scholarly journals Fatal drowning in the Western Cape, South Africa: a 7-year retrospective, epidemiological study

2018 ◽  
Vol 25 (6) ◽  
pp. 529-534 ◽  
Author(s):  
Colleen Jayne Saunders ◽  
Robyn Adriaanse ◽  
Abigail Simons ◽  
Ashley van Niekerk

IntroductionDrowning is a neglected public health threat in low-income and middle-income countries where the greatest drowning burden is observed. There is a paucity of drowning surveillance data from low-resource settings, particularly in Africa. Understanding local epidemiological factors will enable the development of context-specific drowning prevention initiatives and the appropriate allocation of resources.AimThe primary aim of this study was to describe the epidemiology of fatal drowning in the Western Cape, South Africa.MethodThis retrospective study describes fatal drowning incidents captured in the Western Cape vital registration system between 2010 and 2016. Data were obtained from the Forensic Pathology Services of the Western Cape Government. One-way analysis of variance was performed to detect a trend in mean drowning mortality rates between 2010 and 2016. χ2 tests for independence were performed to detect differences in the distribution of variables between groups.ResultsA total of 1391 fatal drownings occurred in the Western Cape between 2010 and 2016, with an age-adjusted drowning mortality rate of 3.2 per 100 000 population. Rates were fourfold higher in men compared with women. Children, particularly young children aged 0–4 years, and young adult men between 20 and 34 years of age were identified to be at high risk of fatal drowning. Drowning occurred predominantly in large, open bodies of water with concentrations in summer and public holidays.ConclusionsThe Western Cape drowning prevention strategy should prioritise interventions to reduce drowning in children and young adult men, with a targeted focus on festive periods such as public holidays.

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Ronita Mahilall ◽  
Leslie Swartz

Abstract Background South Africa is a very diverse middle-income country, still deeply divided by the legacy of its colonial and apartheid past. As part of a larger study, this article explored the experiences and views of representatives of hospices in the Western Cape province of South Africa on the provision of appropriate spiritual care, given local issues and constraints. Methods Two sets of focus group discussions, with 23 hospice participants, were conducted with 11 of the 12 Hospice Palliative Care Association registered hospices in the Western Cape, South Africa, to understand what spiritual care practices existed in their hospices against the backdrop of multifaceted diversities. The discussions were analysed using thematic analysis. Results Two prominent themes emerged: the challenges of providing relevant spiritual care services in a religiously, culturally, linguistically and racially diverse setting, and the organisational context impacting such a spiritual care service. Participants agreed that spiritual care is an important service and that it plays a significant role within the inter-disciplinary team. Participants recognised the need for spiritual care training and skills development, alongside the financial costs of employing dedicated spiritual care workers. In spite of the diversities and resource constraints, the approach of individual hospices to providing spiritual care remained robust. Discussion Given the diversities that are largely unique to South Africa, shaped essentially by past injustices, the hospices have to navigate considerable hurdles such as cultural differences, religious diversity, and language barriers to provide spiritual care services, within significant resource constraints. Conclusions While each of the hospices have established spiritual care services to varying degrees, there was an expressed need for training in spiritual care to develop a baseline guide that was bespoke to the complexities of the South African context. Part of this training needs to focus on the complexity of providing culturally appropriate services.


Author(s):  
Deborah Louise Sinclair ◽  
Steve Sussman ◽  
Maarten De Schryver ◽  
Cedric Samyn ◽  
Sabirah Adams ◽  
...  

The dynamics of substitute behaviors and associated factors remain poorly understood globally, and particularly in low- and middle-income contexts. This prospective study describes the prevalence and types of substitute behaviors as well as predictors, correlates, and motivations associated with substitution in persons (n = 137) admitted to residential substance use treatment in the Western Cape province of South Africa. The brief assessment of recovery capital, overall life satisfaction scale, and an adapted version of the addiction matrix self-report measure were completed during and post-treatment. Results indicate that substitutes were employed consciously for anticipated appetitive effects, for time-spending, (re)connecting with others, and enjoyment. At follow-up, 36% of service users had substituted their primary substance(s) with another substance or behavior; 23% had relapsed and 40% had maintained abstinence. While some service users may be especially vulnerable to developing substitute behaviors, targeted prevention and intervention efforts can reduce this risk.


2019 ◽  
Vol 73 (5) ◽  
pp. 422-426
Author(s):  
Melissa Cortina ◽  
Helen E Jack ◽  
Rebecca Pearson ◽  
Kathleen Kahn ◽  
Stephen Tollman ◽  
...  

