Perspectives from South African dietitians on infant and young child feeding regulations

2020 ◽  
Vol 24 (1) ◽  
pp. 169-181
Author(s):  
Megan Clarke ◽  
Nelene Koen ◽  
Lisanne du Plessis
Keyword(s):  
South Africa ◽  
Health Care ◽  
Health Care Providers ◽  
Knowledge Score ◽  
Care Providers ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Infant And Young Child

AbstractObjective:This study aimed to determine the knowledge, perceptions and practices of dietitians in South Africa regarding the Regulations Relating to Foodstuffs for Infants and Young Children (R991).Design:A mixed methods, cross-sectional design was used.Setting:Quantitative data were collected using an online survey (n 282) and qualitative data by means of two focus group discussions (n 12).Participants:Participants were dietitians registered with the Health Professions Council of South Africa.Results:Dietitians’ average knowledge score was 64·8 % ± 12·5. Those working in infant and young child feeding had a 5 % higher knowledge score (95 % CI 1·4, 8·6, P = 0·01). Perceptions towards the Regulations were generally positive, and the majority of practices were compliant. Positive perceptions seemed to correlate with compliant practices. The most frequently selected enabler to the implementation of the Regulations was ‘Increase in other initiatives which support, protect and promote breastfeeding’, and the most frequently selected barrier was ‘Lack of awareness of the Regulation among health care providers’. The major themes from the focus group discussions comprised: less knowledge among dietitians and mothers about products controlled under the Regulations, non-compliance of other health care providers, the dietitians’ role in support and enforcement, the discrepancy between practice in private and public sectors and a lack of enforcement.Conclusions:South Africa has taken a bold step in legislating the International Code of Marketing of Breast-milk Substitutes and should upscale programmes to ensure consistent monitoring and enforcing of the Regulations.

scholarly journals Development and Testing of Responsive Feeding Counseling Cards to Strengthen the UNICEF Infant and Young Child Feeding Counseling Package

2020 ◽  
Vol 4 (9) ◽  
Author(s):  
Amber J Hromi-Fiedler ◽  
Grace J Carroll ◽  
Madelynn R Tice ◽  
Adam Sandow ◽  
Richmond Aryeetey ◽  
...  
Keyword(s):  
Health Care ◽  
Young Child ◽  
Health Care Providers ◽  
Care Providers ◽  
Systematic Observation ◽  
Child Feeding ◽  
Group Education ◽  
Cultural Appropriateness ◽  
Young Child Feeding ◽  
Infant And Young Child

Abstract Background The UNICEF Community-based Infant and Young Child Feeding Counseling Package (C-IYCFCP) currently has limited responsive feeding (RF) content, thus limiting dissemination of RF messages within infant and young child feeding (IYCF) counseling. Objectives This project 1) developed counseling cards based on existing evidence-based RF guidelines and 2) tested their feasibility in Ghana. Methods Five RF counseling cards were developed focusing on eating with family; introducing new foods; hunger/satiety cues; food texture; and calming a child. Four focus group discussions (FGDs) were conducted with adult mothers and fathers of children younger than 3 y of age to assess the cultural appropriateness of the cards and accompanying key messages. The feasibility of including cards as part of IYCF counseling was tested via 1) systematic observation of 8 group education sessions utilizing the cards with the same target audience and 2) in-depth interviews with health care providers involved in IYCF training and/or counseling. Results FGD findings guided changes to all cards to ensure comprehension and cultural appropriateness. The group education sessions suggested that the counseling cards provided important RF messages that are specific, clear, and feasible to implement. Health care providers strongly endorsed the need for and utility of the RF counseling cards and felt they were feasible and important to integrate into the C-IYCFCP currently being used to deliver IYCF training and counseling in Ghana. Conclusions The counseling cards have a strong potential to add key RF dimensions to IYCF training and counseling in Ghana.

scholarly journals Development and Testing of Responsive Feeding Counseling Cards in Ghana (OR03-07-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Amber Hromi-Fiedler ◽  
Grace Carroll ◽  
Madelynn Tice ◽  
Adam Sandow ◽  
Richmond Aryeetey ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Large Scale ◽  
Care Providers ◽  
Or Education ◽  
Community Based ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Education In Ghana ◽  
Project Objectives

