ekurhuleni, an area east of the Gauteng province, South Africa. METHODS: The study used a qualitative, exploratory, descriptive and contextual design. In-depth individual phenomenological interviews were conducted with eight purposively selected PHC professional nurses working in PHC clinics and two PHC nurse managers supervising PHC clinics in Ekurhuleni. Giorgi's coding method was used to analyse the data. RESULTS: Three themes were identified from the results of the exploration and description of PHC professional nurses' and PHC nurse managers' perceptions of the developed strategies. The use of active listening skills, showing interest in what is being said, asking questions and providing constructive feedback that focuses on the issue were the most effective strategies in improving effective communication between PHC nurse managers and PHC professional nurses. The PHC professional nurses were encouraged to put patients' interests first whilst adhering to the ethical principles of nursing. CONCLUSION: Although caring is considered as the core of nursing practice, PHC professional nurses and PHC nurse managers perceive that rendering effective caring for patients needs to be reinforced through the use of strategies that will enable change and improve clinical practice in PHC clinics. <![CDATA[<b>Adolescent human immunodeficiency virus self-management: Needs of adolescents in the Eastern Cape</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100006&lng=pt&nrm=iso&tlng=pt BACKGROUND: Human immunodeficiency virus (HIV) is a chronic illness and adolescents living with HIV (ALHIV) need the support of the whole family to self-manage (handle, direct and control) their chronic illness. Little is known about self-management amongst ALHIV in the context of the Eastern Cape, South Africa. AIM: This study explored the self-management needs of ALHIV in the Nelson Mandela Bay area of the Eastern Cape to make recommendations that can be used in further research to develop a programme to support adolescents with self-management. SETTING: The study was conducted at two primary healthcare clinics in the Nelson Mandela Bay area of the Eastern Cape. METHODS: A qualitative descriptive design was applied. Thirteen adolescents between the age of 14 and 19 years were interviewed. The data were collected through individual interviews. Data analysis was done using the six steps described by Creswell. RESULTS: Adolescents living with HIV have limited knowledge and understanding about HIV and sexual reproductive health. Some ALHIV lack self-regulation skills related to decisions about disclosure, managing stigma and emotions, taking treatment, effective communication and setting goals. Human immunodeficiency virus services were not adolescent-friendly, with long queues and no dedicated services for adolescents. Family and friends were a key self-management resource for ALHIV. CONCLUSION: Adolescents living with HIV have several self-management needs in the domains of knowledge and beliefs, self-regulation skills and abilities, and self-management resources. Healthcare workers should support adolescents and their caregivers to acquire self-management skills as this may lead to better treatment and health outcomes. <![CDATA[<b>Barriers and opportunities to using health information in policy implementation: The case of adolescent and youth friendly health services in the Western Cape</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100007&lng=pt&nrm=iso&tlng=pt BACKGROUND: The production, use and exchange of health information is an essential part of the health services, as it is used to inform daily decision-making and to develop new policies, guidelines and programmes. However, there is little insight into how health care workers (HCWs) get access to and use health information when implementing new health programmes. AIM: This study explored the multifaceted role of health information within policy implementation processes and aimed to understand the complexities experienced by HCWs who need to develop adolescent health profiles (AHPs), a criterion of implementing a larger Adolescent and Youth Friendly Services Programme (AYFSP). SETTING: This case study was undertaken in Gugulethu, a peri-urban, low-income neighbourhood in Cape Town, South Africa. METHODS: Data were collected through ethnographic qualitative methods, including participant observation, interviews and workshops, and 15 participants were enrolled for this purpose. RESULTS: Findings showed that HCWs experienced different barriers when accessing information to develop the AHPs, including a lack of access to databases, a lack of support and inadequate guidelines. Nevertheless, HCWs were resourceful in using informal information and building strategic relationships to navigate and gain access to the necessary data to develop AHPs. CONCLUSION: This case study provided insights into the practical difficulties and innovative strategies which arise when HCWs attempt to access and use health information within a real-life health programme. Findings highlighted the need for more training, support and guidance for HCWs to improve the meaningful use of health information during policy implementation processes and to strengthen health services in South African primary care clinics. <![CDATA[<b>Prevalence and correlates of hazardous, harmful or dependent alcohol use and drug use amongst persons 15 years and older in South Africa: Results of a national survey in 2017</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100008&lng=pt&nrm=iso&tlng=pt BACKGROUND: Harmful alcohol and illicit drug use significantly contribute the burden of disease. AIM: This study aimed to assess the prevalence and correlates of hazardous, harmful or dependent alcohol (HHDA) use and drug use amongst persons 15 years and older in South Africa. SETTING: Population-based survey. METHOD: In a national cross-sectional 2017 survey, 39 210 persons 15 years and older (Median = 34 years) responded to a questionnaire on substance and health variables. The prevalence of HHDA use was 10.3% and past 3-month drug use 8.6%. RESULTS: In adjusted logistic regression analysis, men of middle age (25-34 year olds) with higher education, urban residence, drug use and psychological distress were positively associated and Indian or Asian and white population groups were negatively associated with HHDA. Women of middle age (25-34 year old) and mixed race, residing on rural farms and urban areas, with drug use and psychological distress were positively associated and older age (55 years and older) and Indians or Asians were negatively associated with HHDA. In adjusted logistic regression analysis, men, having Grade 8-11 education, mixed race, being unemployed, and the HHDA used were positively associated and middle and older age (25 years and older) and being a student or learner were negatively associated with past 3-month any drug use. Women, who were mixed race, Indians or