scholarly journals Acceptability and feasibility of a school-based contraceptive clinic in a low-income community in South Africa

2019 ◽  
Vol 20 ◽  
Author(s):  
Nondumiso Khoza ◽  
Phindile Zulu ◽  
Maylene Shung-King
Keyword(s):  
South Africa ◽  
Side Effects ◽  
Low Income ◽  
Teenage Pregnancy ◽  
Health Workers ◽  
School Principal ◽  
Social Consequences ◽  
Teenage Girls ◽  
School Based ◽  
Contraceptive Side Effects

AbstractAimTo investigate how acceptable and feasible a school-based contraceptive clinic (SBCC) would be in a low-income South African community.BackgroundTeenage pregnancy is an important issue in South Africa, with significant health and social consequences. Issues regarding lack of confidentiality in an intimate community, unwelcoming health workers, long distances to clinics and perceptions of contraceptive side effects may all inhibit contraceptive use by adolescents. Although SBCC has been initiated and investigated in other countries, this approach is inadequately researched in South Africa.MethodsA mixed method study was conducted to assess the attitudes of one community towards establishment of an SBCC in their area. Methods of data collection included: focus group discussions (FGDs) with teenage girls from a local high school; a key informant interview with the school principal; a structured survey, including open-ended questionnaires with randomly selected parents of teenage girls from the same community; and a documentary analysis to explore relevant legal and policy considerations.FindingsTeenage girls, the school principal and parents with teenage daughters largely supported the idea of an SBCC, but with concerns about confidentiality, the possibility of increased promiscuity and contraceptive side effects. While legal statutes and policies in South Africa do not pose any barriers to the establishment of an SBCC, some logistical barriers remain.

scholarly journals Re-Conceptualizing School Continuation & Re-Entry Policy for Young Mothers Living in an Urban Slum Context in Nairobi, Kenya: A Participatory Approach

2018 ◽  
Vol 12 (2) ◽  
pp. 310-328
Author(s):  
Milka Perez Nyariro
Keyword(s):  
Low Income ◽  
Teenage Pregnancy ◽  
Urban Slum ◽  
Policy Formulation ◽  
Policy Dialogue ◽  
Young Mothers ◽  
Policy Reforms ◽  
Education Policies ◽  
Teenage Girls ◽  
Inequality In Education

This article discusses the barriers to school continuation for pregnant girls and young mothers living in low-income and marginalized contexts in Nairobi, Kenya. In the article, I suggest adopting a girl-centered framework in the policy formulation process (Moletsane, Mitchell, & Lewin, 2015). This perspective puts girls’ voices at the center of the policy formulation process to help address the persistent gender inequality in education through problem identification and an exploration of ways to combat the challenges faced by girls. The article, which analyzes studies of government’s education policies, is supported by data from my recent fieldwork investigating young mothers’ challenges to school continuation and re-entry in Kenya, within the context of Kenya’s re-entry and continuation policy effected in 1994. I discuss the school re-entry and continuationpolicies in low-income contexts using the framework of critical feminism. I argue that there is need to integrate multi-pronged, participatory and feminist frameworks to promote systematic government educational policy reforms to shore up gender equality (King & Winthrop, 2015).  To support this argument, I develop three main claims: (a) broad conceptualization of the causes of teenage pregnancy will promote the use of multi-pronged approaches to the design of school re-entry and continuation policies; (b) formulation and implementation of any robust policies on re-entry and continuation require strong integration of the voices, perspectives and the lived experiences of pregnant teenage girls and young mothers; and (c) the use of participatory visual methodologies will give voice to pregnant girls and young mothers, and promote policy dialogue while at the same time empowering them and spurring their agency to become part of policy formulation and implementation.

