scholarly journals Estimates and Determinants of Psychological Problems of Pregnant Women during COVID-19 Epidemic in South Africa

2021 ◽  
Vol 3 (1) ◽  
pp. 143-149
Author(s):  
A. M. Hoque ◽  
M. Hoque ◽  
M. E. Hoque ◽  
G. Van Hal
Keyword(s):  
South Africa ◽  
Health Care ◽  
Pregnant Women ◽  
Care Facility ◽  
Psychological Problems ◽  
Primary Health Care Facility ◽  
Cross Sectional ◽  
Adequate Funding ◽  
Part Time ◽  
Anxiety Depression

The COVID-19 epidemic has impacted significantly on the general population including pregnant women. The psychological impact of COVID-19 among vulnerable population like pregnant women is yet to be estimated. Therefore, the objective of this study was to estimate the prevalence and factors associated with anxiety, depression, and overall psychological problems. A questionnaire-based cross-sectional study was conducted among black pregnant women attending a Primary Health Care facility in South Africa. Logistic regression analysis was performed to determine the significant factors for psychological problems. A total of 346 pregnant women participated in this study. The rates of anxiety, depression and overall psychological problems were 35.7%, 38.2% and 34.3% respectively. Gestational age between 14-26 weeks were 60% (OR=.397, p<0.05), part-time employment 53% (OR=0.47, p<0.05) and pregnant women having adequate funding for monthly expenses were 62% less likely (OR=0.381, p<0.05) to have anxiety problems. Married women were 2.5 times more likely (OR=2.54, p<0.05) and women living together or widowed were 2.9 times more likely (OR=2.91, p<0.05) to have anxiety. Pregnant women aged between 20-29 years were nine times (OR=9.03, p=0.016), women aged 30 to 39 years were 6.3 times (OR=6.3, p=0.032) more likely to have depression. Parity one 91% (OR=0.094, p=0.007), parity two 86% (OR=.143, p=0.027) and part-time employment 65% (OR=0.354, p=0.002) were less likely to have depression. Comparing with women aged >39 years, women who were between 20-29 years were 28 times (OR=27.8, p<0.01) and women aged between 30-39 years were nine times more likely to have overall psychological problems. Respondents with parity one was 83% (OR=0.17, p<0.05) less likely to have psychological problems when compared with other parity groups and women having adequate funding were 65% less likely (OR=0.35, p<0.05) to have overall psychological problems than those did not have adequate funding. Higher rates of anxiety, depression and overall psychological problems are found among black pregnant women. It is therefore imperative that appropriate and timely mental health care supports are provided to reduce adverse health outcomes.

scholarly journals COVID-19 Vaccine Acceptability Among Pregnant Women at a Primary Health Care Facility in Durban, South Africa

2020 ◽  
Vol 2 (5) ◽  
Author(s):  
A. M. Hoque ◽  
S. Buckus ◽  
M. Hoque ◽  
M. E. Hoque ◽  
G. Van Hal
Keyword(s):  
South Africa ◽  
Pregnant Women ◽  
Community Health Center ◽  
Care Facility ◽  
Health Care Facility ◽  
Primary Health Care Facility ◽  
Vaccine Acceptability ◽  
Cross Sectional ◽  
Vaccine Acceptance ◽  
Public Health Officials

A vaccine represents the most promising strategy for combatting the COVID-19 pandemic through primary prevention. No study has been reported on the acceptability of the COVID-19 vaccine in South Africa (SA) and in the region. The objective of this study was to determine the acceptance of a COVID-19 vaccine among pregnant women. A cross-sectional, descriptive study was conducted at the Kwadabeka Community Health Center (KCHC), Durban. Logistic regression analysis was performed to determine the factors for vaccine acceptability among pregnant women. About two-thirds of pregnant women (63.3%) may accept COVID-19 vaccination once it becomes available in SA. Participants who were <22 years of age were 72% less likely (OR=0.28, CI: 0.13 -0.62) to accept the vaccine, compared to those who were >39 years old. Women with 0-1 parity were 4.3 times more likely (OR=4.3, CI: 1.98-9.48) to accept the vaccine than those with four or more parity. Single pregnant women were less likely (OR=0.23, CI: 0.10- 0.51) to accept the vaccine than those living with their partners. Employed pregnant women had four times more chances of accepting the vaccine (OR= 4.2, CI: 2.28-7.75) than unemployed pregnant women. It was also found that having a positive attitude towards vaccination increased the chance of accepting the vaccine by four times (OR=4.05, CI: 1.89-8.69). Our study found a 63.3% acceptance of a COVID-19 vaccine, but there were noticeable demographic, knowledge, attitude and practice disparities observed in vaccine acceptance among pregnant women. Before a COVID-19 vaccine is introduced to SA, public health officials and policymakers must prioritize effective COVID-19 vaccine-acceptance messages and mass education for all South Africans, especially for the most vulnerable.