Asians, with the HHDA use were positively associated and older age (45 years and older) were negatively associated with the past 3-month drug use. CONCLUSION: About one in 10 participants with several sociodemographic and health indicators was identified to be associated with HHDA and any drug use. <![CDATA[<b>Suboptimal control for patients with type 2 diabetes in the Central Chronic Medicine Dispensing programme in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100009&lng=pt&nrm=iso&tlng=pt BACKGROUND: In South Africa, the Central Chronic Medicine Dispensing and Distribution (CCMDD) programme allows stable patients with non-communicable diseases, including type 2 diabetes mellitus (T2DM), to collect their medication from a pick-up location near their home, thus avoiding long waiting times and travel expenses. The CCMDD programme aims at improving patient retention and adherence through better access to medicines, resulting in better health outcomes. AIM: We assessed whether patients with T2DM enrolled in CCMDD achieved the recommended targets for glycaemic, blood pressure (BP) and lipid control. SETTING: City of Tshwane, South Africa. METHODS: We reviewed the records of 198 T2DM patients enrolled in CCMDD and assessed their control of haemoglobin A1c (HbA1c), BP and lipids. RESULTS: Most of the records reviewed belonged to women (64.7%), African (89.9%), hypertensive (82.7%) and to patients exclusively on oral antidiabetic agents (98.5%). Patients were, on average, 57.7 (s.d. = 12.1) years old and had participated in the CCMDD programme for, on average, 2 years. The mean HbA1c was 8% (s.d. = 2). Glycaemic control was achieved by only 29.2% of patients, and 49% of patients had HbA1c between 7% and 9%. Ninety-three patients (66%) had achieved the total cholesterol target, 57.4% achieved BP targets and 6.9% had achieved the low-density lipoprotein cholesterol target. CONCLUSION: A small group of patients achieved the targets for glycaemic, BP and lipid control. Despite improved accessibility to medication, the CCMDD is not synonymous of improved clinical outcomes. Future research should ascertain the factors associated with suboptimal control for these patients. <![CDATA[<b>An ethnographic study exploring the experiences of patients living with cancer illness in support group settings in KwaZulu-Natal, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100010&lng=pt&nrm=iso&tlng=pt BACKGROUND: The major strength of support groups stems from their ability to help patients manage their health within and outside the traditional hospital settings. Despite the known benefits of support groups for people living with cancer, ethnographic studies documenting the cancer patients' experiences of living with cancer within the support group contexts in KwaZulu-Natal are scarce. AIM: The aim of this study was to examine the experiences of patients living with cancer within a support group setting. SETTING: The study setting was support groups in KwaZulu- Natal, South Africa. Materials and Methods: This study was conducted using, participant observation, focus group discussions and in-depth interviews. Data were generated over a 3-month period. Purposive sampling was used to identify the information-rich participants. Thematic data analysis was performed in order to obtain insights into the collective meaning of data generated. RESULTS: Participants viewed the support group settings as creating an environment with a unique sense of community. This was in contrast with the sense of isolation, rejection and lack of empowering knowledge on cancer, often experienced outside these contexts. Moreover, the support groups were lauded for facilitating positive relationships with family and friends and providing a safe space for members to freely express their emotions. CONCLUSION: Psychosocial support provided by support groups can help to ameliorate the distress caused by cancer diagnosis and its treatment; however, these support groups are still few and far in between. Therefore, there should be a greater investment in establishing support groups. <![CDATA[<b>Factors associated with the knowledge of obstetric danger signs, and perceptions of the need for obstetric care amongst married young women in northern Nigeria</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100011&lng=pt&nrm=iso&tlng=pt BACKGROUND: Married adolescents contribute to poor maternal health indicators in many low-and middle-income countries, where restrictive social norms hinder access to, and utilisation of maternal health services. Addressing these barriers is key to improving health outcomes of young mothers and their children. AIM: This study assessed married young women's knowledge of obstetric danger signs and perceptions of the need to attend obstetric services. METHODS: A cross sectional descriptive design, interviewing 1624 randomly selected married young women aged 12-25 years. Data were collected in early 2017 using an interviewer-administered questionnaire on mobile phones, and exported into a statistical software for analysis. RESULTS: We found low levels of knowledge of danger signs, especially those pertaining to the post-partum period. Respondents' age, literacy and household wealth were significantly associated with knowledge of danger signs across the continuum of care. Awareness of danger signs during delivery, was strongly associated with perceptions of need for antenatal care (odds ratio[OR]= 2.269; p < 0.05), and delivery in a health facility (OR = 1.883; P < 0.05). Most respondents believed they must wait for their husband's approval to attend a health facility when in labour. CONCLUSION: Our findings show that the low levels of knowledge of obstetric danger signs, low perceptions of the importance of facility delivery, and the need to obtain husband's permission before seeking care, are highly contextualised and reflect the socio-cultural and economic circumstances of married young women in northern Nigeria. Interventions must consider these cultural context, and include a strong male-involvement component. <![CDATA[<b>Retaining doctors and reducing burnout through a flexible work initiative in a rural South African training hospital</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100012&lng=pt&nrm=iso&tlng=pt BACKGROUND: South African doctors work up to 60 h per week to ensure 24-h service delivery. Many doctors are physically and emotionally exhausted, neglecting families, self-care, patient empathy and innovative thinking about complex health issues. Exposure to clinical work hours demonstrated a dose effect with burnout, suggesting cause and effect, affecting up to 80% of doctors. To retain good doctors, their complex needs must be recognised and allowances made for flexible work options. TAKING A RISK: George Hospital, a large regional training hospital in a rural district, converted some full-time medical officer posts to part-time posts. This was in response to doctors' requests for