Abstract Objectives The United Nations Children Fund (UNICEF) Community based Infant and Young Child Feeding (IYCF) counselling package currently lacks comprehensive responsive feeding curriculum, thus limiting dissemination of these messages within IYCF counselling. Thus, project objectives were to: a) develop counselling cards based on recent evidence-based responsive feeding guidelines and b) test their feasibility in Ghana. Methods Five counselling cards were developed addressing the responsive feeding topics of: enjoying eating with family; hunger/satiety cues; introducing new foods; food texture as a function of child development; soothing a child. The UNICEF image bank was used to develop counselling cards with images compatible with the UNICEF Community based IYCF counselling package. Two peri-urban focus groups (FG) were conducted with Ghanaian mothers (N = 7) and fathers (N = 6) of children < 3 years to assess the cultural appropriateness of the cards. Card revisions were made and re-tested in two rural FGs with the same target audience (N = 10 mothers; N = 4 fathers). Feasibility of including the cards as part of IYCF counselling was tested via: a) in-depth interviews with health care providers providing IYCF training and/or education (N = 14) and b) systematically observing eight educational sessions utilizing the cards with Ghanaian mothers (N = 20) and fathers (N = 18) of children < 3 years. Results FG findings led to changes to card images for each topic to ensure they were culturally and health literacy appropriate. Educational session findings strongly suggest the counselling cards provide important responsive feeding messages that are specific, clear, and feasible for mothers and fathers of children < 3 years to implement. Health care providers strongly endorsed the need for and utility of the responsive feeding counselling cards. Furthermore, they felt the cards and corresponding messages were feasible and important to integrate into the UNICEF Community based IYCF counselling package currently being used to deliver IYCF training and education in Ghana. Conclusions The counselling cards developed and tested have a strong potential to add the key responsive feeding dimension to IYCF training, education, and counselling in Ghana on a large scale. Funding Sources Yale Global Health Leadership Institute.

scholarly journals Patient, caregiver, and health care provider perspectives on barriers and facilitators to heart failure care in Kerala, India: A qualitative study

2020 ◽  
Vol 5 ◽  
pp. 250
Author(s):  
Prinu Jose ◽  
Ranjana Ravindranath ◽  
Linju M. Joseph ◽  
Elizabeth C. Rhodes ◽  
Sanjay Ganapathi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Focus Group ◽  
Qualitative Study ◽  
Health Care Providers ◽  
Self Management ◽  
Care Providers ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
High Quality

Background: Deficits in quality of care for patients with heart failure (HF) contribute to high mortality in this population. This qualitative study aims to understand the barriers and facilitators to high-quality HF care in Kerala, India. Methods: Semi-structured, in-depth interviews were conducted with a purposive sample of health care providers (n=13), patients and caregivers (n=14). Additionally, focus group discussions (n=3) were conducted with patients and their caregivers. All interviews and focus group discussions were transcribed verbatim. Textual data were analysed using thematic analysis. Results: Patients’ motivation to change their lifestyle behaviours after HF diagnosis and active follow-up calls from health care providers to check on patients’ health status were important enablers of high-quality care. Health care providers’ advice on substance use often motivated patients to stop smoking and consuming alcohol. Although patients expected support from their family members, the level of caregiver support for patients varied, with some patients receiving strong support from caregivers and others receiving minimal support. Emotional stress and lack of structured care plans for patients hindered patients’ self-management of their condition. Further, high patient loads often limited the time health care providers had to provide advice on self-management options. Nevertheless, the availability of experienced nursing staff to support patients improved care within health care facilities. Finally, initiation of guideline-directed medical therapy was perceived as complex by health care providers due to multiple coexisting chronic conditions in HF patients. Conclusions: Structured plans for self-management of HF and more time for patients and health care providers to interact during clinical visits may enable better clinical handover with patients and family members, and thereby improve adherence to self-care options. Quality improvement interventions should also address the stress and emotional concerns of HF patients.