scholarly journals Can public sector community health workers deliver a nurturing care intervention in South Africa? The Amagugu Asakhula feasibility study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Sonja Klingberg ◽  
Esther M. F. van Sluijs ◽  
Stephanie T. Jong ◽  
Catherine E. Draper
Keyword(s):  
South Africa ◽  
Health Care ◽  
Public Sector ◽  
Health Workers ◽  
Care Facility ◽  
Health Care Facility ◽  
Preschool Age ◽  
Primary Health Care Facility ◽  
Community Based ◽  
Primary Health

Abstract Background Nurturing care interventions have the potential to promote health and development in early childhood. Amagugu Asakhula was designed to promote developmentally important dietary and movement behaviours among children of preschool age (3–5 years) in South Africa. An initial formative study in Cape Town found the intervention to be feasible and acceptable when delivered by community health workers (CHWs) linked to a community-based organisation. This study evaluated the delivery of the Amagugu Asakhula intervention by CHWs linked to a public sector primary health care facility in Soweto, as this mode of delivery could have more potential for sustainability and scalability. Methods A qualitative design was utilised to assess feasibility, acceptability, adoption, appropriateness, implementation, fidelity and context. CHWs (n = 14) delivered the intervention to caregivers (n = 23) of preschool-age children in Soweto over 6 weeks. Following the completion of the intervention, focus group discussions were held with CHWs and caregivers. Further data were obtained through observations, study records and key informant interviews (n = 5). Data were analysed using deductive thematic analysis guided by a process evaluation framework. Results The delivery of the Amagugu Asakhula intervention through CHWs linked to a primary health care facility in Soweto was not found to be feasible due to contextual challenges such as late payment of salaries influencing CHW performance and willingness to deliver the intervention. CHWs expressed dissatisfaction with their general working conditions and were thus reluctant to take on new tasks. Despite barriers to successful delivery, the intervention was well received by both CHWs and caregivers and was considered a good fit with the CHWs’ scope of work. Conclusions Based on these findings, delivery of the Amagugu Asakhula intervention is not recommended through public sector CHWs in South Africa. This feasibility study informs the optimisation of implementation and supports further testing of the intervention’s effectiveness when delivered by CHWs linked to community-based organisations. The present study further demonstrates how implementation challenges can be identified through qualitative feasibility studies and subsequently addressed prior to large-scale trials, avoiding the wasting of research and resources.

scholarly journals Pattern of intimate partner violence disclosure among pregnant women attending ante-natal clinic in Oyo East Local Government, Nigeria

2017 ◽  
Vol 59 (2) ◽  
pp. 31
Author(s):  
Abayomi Olusola Ayodapo ◽  
Olutoyin O Sekoni ◽  
Michael C Asuzu
Keyword(s):  
Health Care ◽  
Intimate Partner Violence ◽  
Local Government ◽  
Pregnant Women ◽  
Partner Violence ◽  
Care Facility ◽  
Public Health Problem ◽  
Intimate Partner ◽  
Health Care Facilities ◽  
Cross Sectional

Background: Intimate partner violence (IPV) is a significant public health problem. Despite being a phenomenon that occurs globally, few studies have reviewed the issue of intimate partner violence among pregnant women as it relates to disclosure of abuse. This study sets out to determine the prevalence and pattern of disclosure of intimate partner violence among pregnant women attending antenatal clinic in Oyo East Local Government of Oyo State. Methods: A descriptive cross-sectional study among pregnant women aged 18–49 years. A total of 350 pregnant women in the sole secondary health care facility and 3 out of the 18 primary health care facilities randomly selected by balloting were consecutively recruited. A pre-tested semi-structured questionnaire adapted from the WHO Multi-Country Study on Women’s Health and Domestic Violence was used to collect data. Data were analysed with SPSS® version 16. Results: Of 252 (72.0%) women who had been exposed to violence by their partner in pregnancy, 72 (28.6%) disclosed their IPV experience. The experience was disclosed to relatives, friends and religious leaders. Of the 72 that disclosed their IPV experience, 31 (43.1%) reported for the purpose of seeking redress through religious or local leaders, healthcare professionals and law enforcement agencies. Conclusion: Intimate partner violence is common among pregnant women, but a culture of silence still persists, making identification of the exposed difficult. These data may encourage healthcare providers to include screening for IPV in the curriculum of the antenatal care. (Full text of the research articles are available online at www.medpharm.tandfonline.com/ojfp) S Afr Fam Pract 2017; DOI: 10.1080/20786190.2016.1272245

scholarly journals Primary Health Care Facility Preparedness for Outpatient Service Provision During the COVID-19 Pandemic in India: Cross-Sectional Study (Preprint)