more flexible work options, often after returning from maternity leave or in response to burnout. Perceived risks revolved around institutional resource security and that part-time post vacancies would be difficult to fill. REAPING THE BENEFITS: Employing doctors in part-time posts has created stability and continuity in the health team. The hospital had generated a cohort of young professionals who care with empathy and have emotional resilience to train others and plough their skills back into the healthcare service. CONCLUSION: Reducing working hours and creating flexible options were concrete ways of promoting resilience and retaining competent doctors. We recommend that training and work of doctors be structured towards more favourable options to encourage retention, which may lead to better patient care. <![CDATA[<b>When people do not 'Zol': Reduced emergency centre attendance of patients with chronic obstructive pulmonary disease during coronavirus disease 2019 lockdown with the accompanying tobacco sales ban in South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100013&lng=pt&nrm=iso&tlng=pt The coronavirus disease 2019 (COVID-19) pandemic has spread throughout the world, with devastating effects of the virus as well as the repercussions of the resulting 'lockdowns'. South Africa went into a national lockdown in March 2020 to mitigate the impact of the virus. This included a ban on the sales of tobacco and electronic cigarette products. The ban has been a highly contentious issue in South Africa, discussed worldwide, which has drawn many criticisms. The prevalence rate of smoking in South Africa was around 21.5%, with the Western Cape province having a prevalence rate of 39%. We compared the number of chronic obstructive pulmonary disease (COPD) presentations at a large regional referral hospital in the Western Cape province from January to August 2019 with the same period in 2020. Electronic emergency centre data showed a reduction of 69.28% in COPD presentations. To control for some confounders for the same period, we also reviewed patients presenting with urinary tract infections, which showed only a 30.60% reduction. This notable reduction in COPD presentations reduced service pressure of emergency centre and most likely benefitted patients' health. Further research and policies are needed to ensure ongoing reduction in the prevalence of smoking. <![CDATA[<b>Development of African Forum for primary health care</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100014&lng=pt&nrm=iso&tlng=pt The coronavirus disease 2019 (COVID-19) pandemic has spread throughout the world, with devastating effects of the virus as well as the repercussions of the resulting 'lockdowns'. South Africa went into a national lockdown in March 2020 to mitigate the impact of the virus. This included a ban on the sales of tobacco and electronic cigarette products. The ban has been a highly contentious issue in South Africa, discussed worldwide, which has drawn many criticisms. The prevalence rate of smoking in South Africa was around 21.5%, with the Western Cape province having a prevalence rate of 39%. We compared the number of chronic obstructive pulmonary disease (COPD) presentations at a large regional referral hospital in the Western Cape province from January to August 2019 with the same period in 2020. Electronic emergency centre data showed a reduction of 69.28% in COPD presentations. To control for some confounders for the same period, we also reviewed patients presenting with urinary tract infections, which showed only a 30.60% reduction. This notable reduction in COPD presentations reduced service pressure of emergency centre and most likely benefitted patients' health. Further research and policies are needed to ensure ongoing reduction in the prevalence of smoking. <![CDATA[<b>Editorial: The contribution of family physicians to African health systems - A call for short reports</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100015&lng=pt&nrm=iso&tlng=pt The coronavirus disease 2019 (COVID-19) pandemic has spread throughout the world, with devastating effects of the virus as well as the repercussions of the resulting 'lockdowns'. South Africa went into a national lockdown in March 2020 to mitigate the impact of the virus. This included a ban on the sales of tobacco and electronic cigarette products. The ban has been a highly contentious issue in South Africa, discussed worldwide, which has drawn many criticisms. The prevalence rate of smoking in South Africa was around 21.5%, with the Western Cape province having a prevalence rate of 39%. We compared the number of chronic obstructive pulmonary disease (COPD) presentations at a large regional referral hospital in the Western Cape province from January to August 2019 with the same period in 2020. Electronic emergency centre data showed a reduction of 69.28% in COPD presentations. To control for some confounders for the same period, we also reviewed patients presenting with urinary tract infections, which showed only a 30.60% reduction. This notable reduction in COPD presentations reduced service pressure of emergency centre and most likely benefitted patients' health. Further research and policies are needed to ensure ongoing reduction in the prevalence of smoking. <![CDATA[<b>Tribute to Dr Cherifa Sururu</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100016&lng=pt&nrm=iso&tlng=pt The coronavirus disease 2019 (COVID-19) pandemic has spread throughout the world, with devastating effects of the virus as well as the repercussions of the resulting 'lockdowns'. South Africa went into a national lockdown in March 2020 to mitigate the impact of the virus. This included a ban on the sales of tobacco and electronic cigarette products. The ban has been a highly contentious issue in South Africa, discussed worldwide, which has drawn many criticisms. The prevalence rate of smoking in South Africa was around 21.5%, with the Western Cape province having a prevalence rate of 39%. We compared the number of chronic obstructive pulmonary disease (COPD) presentations at a large regional referral hospital in the Western Cape province from January to August 2019 with the same period in 2020. Electronic emergency centre data showed a reduction of 69.28% in COPD presentations. To control for some confounders for the same period, we also reviewed patients presenting with urinary tract infections, which showed only a 30.60% reduction. This notable reduction in COPD presentations reduced service pressure of emergency centre and most likely benefitted patients' health. Further research and policies are needed to ensure ongoing reduction in the prevalence of smoking. <![CDATA[<b>Towards cardiovascular disease prevention in Nigeria: A mixed method study of how adolescents and young adults in a university setting perceive cardiovascular disease and risk factors</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100017&lng=pt&nrm=iso&tlng=pt