Abstract 242: Evaluating the Impact and Barriers to a Collaborative Physician-pharmacist Care Model to Control Hypertension in a Low-income Population

2020 ◽  
Vol 13 (Suppl_1) ◽  
Author(s):  
Kerrilynn C Hennessey ◽  
Carolyn Hickman ◽  
Brianne Krawczyk ◽  
Michelle Opare ◽  
Leslie Churchwell ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Side Effects ◽  
Blood Pressure Control ◽  
Low Income ◽  
Health Workers ◽  
Pressure Control ◽  
Low Income Population ◽  
Early Results ◽  
Patient Reported ◽  
The Impact

Objectives: Physician-pharmacist collaborative practice models have emerged as an effective model for managing hypertension (HTN). We implemented this model in a low-income, hospital-based cardiology clinic and sought to identify programmatic features necessary to control HTN in this vulnerable population. Methods: Patients with persistently elevated blood pressure (>130/80) were referred by their primary cardiologist. Patients were excluded if they were pregnant, had acute kidney injury, or acute cardiovascular complaints including anginal chest pain, decompensated heart failure, or unstable arrhythmia. The initial pharmacist appointment occurred within 2 weeks of referral, with the goal of bi-weekly visits for 6 weeks or until blood pressure was controlled. Patients were prescribed home blood pressure cuffs and given specific instructions for home-based monitoring. Telehealth visits were made available to interested patients. During each encounter, pharmacists assessed response and side effects to medication, adherence, lifestyle behaviors, stressors, and social barriers to blood pressure control. Clinical management and barriers to HTN control were reviewed at standing weekly staff meetings that included cardiologists and pharmacists. Early results: Among 35 people referred, 22 patients attended at least one pharmacist visit. A total of 139 reminder or follow-up calls were made for these 22 patients. Among the first 35 referrals (mean age 58; 57% male; 65% African American or Latinx), 26% have documented substance use disorders, 34% have a mental health comorbidity, 20% were not taking their medications as prescribed on intake, and 17% had side effects from 2 or more prior antihypertensive medications. Medications adjustments were made in 21/43 patient visits (49% of visits). In 8/43 visits more than 1 medication change was made. The most common patient reported barriers to care include transportation (20%) and language barriers (11%). Discussion and Future Direction: Managing HTN in a low-income population requires attention to the social and contextual factors impacting blood pressure control. We plan to: 1) support the uptake of telehealth to address issues of transportation and access; 2) pilot blue-tooth connected blood pressure cuffs to facilitate home monitoring and management; and 3) partner with community health workers to assess best practices for capturing and addressing social determinants of health in the clinical setting.

scholarly journals Community-Based Hearing and Vision Screening in Schools in Low-Income Communities Using Mobile Health Technologies

2021 ◽  
pp. 1-13
Author(s):  
Michelle Manus ◽  
Jeannie van der Linde ◽  
Hannah Kuper ◽  
Renate Olinger ◽  
De Wet Swanepoel
Keyword(s):  
South Africa ◽  
Visual Acuity ◽  
Mobile Health ◽  
Low Income ◽  
Vision Loss ◽  
Health Workers ◽  
Screening Program ◽  
Hearing Screening ◽  
Vision Screening ◽  
Health Technologies

Introduction Globally, more than 50 million children have hearing or vision loss. Most of these sensory losses are identified late due to a lack of systematic screening, making treatment and rehabilitation less effective. Mobile health (mHealth), which is the use of smartphones or wireless devices in health care, can improve access to screening services. mHealth technologies allow lay health workers (LHWs) to provide hearing and vision screening in communities. Purpose The aim of the study was to evaluate a hearing and vision school screening program facilitated by LHWs using smartphone applications in a low-income community in South Africa. Method Three LHWs were trained to provide dual sensory screening using smartphone-based applications. The hearScreen app with calibrated headphones was used to conduct screening audiometry, and the Peek Acuity app was used for visual acuity screening. Schools were selected from low-income communities (Gauteng, South Africa), and children aged between 4 and 9 years received hearing and vision screening. Screening outcomes, associated variables, and program costs were evaluated. Results A total of 4,888 and 4,933 participants received hearing and vision screening, respectively. Overall, 1.6% of participants failed the hearing screening, and 3.6% failed visual acuity screening. Logistic regression showed that female participants were more likely to pass hearing screening ( OR = 1.61, 95% CI [1.11, 2.54]), while older children were less likely to pass visual acuity screening ( OR = 0.87, 95% CI [0.79, 0.96]). A third (32.5%) of referred cases followed up for air-conduction threshold audiometry, and one in four (25.1%) followed up for diagnostic vision testing. A high proportion of these cases were confirmed to have hearing (73.1%, 19/26) or vision loss (57.8%, 26/45). Conclusions mHealth technologies can enable LHWs to identify school-age children with hearing and/or vision loss in low-income communities. This approach allows for low-cost, scalable models for early detection of sensory losses that can affect academic performance.

