scholarly journals Frontline health workers and exclusive breastfeeding guidelines in an HIV endemic South African community: a qualitative exploration of policy translation

2018 ◽  
Vol 13 (1) ◽  
Author(s):  
Sara Nieuwoudt ◽  
Lenore Manderson
Keyword(s):  
South African ◽  
Exclusive Breastfeeding ◽  
Health Workers ◽  
Frontline Health Workers ◽  
African Community ◽  
Policy Translation ◽  
Qualitative Exploration

“Contract to Volunteer”: South African Community Health Worker Mobilization for Better Labor Protection

2017 ◽  
Vol 27 (4) ◽  
pp. 648-666 ◽  
Author(s):  
Zara Trafford ◽  
Alison Swartz ◽  
Christopher J. Colvin
Keyword(s):  
Community Health ◽  
South African ◽  
Health Workers ◽  
Labor Rights ◽  
Future Research ◽  
Local Health ◽  
Decent Work ◽  
National Union ◽  
African Community ◽  
Run Up

In this paper, we explore the increasing activity around labor rights for South African community health workers (CHWs). Contextualizing this activity within broader policy and legal developments, we track the emergence of sporadic mobilizations for decent work (supported by local health activist organizations) and subsequently, the formation of a CHW union. The National Union of Care Workers of South Africa (NUCWOSA) was inaugurated in 2016, hoping to secure formal and secure employment through government and the consequent labor and occupational health protections. Various tensions were observed during fieldwork in the run up to NUCWOSA's formation and raise important questions about representation, legitimacy, and hierarchies of power. We close by offering suggestions for future research in this developing space.

scholarly journals Realities and challenges of breastfeeding policy in the context of HIV: a qualitative study on community perspectives on facilitators and barriers related to breastfeeding among HIV positive mothers in Baringo County, Kenya

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Betty Mogesi Samburu ◽  
Judith Kimiywe ◽  
Sera Lewise Young ◽  
Frederick Murunga Wekesah ◽  
Milka Njeri Wanjohi ◽  
...  
Keyword(s):  
Exclusive Breastfeeding ◽  
Cultural Practices ◽  
Health Workers ◽  
Male Involvement ◽  
Holistic Approach ◽  
Antiretroviral Drugs ◽  
Hiv Positive ◽  
Community Perspectives ◽  
Hiv Positive Mothers ◽  
Facilitators And Barriers

Abstract Background Although recent policies have sought to increase the rates of exclusive breastfeeding (EBF) and continued breastfeeding for HIV exposed infants, few programs have considered the multiple social and cultural barriers to the practice. Therefore, to generate evidence for exclusive and continued breastfeeding policies in Kenya, we examined community perspectives on the facilitators and barriers in adherence to EBF for the HIV positive mothers. Methods Qualitative research was conducted in Koibatek, a sub-County in Baringo County Kenya, in August 2014 among 205 respondents. A total of 14 focus group discussions (n = 177), 14 In-depth Interviews and 16 key informant interviews were conducted. Transcribed data was analyzed thematically. NVivo version 10.0 computer qualitative software program was used to manage and facilitate the analysis. Results Facilitators to exclusive breastfeeding were perceived to include counselling at the health facility, desire to have a healthy baby, use of antiretroviral drugs and health benefits associated with breastmilk. Barriers to EBF included poor dissemination of policies, knowledge gap, misinterpretation of EBF, inadequate counselling, attitude of mother and health workers due to fear of vertical HIV transmission, stigma related to misconception and misinformation that EBF is only compulsory for HIV positive mothers, stigma related to HIV and disclosure, social pressure, lack of male involvement, cultural practices and traditions, employment, food insecurity. Conclusions There are multiple facilitators and barriers of optimal breastfeeding that needs a holistic approach to interventions aimed at achieving elimination of mother to child transmission. Extension of infant feeding support in the context of HIV to the community while building on existing interventions such as the Baby Friendly Community Initiative is key to providing confidential support services for the additional needs faced by HIV positive mothers.

scholarly journals High percentage of undiagnosed HIV cases within a hyperendemic South African community: a population-based study

2017 ◽  
Vol 72 (2) ◽  
pp. 168-172 ◽  
Author(s):  
Alain Vandormael ◽  
Tulio de Oliveira ◽  
Frank Tanser ◽  
Till Bärnighausen ◽  
Joshua T Herbeck
Keyword(s):  
Hiv Testing ◽  
South African ◽  
Hiv Infections ◽  
Population Based ◽  
Hiv Positive ◽  
Aids Epidemic ◽  
Undiagnosed Hiv ◽  
African Community ◽  
Repeat Hiv Testing ◽  
High Level

BackgroundUndiagnosed HIV infections could undermine efforts to reverse the global AIDS epidemic by 2030. In this study, we estimated the percentage of HIV-positive persons who remain undiagnosed within a hyperendemic South African community.MethodsThe data come from a population-based surveillance system located in the Umkhanyakude district of the northern KwaZulu-Natal province, South Africa. We annually tested 38 661 adults for HIV between 2005 and 2016. Using the HIV-positive test results of 12 039 (31%) participants, we then back-calculated the incidence of infection and derived the number of undiagnosed cases from this result.ResultsThe percentage of undiagnosed HIV cases decreased from 29.3% in 2005 to 15.8% in 2011. During this period, however, approximately 50% of the participants refused to test for HIV, which lengthened the average time from infection to diagnosis. Consequently, the percentage of undiagnosed HIV cases reversed direction and steadily increased from 16.1% to 18.9% over the 2012–2016 period.ConclusionsResults from this hyperendemic South African setting show that the HIV testing rate is low, with long infection times, and an unsatisfactorily high percentage of undiagnosed cases. A high level of repeat HIV testing is needed to minimise the time from infection to diagnosis if the global AIDS epidemic is to be reversed within the next two decades.

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