BACKGROUND: Cardiovascular disease (CVD) is a global problem but its increasing prevalence in the working age group in developing countries like Nigeria is concerning and needs urgent attentionMETHODS: The study was a mixed method design: quantitative phase with 402 participants and qualitative phase with 16 participants in two focus groups. The participants in the quantitative survey phase completed two questionnaires on the knowledge and perception of CVD and its risk factors. Data from the quantitative cross-sectional survey were analysed using descriptive and inferential statistics. The qualitative data were analysed using content thematic analysisRESULTS: We report that 39.1% of the participants had high knowledge whilst 61.9% had low and average knowledge of CVD and its risk factors. Of the participants, 78.1% had a wrong perception of CVD and its risk factors. Participants from faculties of veterinary medicine and basic medical sciences had better knowledge than others who were not medically inclined (F = 16.11; p < 0.001). Only participants from the faculty of veterinary medicine had the right perception of CVD and its risk factors. There was no significant difference in knowledge and perception scores between male and female participants. The qualitative study buttressed the results from the cross-sectional survey, where adolescents and young adults highlighted academic stress and poverty as major risk factors for CVDCONCLUSION: Adolescents and young adults in this study did not have good knowledge of CVD and its risk factors. They also had a wrong perception about CVD and its risk factors <![CDATA[<b>Exploring opportunities to enhance effectiveness of mobile health and nutrition strategy for providing health and nutrition services amongst pastoralists in Somali region, Ethiopia</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100018&lng=pt&nrm=iso&tlng=pt BACKGROUND: The health system in Ethiopia's Somali Region is weak with limited number of health facilities with more than 60% of the population living more than 5 km to the nearest health facilities. The deployment of mobile health and nutrition teams has played critical role in providing essential health and nutrition servicesAIM: This study aimed to assess the effectiveness of the mobile health and nutrition strategy in providing health and nutrition services in the targeted woredas (districtsSETTING: Somali Region of EthiopiaMETHODS: The study was a retrospective chart review of the monthly mobile health and nutrition team and the static health facilities in the 29 woredas between April 2019 and March 2020 and the AccessMod analyses for geographical accessibility to health facilities in the regionRESULTS: 40 (40.4%) out of the 99 woredas in Somali regions have at least 80% of the population living more than 5 km from the nearest health facility out of which 18 (45%) woredas are currently being supported by the mobile health team. The mobile team contributed to increasing access to health services in the targeted woredas with 30.8% of the total children vaccinated for measles and 39% of the total children treated for severe acute malnutrition in the targeted 29 woredasCONCLUSION: With mobile health and nutrition strategy being recognised as a useful strategy to deliver health and nutrition services in the region, there is a need to explore opportunities and innovation to enhance the effectiveness of the implementation <![CDATA[<b>Barriers and facilitators in the implementation of bio-psychosocial care at the primary healthcare level in South Kivu, Democratic Republic of Congo</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100019&lng=pt&nrm=iso&tlng=pt BACKGROUND: In the Democratic Republic of Congo (DRC), healthcare services are still focused on disease control and mortality reduction in specific groups. The need to broaden the scope from biomedical criteria to bio-psychosocial (BPS) dimensions has been increasingly recognizedAIM: The objective of this study was to identify the barriers and facilitators to providing healthcare at the health centre (HC) level to enable BPS careSETTINGS: This qualitative study was conducted in six HCs (two urban and four rural) in South-Kivu (eastern DRC) which were selected based on their accessibility and their level of primary healthcare organizationMETHODS: Seven focus group discussions (FGDs) involving 29 healthcare workers were organized. A data synthesis matrix was created based on the Rainbow Model framework. We identified themes related to plausible barriers and facilitators for BPS approachRESULTS: Our study reports barriers common to a majority of HCs: misunderstanding of BPS care by healthcare workers, home visits mainly used for disease control, solidarity initiatives not locally promoted, new resources and financial incentives expected, accountability summed up in specific indicators reporting. Availability of care teams and accessibility to patient information were reported as facilitators to changeCONCLUSION: This analysis highlighted major barriers that condition providers' mindset and healthcare provision at the primary care level in South-Kivu. Accessibility to the information regarding BPS status of individuals within the community, leadership of HC authorities, dynamics of HC teams and local social support initiatives should be considered in order to develop an effective BPS approach in this region <![CDATA[<b>The effectiveness of using text and pictograms on oral rehydration, dry-mixture sachet labels</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100020&lng=pt&nrm=iso&tlng=pt BACKGROUND: Medication labels are often the only information available to patients after obtaining medication from a healthcare practitioner. Pictograms are graphic symbols that have shown to increase understanding of medicine use instructionsAIM: To compare the accuracy of the interpretation of medicine use instructions from two different oral rehydration (OR) dry-mixture sachet labels - the control 'routine textonly' label and an experimental label with 'text-and-pictograms'SETTING: Participants were recruited from waiting rooms in public primary health care (PHC) facilities in Cape TownMETHOD: Each participant was required to answer six questions about OR preparation. Response accuracy was determined by comparing the participant's answer to the actual information written on the relevant label. Afterwards, participants could offer their opinion about the label and ways to improve their understandingRESULTS: Of the 132 participants who were recruited, 67 were allocated to the experimental group and 65 to the control group. Only the significant difference between the experimental and control groups for the six questions regarding the label, was recorded for the answer that could be read from a single pictogram (p = 0.00) on the experimental group's label. When asked about this question, more control participants (15/65) found the dosing instruction difficult