scholarly journals Facilitators of Responsive Feeding/Parenting Knowledge and Practices Among Parents in the Central Region of Ghana

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1069-1069
Author(s):  
Adam Sandow ◽  
Madelynn Tice ◽  
Rafael Pérez-Escamilla ◽  
Richmond Aryeetey ◽  
Amber Hromi-Fiedler
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Central Region ◽  
Parenting Practices ◽  
Care Providers ◽  
Psychosocial Needs ◽  
Child Feeding ◽  
Young Child Feeding ◽  
Funding Sources ◽  
Education Delivery

Abstract Objectives Identify facilitators of the practice of Responsive Feeding/Parenting (RF/P) among parents of children under 3 years of age in the Central Region of Ghana. Methods Qualitative data was collected through six audiotaped focus group discussions with mothers (n = 27) and fathers (n = 18) living in the Central Region of Ghana who a) were 18 years of age or older; b) had a child under 3 years of age; c) were involved in feeding the child. Transcripts were read and coded independently by three authors, consensus was reached about emerging domains and themes, and a final codebook was developed. Results Three factors were identified as direct facilitators of the practice of RF/P: support, health care providers infant and young child feeding (IYCF) education delivery, and IYCF practice. Family, friends and the community gave parents informational, instrumental and emotional support including education/counseling on childcaring practices, doing chores for parents, giving parents the time off to respond to their children's needs. This support enabled parents to learn and adopt some RF/P behaviours. Health care providers delivered education on IYCF, food safety and, in some instances, provided some RF/P counselling/guidance. This then enabled parents to identify the nutritional and the psychosocial needs of their children and to recognize they should attend to these needs using RF/P knowledge and practice. Non-responsive feeding/parenting practices also emerged within IYCF practices demonstrating the need for more high-quality RF/P education. Conclusions Health care providers as well as family/friends facilitate parent's IYCF practices, which in turn influences their RF/P practices. Strengthening IYCF knowledge delivery through enhanced antenatal and postnatal counselling targeting parents as well as family/friends can promote RF/P knowledge and practices among Ghanaian parents. Funding Sources Hecht-Albert Leadership Award to Dr. Hromi-Fiedler through the Global Health Leadership Institute, Yale University.

scholarly journals Attitude and Perception of Physicians and Nurses Toward the Role of Clinical Pharmacists in Riyadh, Saudi Arabia: A Qualitative Study

2019 ◽  
Vol 5 ◽  
pp. 237796081988976
Author(s):  
Nada Alsuhebany ◽  
Lama Alfehaid ◽  
Hind Almodaimegh ◽  
Abdulkareem Albekairy ◽  
Shmeylan Alharbi
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Focus Group ◽  
Health Care Providers ◽  
Care Providers ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Clinical Pharmacists

Clinical pharmacists are responsible for guiding pharmacotherapy and ensuring medication safety along with other health-care providers. This study highlighted barriers that physicians and nurses encounter when interacting with clinical pharmacists. Twenty-seven physicians and nurses were randomly invited to participate in focus-group discussions. Five focus-group discussions were recorded and then transcribed, and the transcripts were reviewed and coded. Three major themes were identified, which were the role of clinical pharmacists, interprofessional communication, and competency. The greatest challenge reported in this study was lack of consistent understanding of the role of clinical pharmacists which to some extent caused communication deficiencies and affected the level of involvement with multidisciplinary teams. Despite that, majority of the participants perceived pharmacists as beneficial in optimizing pharmacotherapy and improving quality of care. Clinical pharmacy services are perceived positively in impacting quality of care as expressed by majority of the study participants. However, there is a lack of common understanding of the role of clinical pharmacists by other health-care providers.

scholarly journals Patients’ and Caretakers’ Satisfaction at Western Regional Hospital, Pokhara, Nepal

2012 ◽  
Vol 5 ◽  
pp. 205-216
Author(s):  
Sushma Dahal ◽  
Ram Prasad Bhandari
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Waiting Time ◽  
Regional Hospital ◽  
Care Providers ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Western Regional ◽  
Attending Physician