BackgroundChildren in low-income and middle-income countries (LMICs) who remain in school have better health and employment outcomes. South Africa, like many LMICs, has a secondary school completion rate under 50%, leaving room for improvement if we can identify factors that affect educational attainment. This is the first longitudinal study to examine the effects of childhood mental health and cognitions on educational outcomes in LMIC.MethodsUsing the Strengths and Difficulties Questionnaire (SDQ) and Cognitive Triad Inventory for Children (CTI-C), we assessed the psychological functioning and cognition of children aged 10–12 in rural South Africa. We linked that data with measures of educational progress collected 5 years later and examined associations between educational progress and (1) behavioural and emotional problems and (2) cognitive interpretations, adjusting for possible confounders.ResultsEducational data were available for 443 individuals. 92% (n=408) of individuals had advanced three or fewer grades in 7 years. Having more positive cognitions (CTIC-C) was positively associated with progressing at least three grade levels (adjusted OR 1.43, 95% CI 1.14 to 1.79). There was no evidence for an association between emotional and behavioural problems (SDQ) and educational progress (OR 0.90, 95% CI 0.72 to 1.11).ConclusionIf children in LMICs can develop more positive perspectives, they may be able to stay in school longer. Cognitions can be modified, and future studies should test interventions that work to improve cognition in childhood, guided, for example, by principles of cognitive–behavioural therapy.


2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Anniza de Villiers ◽  
Nelia P. Steyn ◽  
Catherine E. Draper ◽  
Jillian Hill ◽  
Lucinda Dalais ◽  
...  

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e028657 ◽  
Author(s):  
Alina Sabitova ◽  
Sana Zehra Sajun ◽  
Sandra Nicholson ◽  
Franziska Mosler ◽  
Stefan Priebe

ObjectivesTo systematically review the available literature on physicians’ and dentists’ experiences influencing job motivation, job satisfaction, burnout, well-being and symptoms of depression as indicators of job morale in low-income and middle-income countries.DesignThe review was reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for studies evaluating outcomes of interest using qualitative methods. The framework method was used to analyse and integrate review findings.Data sourcesA primary search of electronic databases was performed by using a combination of search terms related to the following areas of interest: ‘morale’, ‘physicians and dentists’ and ‘low-income and middle-income countries’. A secondary search of the grey literature was conducted in addition to checking the reference list of included studies and review papers.ResultsTen papers representing 10 different studies and involving 581 participants across seven low-income and middle-income countries met the inclusion criteria for the review. However, none of the studies focused on dentists’ experiences was included. An analytical framework including four main categories was developed: work environment (physical and social), rewards (financial, non-financial and social respect), work content (workload, nature of work, job security/stability and safety), managerial context (staffing levels, protocols and guidelines consistency and political interference). The job morale of physicians working in low-income and middle-income countries was mainly influenced by negative experiences. Increasing salaries, offering opportunities for career and professional development, improving the physical and social working environment, implementing clear professional guidelines and protocols and tackling healthcare staff shortage may influence physicians’ job morale positively.ConclusionsThere were a limited number of studies and a great degree of heterogeneity of evidence. Further research is recommended to assist in scrutinising context-specific issues and ways of addressing them to maximise their utility.PROSPERO registration numberCRD42017082579.


Author(s):  
Sam Surka ◽  
Krisela Steyn ◽  
Katherine Everett-Murphy ◽  
Thomas A. Gaziano ◽  
Naomi Levitt

Background: South Africa currently faces an increasing burden of cardiovascular disease. Although referred to clinics after community screening initiatives, few individuals who are identified to be at high risk for developing cardiovascular disease attend. Low health literacy and risk perception have been identified as possible causes. We investigated the knowledge and perceptions about risk for cardiovascular disease in a community.Method: We conducted a series of focus group discussions with individuals from a low incomeperi-urban community in the Western Cape, South Africa. Different methods of presenting risk were explored. The data were organised into themes and analysed to find associations between themes to provide explanations for our findings.Results: Respondents’ knowledge of cardiovascular disease and its risk factors varied, but most were familiar with the terms used to describe cardiovascular disease. In contrast, understanding of the concept of risk was poor. Risk was perceived as a binary concept and evaluation of different narrative and visual methods of presenting risk was not possible.Conclusion: Understanding cardiovascular disease and its risk factors requires a different set of skills from that needed to understand uncertainty and risk. The former requires knowledge of facts, whereas understanding of risk requires numerical and computational skills. Without a better understanding of risk, risk assessments for cardiovascular disease may fail in this community.


Author(s):  
Bonolo Anita Pududu ◽  
Hanna-Andrea Rother

Para-occupational “take-home” exposure risks among forestry workers and their families in low-and middle-income countries (LMICs) have not been well characterized. This is a concern because research shows an association between chronic low-dose herbicide exposure and adverse health effects. This study explored take-home herbicide residue exposure risks among forestry workers in the Western Cape, South Africa, through the community-based participatory research approach of photovoice. A key finding of the study was the absence of provisions related to take-home exposure in the national legislation and workplace policies, which largely contributed to poor adherence to risk reduction practices at worksites, in addition to workers transporting residues to their homes. This study demonstrated evidence of the key omissions regarding take-home exposure at the policy level (e.g., recommendations for employers to reduce take-home risks among employees, and training of workers and their families on take-home exposure) and take-home herbicide residue exposure among worker’s families, including children.


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