to understand when compared to the experimental group (1/67). A third of the control participants (22/65) indicated that they could not see or locate instructions on the labelCONCLUSION: Text and pictograms on written medicine labels may be an effective tool to aid understanding of medicine use instructions amongst patients attending PHC facilities <![CDATA[<b>Perceptions, attitudes and understanding of health professionals of interprofessional practice at a selected community health centre</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100021&lng=pt&nrm=iso&tlng=pt BACKGROUND: Despite being identified as a solution to the challenges related to healthcare service delivery, the incorporation of interprofessional practice (IPP) into clinical practice has been limited. To implement an interprofessional model of healthcare, successfully, health professionals need to have an understanding of IPP and its related contentAIM: The aim of this study was to explore and describe the health professionals' perceptions, attitudes and understanding of IPP at a selected community health centreSETTING: This study was conducted at a primary healthcare facility in the Western Cape, South AfricaMETHODS: Ethical clearance and permission to conduct the study was obtained from all relevant stakeholders. Four focus group discussions were conducted with health professionals at the facility. Themes, codes and categories were highlighted from the transcripts of the audiotape-recorded dataFINDINGS: The findings suggest that health professionals do not have an understanding of IPP, and are thus unable to apply it practically. The health professionals perceived certain healthcare processes in the facility as barriers to the integration of practices. In addition, the health professionals expressed the need for interprofessional relationships, creation of opportunities for IPP, and communication to transform the current practiceCONCLUSION: To implement IPP into this facility, effectively, the authors of this study recommend that facility management implement campaigns for and training on, the transition to IPP, staff induction programmes and regular meetings <![CDATA[<b>The perception and knowledge about episiotomy: A cross-sectional survey involving healthcare workers in a low- and middle-income country</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100022&lng=pt&nrm=iso&tlng=pt BACKGROUND: Episiotomy was introduced into clinical practice without clear evidence of its benefits.The knowledge and understanding of episiotomy guidelines and practice by healthcare workers is substandard in our setting; hence, the injudicious use of this procedure have led to high ratesAIM: To assess the knowledge, perception and practice of episiotomy by healthcare workersSETTING: Research was conducted in a Pietermaritzburg complex, South AfricaMETHODS: A questionnaire-based survey was conducted amongst healthcare workers regarding episiotomy practice. In addition to providing demographic data, the participants were requested to respond to 35 proposed statements regarding episiotomy practice. Data were analysed using SPSS (Statistical Package for the Social Sciences) softwareRESULTS: One hundred and forty-two midwives and 66 medical practitioners completed the questionnaires. There were variations in responses to several statements on episiotomy practice by medical practitioners and nurses based on their level of experience. This study found that the majority of HCWs did not have access to a protocol or policy on episiotomy practice in their units; furthermore, nor knowledge of the South African guidelines for maternity care on episiotomy practice. Significantly, more medical practitioners felt a need for more in-service training and an increase in the number of episiotomies performed under supervision. The commonly reported reason for performing an episiotomy by both medical practitioners and midwives was to reduce 3rd - 4th degree perineal tearsCONCLUSION: Healthcare workers in our setting displayed poor knowledge about the practice of episiotomy and were not aware of existing national guidelines on episiotomy practice <![CDATA[<b>Neglected sexual dysfunction symptoms amongst chronic patients during routine consultations in rural clinics in the North West province</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100023&lng=pt&nrm=iso&tlng=pt BACKGROUND: Sexual dysfunction contributes to personal feelings of loss and despair and being a cause of exacerbated interpersonal conflict. Erectile dysfunction is also an early biomarker of cardiovascular disease. As doctors hardly ever ask about this problem, it is unknown how many patients presenting for routine consultations in primary care suffer from symptoms of sexual dysfunctionAIM: To develop an understanding of sexual history taking events, this study aimed to assess the proportion of patients living with symptoms of sexual dysfunction that could have been elicited or addressed during routine chronic illness consultationsSETTING: The research was carried out in 10 primary care facilities in Dr Kenneth Kaunda Health District, the North West province, South Africa. This rural area is known for farming and mining activitiesMETHODS: This study contributed to a broader research project with a focus on sexual history taking during a routine consultation. A sample of 151 consultations involving patients with chronic illnesses were selected to observe sexual history taking events. In this study, the patients involved in these consultations completed demographic and sexual dysfunction questionnaires (FSFI and IIEF) to establish the proportions of patients with sexual dysfunction symptomsRESULTS: A total of 81 women (78%) and 46 men (98%) were sexually active. A total of 91% of the women reported sexual dysfunction symptoms, whilst 98% of men had erectile dysfunction symptoms. The youngest patients to experience sexual dysfunction were a 19-year-old woman and a 26-year-old man. Patients expressed trust in their doctors and 91% of patients did not consider discussion of sexual matters with their doctors as too sensitiveCONCLUSION: Clinical guidelines, especially for chronic illness care, must include screening for sexual dysfunction as an essential element in the consultation. Clinical care of patients living with chronic disease cannot ignore sexual well-being, given the frequency of problems. A referral to a sexual medicine specialist, psychologist or social worker can address consequences of sexual dysfunction and improve relationships <![CDATA[<b>Prevalence and determinants of poor glycaemic control amongst patients with diabetes followed at Vanga Evangelical Hospital, Democratic Republic of the Congo</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100024&lng=pt&nrm=iso&tlng=pt BACKGROUND: The prevalence of diabetes mellitus is increasing dramatically in developing countries, where diabetic patients usually present with poor glycaemic control, leading