Curative services are highly demanded component of health service. Besides competence in technical aspects; behavior of health care providers, availability of consumer friendly environment and the trusting relationship with the physician along with open two way communication between health care provider and consumer determines the consumers’ perception about the quality of service that further determines whether they seek and continue to use services. This study was conducted with the objective of finding out consumers’ satisfaction with the services of Western Regional Hospital, Pokhara and the findings can be helpful in designing interventions accordingly. A client-exit interview was conducted which included 146 respondents representing both old and new OPD cases of the hospital. Two Focus Group Discussions were also conducted. Results obtained showed that service of hospital were of good satisfaction to more than half of the respondents. Drug availability and cheap cost of service were strong aspects of hospital. More than half of the respondents had visited private medicals before coming to hospital. Poor place of examination, poor hospital sanitation, long waiting time for doctor and service of staffs other than doctor were some of the aspects that consumers were poorly satisfied with. Fifty four out of 115 (47%) who had spent less than 5 minutes with the doctor, had good satisfaction with doctors’ service. Hence, consumers’ satisfaction is influenced by the factors like behavior of attending physician and other hospital staffs, place of examination, waiting time for doctor, hospital sanitation etc.DOI: http://dx.doi.org/10.3126/dsaj.v5i0.6364 Dhaulagiri Journal of Sociology and Anthropology Vol. 5, 2011: 205-16

scholarly journals Patient, caregiver, and health care provider perspectives on barriers and facilitators to heart failure care in Kerala, India: A qualitative study

2021 ◽  
Vol 5 ◽  
pp. 250
Author(s):  
Prinu Jose ◽  
Ranjana Ravindranath ◽  
Linju M. Joseph ◽  
Elizabeth C. Rhodes ◽  
Sanjay Ganapathi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Care ◽  
Focus Group ◽  
Qualitative Study ◽  
Health Care Providers ◽  
Self Management ◽  
Care Providers ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
High Quality

Background: Deficits in quality of care for patients with heart failure (HF) contribute to high mortality in this population. This qualitative study aimed to understand the barriers and facilitators to high-quality HF care in Kerala, India. Methods: Semi-structured, in-depth interviews were conducted with a purposive sample of health care providers (n=13), patients and caregivers (n=14). Additionally, focus group discussions (n=3) were conducted with patients and their caregivers. All interviews and focus group discussions were transcribed verbatim. Textual data were analysed using thematic analysis. Results: Patients’ motivation to change their lifestyle behaviours after HF diagnosis and active follow-up calls from health care providers to check on patients’ health status were important enablers of high-quality care. Health care providers’ advice on substance use often motivated patients to stop smoking and consuming alcohol. Although patients expected support from their family members, the level of caregiver support for patients varied, with some patients receiving strong support from caregivers and others receiving minimal support. Emotional stress and lack of structured care plans for patients hindered patients’ self-management of their condition. Further, high patient loads often limited the time health care providers had to provide advice on self-management options. Nevertheless, the availability of experienced nursing staff to support patients improved care within health care facilities. Finally, initiation of guideline-directed medical therapy was perceived as complex by health care providers due to multiple coexisting chronic conditions in HF patients. Conclusions: Structured plans for self-management of HF and more time for patients and health care providers to interact during clinical visits may enable better clinical handover with patients and family members, and thereby improve adherence to self-care options. Quality improvement interventions should also address the stress and emotional concerns of HF patients.

scholarly journals Are antiretrovirals prescribed according to the recommended prescribed daily doses in the private healthcare sector in South Africa

2011 ◽  
Vol 16 (1) ◽  
Author(s):  
Norah L. Katende-Kyenda ◽  
Martie Lubbe ◽  
Juan H.P. Serfontein ◽  
Ilse Truter
Keyword(s):  
South Africa ◽  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Health Care Sector ◽  
Hiv And Aids ◽  
Healthcare Sector ◽  
Private Health Care ◽  
Care Providers ◽  
Increased Risk