Critical Analysis of the Right to Education for Pregnant School-going Teenage Girls in South Africa

2021 ◽  
Vol 10 (3) ◽  
pp. 73-85
Author(s):  
Isaiah M. Sefoka ◽  
◽  
Kola O. Odeku
Keyword(s):  
South Africa ◽  
Teenage Pregnancy ◽  
Legal Protection ◽  
Dropping Out ◽  
Research Approach ◽  
Human Right ◽  
Right To Education ◽  
Teenage Girls ◽  
The Right ◽  
Out Of School

Most inadvertently, teenage girls in school fall pregnant. Over recent years, South Africa has seen an exponential increase in teenage pregnancy. A significant number of pregnant teenage girls end up dropping out of school as often they are unable to cope with the huge responsibility associated with pregnancy, and some schools are not supportive of pregnant learners. However, pregnant teenage girls still have the right to education. To make it methodologically sound, this study utilized a literature review research approach, mainly sourced from google scholar search engine, to address issues relating to the legal protection of pregnant teenagers. The study found that, in schools, pregnant girls were discriminated against on different grounds, and sometimes expelled. The research presented consequences of teenage pregnancy such as, dropping out of school, loneliness, anxiety/stress, and so on. More importantly, using the jurisprudence of the South African courts, the paper accentuates that pregnant teenagers still have the right to education, and being pregnant cannot be used to deprive or deny them this fundamental human right. It prohibits discrimination in schools on the basis of pregnancy, and presents arguments for continuation of schooling, and all assistance needed to ensure that the right to education is protected at all costs, even during pregnancy.

scholarly journals International migration of health labour: monitoring the two-way flow of physicians in South Africa

2019 ◽  
Vol 4 (5) ◽  
pp. e001566 ◽  
Author(s):  
Akhenaten Siankam Tankwanchi ◽  
Amy Hagopian ◽  
Sten H Vermund
Keyword(s):  
South Africa ◽  
Low Income ◽  
Health Personnel ◽  
Health Workers ◽  
Oecd Countries ◽  
International Medical ◽  
International Medical Graduates ◽  
Medical Council ◽  
Medical Graduates ◽  
The Difference

IntroductionAlthough health labour migration is a global phenomenon, studies have neglected the flow of health workers into low-income and middle-income countries (LMICs). In compliance with the data-monitoring recommendation of the WHO Global Code of Practice on the International Recruitment of Health Personnel (Code), we estimated post-Code physician net migration (NM) in South Africa (SA), and SA’s net loss of physicians to Organisation for Economic Co-operation and Development (OECD) countries from 2010 to 2014.MethodsWe sourced data from the National Reporting Instrument reports, the OECD and the General Medical Council. Using the numbers of foreign nationals and international medical graduates (IMGs) registered in SA, and SA medical graduates registered in OECD countries (South African-trained international medical graduates (SA-IMGs)) as respective proxies for immigration and emigration, we estimated ‘NM’ as the difference between immigrant physicians and emigrant physicians and ‘net loss’ as the difference between OECD-trained IMGs and OECD-based SA-IMGs.ResultsIn 2010, SA hosted 8443 immigrant physicians, while OECD countries hosted 14 933 SA-IMGs, yielding a NM of −6490 physicians and a NM rate of −18% in SA. By 2014, SA-based immigrant physicians had increased by 4%, while SA-IMGs had decreased by −15%, halving the NM rate to −9%. SA-to-OECD estimated net loss of physicians dropped from −12 739 physicians in 2010 to −10 563 in 2014. IMGs represented 46% of 2010–2014 new registrations in SA, with the UK, Nigeria and the Democratic Republic of the Congo serving as leading sources. Registrants from conflict-scarred Libya increased >100-fold. More than 3400 SA-IMGs exited OECD-based workforces.ConclusionNM is a better measure of the brain drain than simply the emigration fraction. Strengthened health personnel data management and reporting through implementation of the Code-related system of National Health Workforce Accounts will further increase our understanding of health worker mobility in LMICs, with policymakers empowered to make more informed policies to address shortage.