to complications and worsening the prognosisAIM: The aim of this study was to determine the extent of poor glycaemic control and its determinants in diabetic patientsSETTING: The study was conducted in a rural area of the province of Kwilu, Democratic Republic of the CongoMETHODS: This research comprised a cross-sectional study involving 300 Type 1 and 2 diabetic patients attending Vanga Evangelical Hospital in the Democratic Republic of the Congo from January 2018 to March 2018. Patients' sociodemographic, clinical and biological characteristics, accessibility to the health structure and treatment were described. The determinants of poor glycaemic control were identified using multivariate logistic regression at the p < 0.05 level of statistical significanceRESULTS: The mean age of participants was 46.9 ± 16.3 years, 68.4% were men, and 62.3% had Type 2 diabetes mellitus. Poor glycaemic control was present in 78% of patients. The independent determinants of poor glycaemic control were tobacco use (adjusted odds ratio [aOR]: 2.01 [1.77-5.20], p = 0.015), the presence of comorbidities (aOR: 2.86 [1.95-6.65], p = 0.007), the presence of a factor contributing to hyperglycaemia (aOR: 2.74 [1.83-3.67], p = 0.014), missing scheduled appointments (aOR: 2.59 [1.94-7.13], p = 0.006) and non-adherence to treatment (aOR: 4.09 [1.35-6.39], p = 0.008CONCLUSION: This study shows that more than three-quarters of diabetics undergoing treatment are not controlled, with mainly patient-related factors as the main explanatory factors for this poor glycaemic control. Therefore, the establishment of a therapeutic education programme and wider integration of diabetes care services, mainly at the primary level of the healthcare pyramid, should contribute to improved diabetes treatment <![CDATA[<b>Effect of a supportive-educative nursing intervention programme on knowledge of chlorhexidine gel for umbilical cord management amongst mothers in Cross River State, Nigeria</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100025&lng=pt&nrm=iso&tlng=pt BACKGROUND: Umbilical cord infection contributes significantly to neonatal mortality rate in sub-Saharan Africa. Studies have shown low knowledge of chlorhexidine (CHX) gel for umbilical cord management amongst mothers in low-resource settings, including NigeriaOBJECTIVE: The objective of this study was to assess the effectiveness of a supportive-educative nursing intervention programme on knowledge of CHX gel amongst mothers in Cross River State, NigeriaMETHODS: A quasi-experimental study design was used, and study participants comprised 168 expectant mothers, who were purposely selected and assigned to randomised control and intervention groups. The instrument for data collection was a researcher-developed structured questionnaire. The data were analysed using Statistical Package for Social Sciences version 23 for descriptive and inferential statistics at significant level was set at p < 0.05RESULTS: The result showed that at post-test the knowledge score of mothers on CHX gel improved significantly in the intervention group (t 77 = 24.394; p < 0.05). The result showed no significant difference between mothers' demographic variables and knowledge of CHX gelCONCLUSION: A supportive-educative nursing intervention programme could effectively improve knowledge of CHX gel for umbilical cord management amongst mothers. This underscores the need to improve mothers' knowledge of CHX gel by healthcare personnel <![CDATA[<b>Comparison of respiratory and skin disorders between residents living close to and far from Solous landfill site in Lagos State, Nigeria</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100026&lng=pt&nrm=iso&tlng=pt BACKGROUND: Solid waste dump sites have proven to have potentially high risk to human health as it serves as a source of air, soil and underground water pollutionAIM: This study aimed to assess and compare the knowledge, respiratory disorders and skin disorders between residents living close to and far from landfill sites in Lagos State, NigeriaSETTING: Igando (a community within 5 km close to) and Badagry (a community beyond 5 km from) Solous Landfill sites in Lagos state, NigeriaMETHODS: A comparative cross-sectional study amongst 103 respondents recruited from each of the two study sites by multistage sampling method was carried out. Data were collected using pretested, structured, interviewer-administered questionnaire, and analysed using Microsoft Excel 2007, EPI Info 7 and WinPepi statistical software packages. Student t-test, Fisher's exact and Chi-square tests were carried out. The p ≤ 0.05 was considered statistically significantRESULTS: The mean age of Igando and Badagry respondents was 34.18 ± 10.21 years and 32.62 ± 9.84 years, respectively. The two communities differed significantly (p < 0.0001) with respect to distance of workplace from landfill site and duration of stay in the residential location. The mean knowledge score of respondents on respiratory and skin disorders associated with solid waste dump site close to landfill sites (82.53 ± 20.60) was statistically significantly higher than those of respondents far from landfill sites (71.84 ± 20.57) (p = 0.0003). Respiratory and skin disorders experiences of respondents close to landfill sites were statistically significantly (p < 0.0001) higher than those of residents far from landfill sites with respect to wheezing, frequent sneezing, unpleasant odour, fever and skin rashesCONCLUSION: Respiratory and skin disorders experienced by respondents close to landfill sites are higher than those of residents far from landfill sites. Landfill sites should not be located close to human settlements <![CDATA[<b>Prevalence of depressive symptoms in urban primary care settings: Botswana</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100027&lng=pt&nrm=iso&tlng=pt BACKGROUND: The prevalence of depression is estimated to be high in primary care settings, especially amongst people with chronic diseases. Early identification and management of depression can improve chronic disease outcomes and quality of life, however, there are many missed opportunities in primary careAIM: This study aimed to determine the prevalence and correlates of depression and depressive symptoms in two urban primary care settingsSETTING: The study was conducted at two primary care facilities in the capital city of BotswanaMETHODS: We administered a demographic questionnaire and the Patient Health Questionnaire-9 (PHQ-9) to adults attending two primary care facilities. The association between depressive symptoms and demographic variables was determined using Chi-square; level of significance was set at 0.05. We carried out a multivariate analysis using Kruskal-Wallis test to determine the association between demographic characteristics and depressionRESULTS: A sample of 259 participants were recruited (66.8% women, median age 32). The mean PHQ-9 score was 8.71. A total of 39.8% of participants