Current antiretroviral treatment (ART) guidelines recommend different combinations that have led to major improvements in the management of HIV and AIDS in the developed and developing world. With the rapid approval of many agents, health care providers may not be able to familiarise themselves with them all. This lack of knowledge leads to increased risk of dose- prescribing errors, especially by non-HIV and AIDS specialists. The purpose of this retrospective non-experimental, quantitative drug utilisation study was to evaluate if antiretrovirals (ARVs) are prescribed according to the recommended prescribed daily doses (PDDs) in a section of the private health care sector in South Africa (SA). Analysed ARV prescriptions (49995, 81096 and 88988) for HIV and AIDS patients were claimed from a national medicine claims database for the period 1 January 2005 through to 31 December 2007. ARV prescriptions prescribed by general practitioners (GPs) with PDDs not according to the recommended ARV dosing increased dramatically, from 12.33% in 2005 to 24.26% in 2007. Those prescribed by specialists (SPs) increased from 15.46% in 2005 to 35.20% in 2006 and decreased to 33.16% in 2007. The highest percentage of ARV prescriptions with PDDs not according to recommended ARV dosing guidelines was identified in ARV regimens with lopinavir−ritonavir at a PDD of 1066.4/264 mg and efavirenz at a PDD of 600 mg prescribed to patients in the age group of Group 3 (19 years > age ≤ 45 years). These regimens were mostly prescribed by GPs rather than SPs. There is a need for more education for all health care professionals and/or providers in the private health care sector in SA on recommended ARV doses, to avoid treatment failures, development of resistance, drug-related adverse effects and drug interactions.OpsommingHuidige riglyne vir behandeling met antiretrovirale middels beveel verskillende kombinasies aan wat tot groot verbetering in die beheer van MIV en VIGS in die ontwikkelde en ontwikkelende wêreld gelei het. Met die vinnige goedkeuring van talle nuwe middels kan dit gebeur dat verskaffers van gesondheidsorg nie kan bybly om hulle hiermee op hoogte te hou nie. Hierdie gebrek aan kennis lei tot ‘n hoër risiko vir foute in die voorgeskrewe dosis en veral deur persone wat nie spesialiste in MIV en VIGS is nie. Die doel van hierdie nie-eksperimentele, retrospektiewe, kwantitatiewe studie van die gebruik van geneesmiddels was om te bepaal of antiretrovirale middels in ‘n deel van die privaat gesondheidsorgsektor in Suid-Afrika (SA) volgens die aanbevole voorgeskrewe daaglikse dosisse (VDD) voorgeskryf word. Voorskrifte van antiretrovirale middels (49995, 81096 en 88988) aan pasiënte met MIV en VIGS wat in die periode van 1 Januarie 2005 tot 31 Desember 2007 van ‘n nasionale medisyne databasis geëis is, is ontleed. Voorskrifte van antiretrovirale middels deur algemene praktisyns (APs) met VDDs wat nie volgens die aanbevole dosisse vir antiretrovirale middels was nie, het dramaties van 12.33% in 2005 tot 24.26% in 2007 toegeneem. Die wat deur spesialiste (SPs) voorgeskryf is, het van 15.46% in 2005 tot 35.20% in 2006 toegeneem en in 2007 tot 33.16% gedaal. Die hoogste persentasie van voorskrifte vir antiretrovirale middels met VDDs wat nie volgens die riglyne was nie, was in die regimens met lopinavir−ritonavir met ‘n VDD van 1066.4/264 mg en efavirens met ‘n VDD van 600 mg wat aan pasiënte in die ouderdomsgroep van ouer as 19 tot en met 45 jaar voorgeskryf is. Hierdie regimens is meer deur APs as deur SPs voorgeskryf. Daar is ‘n behoefte aan nog opleiding van alle gesondheidsprofessies en/of voersieners in die privaat gesondheidsorgsektor in SA oor die aanbevole antiretrovirale middel-dosisse om mislukking van behandeling, ontwikkeling van weerstand, nadelige effekte vanweë geneesmiddels en geneesmiddel interaksies te voorkom.

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