Factors that Contribute to the High Rate of Teenage Pregnancy and its Reduction in a High-Risk Area in North West, South Africa

2020 ◽  
Vol 22 (2) ◽  
Author(s):  
Leepile Alfred Sehularo ◽  
Kebitsamang Elizabeth Medupe ◽  
Omphemetse Meno
Keyword(s):  
South Africa ◽  
High Risk ◽  
Teenage Pregnancy ◽  
High Rate ◽  
Risk Area ◽  
High Risk Area ◽  
North West ◽  
Teenage Girls ◽  
Individual Interviews ◽  
The North

Teenage pregnancy is a global concern, and is associated with high levels of sociomedical morbidity. However, no studies have been conducted on this topic at a high-risk area in the North West province of South Africa. The aim of this study was to explore and describe the factors that contribute to the high rate of teenage pregnancy and its reduction in a high-risk area in North West. A qualitative, exploratory, descriptive and contextual research design was used to achieve the aim of the study. A non-probability purposive sampling method was used to select 15 teenage girls aged between 13 and 19 years. A total of 15 semi-structured individual interviews were used to collect data from the teenagers. Tech’s open-coding method of qualitative data analysis was used separately by the researcher and the co-coder to analyse the data. Two themes emerged, namely, contributory factors of teenage pregnancies and factors that could help to reduce teenage pregnancies. The findings of the study indicate that to effectively reduce teenage pregnancies in the high-risk area in North West, the teenagers, friends, parents, families, tavern owners and health professionals must adopt a collaborative approach to work together to fight this problem. Recommendations were made to reduce teenage pregnancies in the high-risk area in North West.

scholarly journals Youths’ perceptions of community health workers’ delivery of family planning services: a cross-sectional, mixed-methods study in Nakaseke District, Uganda

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Robert Kalyesubula ◽  
Jessica Mitter Pardo ◽  
Stephanie Yeh ◽  
Richard Munana ◽  
Ivan Weswa ◽  
...  
Keyword(s):  
Family Planning ◽  
Side Effects ◽  
Health Workers ◽  
Health Sector ◽  
Group Discussions ◽  
Cross Sectional ◽  
Seeking Behavior ◽  
Contraceptive Side Effects ◽  
Opposite Sex ◽  
Unintended Adolescent Pregnancy

Abstract Background High rates of unintended adolescent pregnancy are a significant health problem in Uganda. To improve access to family planning (FP) services, community-based Village Health Teams (VHTs) are widely employed in Uganda to deliver education and services. However, evaluations of FP programs suggest that mainly older, married women use VHT FP services. Methods To better understand youth reluctance to use VHTs, we collected quantitative FP and contraceptive-seeking behavior data from a survey of 250 youths aged 15–25 in randomly selected households in Nakaseke District, which we triangulated with data from 3 focus group discussions (FGDs) (n = 15). Results Most respondents received FP services from the formal health sector, not VHTs. Only half had talked to a VHT, but 65% knew that VHTs provide free FP services, and most (82%) felt comfortable talking to VHTs about FP. The main reasons for discomfort were fear that VHTs would violate privacy (mentioned by 60% of those not comfortable), that VHTs would talk to parents (33%), shyness (mentioned by 42% of those ≤18), and fear of being judged (14%). Concern about side effects was the most common reason for not using FP methods. Survey respondents said having VHTs of the same sex was important, particularly those in the youngest age group (OR = 4.45; 95%CI: 1.24, 16.00) and those who were unmarried (OR = 5.02; 95%CI: 2.42, 10.39). However, FGD participants (who were older than survey respondents on average) often preferred older VHTs of the opposite sex, whom they viewed as more professional and trustworthy. Respondents said the primary deciding factors for using VHTs were whether privacy would be respected, the proximity of care, and the respectfulness of care. Conclusions VHTs are a known source of FP services but not widely used by youth due to privacy and quality of care concerns. VHT messaging and training should increase focus on ensuring privacy, protecting confidentiality, providing respectful care, and addressing concerns about contraceptive side effects. Preferences for VHTs of similar age and sex may be more important for younger adolescents than older youths for whom quality concerns predominate.