screened positive for depression at a cut-off of 9.0% and 35.1% at a cut-off of 10. Depressive symptoms were significantly associated with employment status and income using the Kruskal-Wallis test, χ² (1) = 5.649, p = 0.017CONCLUSION: The high rates of depressive symptoms amongst the study population highlight the need for depression screening in primary care settings. The association between unemployment and income underscore the impact of socio-economic status on mental health in this setting <![CDATA[<b>High prevalence of overall overweight/obesity and abdominal obesity amongst adolescents: An emerging nutritional problem in rural high schools in Limpopo Province, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100028&lng=pt&nrm=iso&tlng=pt BACKGROUND: As the gap in nutritional profiles between urban and rural rapidly reduces because of nutrition transition, rural adolescents are likely to engage in urban lifestyle behavioursAIM: The study determined the prevalence of overweight/obesity amongst adolescents in rural high schools and the association with selected factorsSETTING: Fetakgomo Municipality in rural Limpopo Province, South AfricaMETHODS: A cross-sectional study was conducted amongst 378 adolescents selected through multistage sampling from high schools. Data collected were socio-demography, nutritional knowledge, dietary practices and anthropometry. The International Obesity Task Force age and sex-specific body mass index (BMI) cut-off values were used to determine overweight/obesity, whilst adult BMI cut-off values were used for those ≥ 18 years. Waist-to-height ratio (WHtR) greater than 0.5 indicated abdominal obesity, as well as waist circumference (WC) and waist-to-hip ratio (WHR) above the cut-off valuesRESULTS: The proportion of overweight/obesity amongst adolescents was 35%, whilst 25% had abdominal obesity by WHR and 21% by WHtR. Multivariate logistic regression showed that being a girl (AOR = 2.9, 95% CI: 1.74-4.85), older adolescent (AOR = 3.1, 95% CI: 1.57-6.29) and living in a household with employed adults (AOR = 2.3, 95% CI: 1.19-4.51) were associated with increased odds of being overweight/obese. Eating breakfast was associated with reduced odds of being overweight/obese (AOR = 0.6, 95% CI: 0.34-0.97CONCLUSION: Overweight/obesity and abdominal obesity amongst adolescents were more prevalent than underweight. The Integrated School Health Programme should have clear guidelines on food items served and sold at schools <![CDATA[<b>Food insecurity and its impact on glycaemic control in diabetic patients attending Jabulani Dumani community health centre, Gauteng province, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100029&lng=pt&nrm=iso&tlng=pt BACKGROUND: To the best of our knowledge no studies have been conducted to assess the relationship between food insecurity and poor glycaemic control in diabetic patients in peri-urban settings of the South African contextAIM: The study aimed to assess food insecurity and its relationships with glycaemic control and other patient characteristics amongst diabetic patients attending Jabulani Dumani Community Health CentreSETTING: The study was conducted in a primary healthcare facility in the south sub-district of Ekurhuleni health district, the Gauteng province, South AfricaMETHODS: This was a cross-sectional descriptive study involving 250 patients. Data were collected by using an interview-administered Household Food Insecurity Access Scale questionnaire. Descriptive and inferential statistical analyses by using Stata 14.0 statistical software were performed. Chi square and logistic regression tests assessed the association between socio-demographic characteristics, glycaemic control and food insecurityRESULTS: Amongst 250 recruited participants, 82.4% were above 50 years, 64% women, 88.8% South African citizens and 42.4% had a household size of ≥ 5 people. Sixty-four percent and 69.9% were classified as having food insecurity and poor glycaemic control, respectively. On further analysis, food insecurity was associated with unemployment (adjusted odds ratio [AOR] = 2.94; 95% confidence interval [CI]: 1.51-5.75), being a South African citizen (AOR = 1.60; 95% CI: 0.66-3.86), household size of ≥ 5 people (AOR = 1.77; 95% CI: 0.98-3.19) and uncontrolled glycaemic level (AOR = 5.38; 95% CI: 2.91-9.96CONCLUSION: Food insecurity in diabetic patients constitutes a serious challenge for glycaemic control. It is critical for healthcare providers in primary care settings to ensure screening for early identification and management of food insecurity and take measures to prevent poor glycaemic control <![CDATA[<b>Late registration for antenatal care by pregnant women with previous history of caesarean section</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100030&lng=pt&nrm=iso&tlng=pt BACKGROUND: Despite good access to antenatal care (ANC) services for most women, and regular training of healthcare workers in obstetrics and gynaecology, many pregnant women with a previous history of caesarean section (C/S) still presented late for ANC services at Letsholathebe II Memorial Hospital (LIIMH) in Maun, Botswana. This may increase morbidity and mortality in women with previous C/S delivery and neonates. Knowing why women with previous C/S present late for ANC may help in the formulation of interventions that decrease morbidity and mortality amongst these women and neonatesAIM: The aim of this study was to explore the reasons why pregnant women with a previous history of C/S registered late for ANC, at LIIMHSETTING: This study was performed at LIIMH, a district hospital situated in Maun, BotswanaMETHODS: This was a descriptive qualitative study. Consenting pregnant women with previous C/S who presented at LIIMH after the 20 weeks of pregnancy were interviewed until data saturation. The data was analysed for themesRESULTS: The reasons for late registration at LIIMH include lack of information, misconception on the appropriate booking time and venue, dissatisfaction with the quality of ANC clinic services, use of alternative ANC providers, delayed referral, and pregnancy experienceCONCLUSION: Lack of knowledge of ANC delivery venue, using alternative ANC providers, and dissatisfaction with ANC clinic services, contributed to late registration. Pregnant women with previous history of C/S should be informed about ANC, delivery plans, and the assistance of alternative ANC providers should be explored <![CDATA[<b>Primary care nurses' preparedness for COVID-19 in the Western Cape province, South Africa</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100031&lng=pt&nrm=iso&tlng=pt INTRODUCTION: The novel coronavirus 2019 or COVID-19 pandemic has brought about a global public health crisis. Primary care (PC) nurses render first line care, or refer for more specialised servicesAIM: To investigate the preparedness of PC nurses for COVID-19 in the Western CapeSETTING: The Western Cape province of South AfricaMETHODS: We administered an online survey, with closed and open-ended questions, to 83 Stellenbosch University postgraduate PC nursing students and alumni working in the Western Cape, between 03 July and 01 September 2020RESULTS: The results indicated that 43.3% of participants were confident about the infection, prevention, and control (IPC) training they received and 56.7% felt prepared to provide direct care to suspected cases of COVID-19. Primary care nurses were more comfortable to triage (78.3%) than to manage persons with COVID-19 (42.2%), indicating that they may not be functioning to the full capacity of their education and training. Adequate infrastructure was reported by less than a third of the participants (30.1%) and 59.1% reported that personal protective equipment (PPE) was always available. Primary care nurses needed support in coping with stress (57.8%) although few (14.5%) reported access to mental health servicesCONCLUSION: Primary care nurses were not prepared optimally for the COVID-19 pandemic. Challenges included adequate training, infrastructure, the availability of personal protective equipment, COVID-19 testing of health care workers and management support. Primary care nurses need comprehensive support to manage stress and anxiety <![CDATA[<b>The pattern and socio-cultural determinants of intimate partner violence in a Nigerian rural community</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100032&lng=pt&nrm=iso&tlng=pt BACKGROUND: Intimate partner violence (IPV) refers to a violation of women's reproductive rights as it impacts on their sexual and reproductive health autonomyAIM: In this study, we aimed at assessing the pattern of IPV and the socio-cultural determinants and predictors of partner violence in a rural community setting where the bulk of the abuse prevailsSETTING: This study was conducted in a rural community in Southern NigeriaMETHODS: This study employed a mixed method comprising seven focus group discussions (FGDs) and quantitative components. The cross-sectional survey was conducted amongst 209 ever married or cohabited females in 2018 using the World Health Organization (WHO) multi-country survey questionnaire adapted to the study objectives. Data analysis was conducted by using IBM SPSS v21.0. The level of significance was set at p < 0.05RESULTS: The overall IPV prevalence was 79.4%. The prevalence of partner's controlling behaviour, emotional IPV, physical IPV and sexual IPV was 62.6%, 55.98%, 49.3% and 2.6%, respectively. Membership of an interest group was protective against IPV (OR = 0.430, 95% CI = 0.193-0.957) whilst the belief that a good wife obeys her partner even if she disagrees (OR = 9.201, 95% CI = 1.299-65.194) and the belief that it is the wife's obligation to have sex with the husband even if she doesn't feel like (OR = 2.356, 95% CI = 1.049-5.288) were risk factorsCONCLUSION: The burden of IPV in the studied rural community is enormous. There should be public enlightenment to desensitise people regarding the erroneous views that encourage partner violence. We encourage women to become a part of social groups that can enhance their education and empowerment <![CDATA[<b>Caregiver burden and associated factors amongst carers of women with advanced breast cancer attending a radiation oncology clinic in Nigeria</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100033&lng=pt&nrm=iso&tlng=pt BACKGROUND: The responsibility of caring for patients with advanced cancer in sub-Saharan Africa is mostly shouldered by family members because of paucity of institutional facilities. There is a growing concern that the number of women needing treatment for advanced breast cancer is rising at an unprecedented rate in NigeriaAIM: To assess the caregiver burden and its associated factors amongst family caregivers of women with advanced breast cancerSETTING: The study was conducted at the radiation oncology clinic of the University College Hospital, Ibadan, NigeriaMETHODS: A cross-sectional descriptive study was conducted amongst 157 eligible family caregivers of women with advanced breast cancer. The family caregivers completed an interviewer-administered questionnaire, which included the socio-demographic data, the caregiving process and the Zarit Burden Interview (ZBI). Logistic regression was used to identify factors, and ethical approval was obtainedRESULTS: Over half (53%) of the respondents were males with spousal caregivers dominantly constituting 27.4% of all respondents, closely followed by daughters (25.5%) of the care recipients. The mean ZBI score was 29.84 ± 13.9. Most (72%) of the caregivers experienced burden. Factors associated with caregiver burden were previous hospitalisation of the care recipient (odds ratio [OR] = 3.74, confidence interval [CI]: 1.67 to 8.38) and perceived dysfunction in patients activities of daily living (OR = 2.57, CI: 1.14 to 5.78CONCLUSION: Family caregivers of women with advanced breast cancer experience burden of care. Recognition of this vulnerable population and the care recipient as a dyad is a sine qua non in mitigating the burden associated with their caregiving role <![CDATA[<b>Opinion and uptake of chloroquine for treatment of COVID-19 during the mandatory lockdown in the sub-Saharan African region</b>]]> http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S2071-29362021000100034&lng=pt&nrm=iso&tlng=pt BACKGROUND: As the search for effective treatment of coronavirus disease 2019 (COVID-19) infection continues, the public opinion around the potential use of chloroquine (CQ) in treating COVID-19 remains mixedAIM: To examine opinion and uptake of CQ for treating COVID-19 in the sub-Saharan African (SSA) regionSETTING: This study was conducted through an online survey software titled SurveyMonkeyMETHODS: Anonymous online survey of 1829 SSA countries was conducted during the lockdown period using Facebook, WhatsApp and authors' networks. Opinion and uptake of CQ for COVID-19 treatment were assessed using multivariate analysesRESULTS: About 14% of respondents believed that CQ could treat COVID-19 and of which, 3.2% took CQ for COVID-19 treatment. Multivariate analyses revealed that respondents from Central (adjusted odds ratios [aOR]: 2.54, 95% confidence interval [CI] 1.43, 4.43) and West Africa (aOR: 1.79, 95% CI 1.15, 2.88) had higher odds of believing that CQ could treat COVID-19. Respondents from East Africa reported higher odds for uptake of CQ for COVID-19 than Central, Western and Southern Africans. Knowledge of the disease and compliance with the public health advice were associated with both belief and uptake of CQ for COVID-19 treatmentCONCLUSION: Central and West African respondents were more likely to believe in CQ as a treatment for COVID-19 whilst the uptake of the medication during the pandemic was higher amongst East Africans. Future intervention discouraging the unsupervised use of CQ should target respondents from Central, West and East African regions