The Relationship between the Child Support Grant and Teenage Fertility in Post-Apartheid South Africa

2013 ◽  
Vol 13 (4) ◽  
pp. 505-519
Author(s):  
Eric O. Udjo
Keyword(s):  
South Africa ◽  
Low Income ◽  
Teenage Pregnancy ◽  
Child Support ◽  
Social Assistance ◽  
Vulnerable Groups ◽  
Child Support Grant ◽  
The Right ◽  
The Impact ◽  
The Relationship

Governments often provide some form of social assistance to vulnerable groups. The right to social security is enshrined in the South African Constitution and the Social Assistance Act 13 of 2004. The country provides for a child support grant to single parents or caregivers who are low-income earners. The impact of the child support grant on teenage pregnancy in South Africa has aroused interest in the last couple of years, sparking debate that it may be encouraging teenage pregnancy. However, empirical evidence has been produced to confirm this relationship. This study examines the relationship between receiving the child support grant and being pregnant with another child in two national data sets using logistic regression analysis and empirical data. The results indicate that teenagers who receive the child support grant are significantly less likely to be pregnant with another child compared with teenagers who do not receive the child support grant.

Sexuality, Schooling, and Adolescent Females: The Missing Discourse of Desire

1988 ◽  
Vol 58 (1) ◽  
pp. 29-54 ◽  
Author(s):  
Michelle Fine
Keyword(s):  
Public Schools ◽  
Sex Education ◽  
Low Income ◽  
Teenage Pregnancy ◽  
Sexuality Education ◽  
Adolescent Females ◽  
Education Policies ◽  
Health Clinics ◽  
School Based ◽  
Sexual Responsibility

Michelle Fine argues that the anti-sex rhetoric surrounding sex education and school-based health clinics does little to enhance the development of sexual responsibility and subjectivity in adolescents. Despite substantial evidence on the success of both school-based health clinics and access to sexuality information, the majority of public schools do not sanction or provide such information. As a result, female students, particularly low-income ones, suffer most from the inadequacies of present sex education policies. Current practices and language lead to increased experiences of victimization, teenage pregnancy, and increased dropout rates,and consequently, ". . . combine to exacerbate the vulnerability of young women whom schools, and the critics of sex education and school-based health clinics, claim to protect."The author combines a thorough review of the literature with her research in public schools to make a compelling argument for "sexuality education" that fosters not only the full development of a sexual self but education in its broadest sense.

scholarly journals Experiences of Seeking Antenatal Care and Delivery Among Teenagers at Health Facilities in Kibuku District, Eastern Uganda

2020 ◽  
Author(s):  
Robert K Basaza ◽  
Josephine N Mawerere ◽  
Rebecca Namusana
Keyword(s):  
Antenatal Care ◽  
Rural Areas ◽  
Teenage Pregnancy ◽  
Health Workers ◽  
Average Rate ◽  
Health Facilities ◽  
Limited Information ◽  
Teenage Girls ◽  
Personal Experiences ◽  
Eastern Uganda

Abstract Background: Uganda is ranked 14th out of 54 countries in Africa with the highest levels of teenage pregnancies. The teenage pregnancy rate in Kibuku District in 2016 was at 35.8%, higher than the average rate in Uganda (25%) and also above the average one for rural areas in Uganda which was at 27%. Unfortunately, there is limited information on the experiences of seeking antenatal care and delivery among teenagers in the district. Method: This paper explored what these teenagers experience when they seek services at health facilities in Kibuku district, Eastern Uganda. This study used a phenomenological design. Data was collected using in-depth interviews from pregnant teenagers aged 13-19 years, seeking antenatal care (ANC) or who had delivered. They were purposively selected to participate in the study. Data collected was thematically analyzed through coding.Results: Most teenage mothers know the importance of seeking ANC and delivering from a health facility. Unfortunately, only a few seek services early due to some experiences. These include personal experiences like financial constraints; interpersonal experiences like support they receive from the people they stay with who include husbands and parents, medication given, health workers’ attitude and health education given.Conclusion: The personal experiences of pregnant teenagers or those who had delivered at health facilities is that they knew the importance of seeking ANC and delivery at health facilities. The experiences with the health facilities also contributed to the seeking behavior of the teenage girls. For example, the comfort received by the girls at the facility, medication administered, the way they were treated by the health workers and the availability of utilities. The teenage girls need to be sensitized by health and social workers about the sensitive nature of their health when they are pregnant so that they are able to make personal decisions.

Sign in / Sign up

Export Citation Format

Share Document