2020 ◽  
Author(s):  
Suneela Garg ◽  
Saurav Basu ◽  
Ruchir Rustagi ◽  
Amod Borle
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Infection Control ◽  
Care Facility ◽  
Health Care Facilities ◽  
Control Measures ◽  
Primary Health Care Facility ◽  
Outpatient Services ◽  
Cross Sectional ◽  
Primary Health

BACKGROUND Primary health centers (PHCs) represent the first tier of the Indian health care system, providing a range of essential outpatient services to people living in the rural, suburban, and hard-to-reach areas. Diversion of health care resources for containing the coronavirus disease (COVID-19) pandemic has significantly undermined the accessibility and availability of essential health services. Under these circumstances, the preparedness of PHCs in providing safe patient-centered care and meeting the current health needs of the population while preventing further transmission of the severe acute respiratory syndrome coronavirus 2 infection is crucial. OBJECTIVE The aim of this study was to determine the primary health care facility preparedness toward the provision of safe outpatient services during the COVID-19 pandemic in India. METHODS We conducted a cross-sectional study among supervisors and managers of primary health care facilities attached to medical colleges and institutions in India. A list of 60 faculties involved in the management and supervision of PHCs affiliated with the community medicine departments of medical colleges and institutes across India was compiled from an accessible private organization member database. We collected the data through a rapid survey from April 24 to 30, 2020, using a Google Forms online digital questionnaire that evaluated preparedness parameters based on self-assessment by the participants. The preparedness domains assessed were infrastructure availability, health worker safety, and patient care. RESULTS A total of 51 faculties responded to the survey. Each medical college and institution had on average a total of 2.94 (SD 1.7) PHCs under its jurisdiction. Infrastructural and infection control deficits at the PHC were reported in terms of limited physical space and queuing capacity, lack of separate entry and exit gates (n=25, 49%), inadequate ventilation (n=29, 57%), and negligible airborne infection control measures (n=38, 75.5%). N95 masks were available at 26 (50.9%) sites. Infection prevention and control measures were also suboptimal with inadequate facilities for handwashing and hand hygiene reported in 23.5% (n=12) and 27.4% (n=14) of sites, respectively. The operation of outpatient services, particularly related to maternal and child health, was significantly disrupted (<i>P</i>&lt;.001) during the COVID-19 pandemic. CONCLUSIONS Existing PHC facilities in India providing outpatient services are constrained in their functioning during the COVID-19 pandemic due to weak infrastructure contributing to suboptimal patient safety and infection control measures. Furthermore, there is a need for effective planning, communication, and coordination between the centralized health policy makers and health managers working at primary health care facilities to ensure overall preparedness during public health emergencies.

scholarly journals Utilization of delivery services in the context of Prevention of HIV from Mother- To-Child (PMTCT) in a rural community, South Africa

Curationis ◽  
2006 ◽  
Vol 29 (1) ◽  
Author(s):  
K Peltzer ◽  
T Mosala ◽  
O Shisana ◽  
A Nqeteko
Keyword(s):  
South Africa ◽  
Pregnant Women ◽  
Rural Community ◽  
Traditional Birth Attendant ◽  
Care Facility ◽  
Hiv Knowledge ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Delivery Services ◽  
Mother To Child

The aim of this study was to investigate the utilization of delivery services in the context of PMTCT in a rural community in South Africa. Based on a cross-sectional survey, the sample included 870 pregnant women who had delivered before recruited from five PMTCT clinics and surrounding communities. Results indicated that 55.9% had delivered their last child in a health care facility and 44.1% at home (mostly without assistance from a traditional birth attendant). The odds of access to the health facility were (1) women who stayed close to the hospital (OR=2.87), (2) those who had higher formal education (OR=l .55), (3) higher traveling costs (affordability) to get to nearest clinic (OR=1.77), and (4) those who were single (OR=1.58). Childbirth experiences of the mother or mother-in-law greatly influenced the delivery choices in terms of home delivery. The majority of the pregnant women were aware of mother-to-child HIV transmission but only 9% of the pregnant women had ever been tested for HIV. HIV knowledge, HIV testing behaviour and attitudes were found to be not associated with the delivery option.

scholarly journals Primary Health Care Facility Preparedness for Outpatient Service Provision During the COVID-19 Pandemic in India: Cross-Sectional Study

10.2196/19927 ◽  
2020 ◽  
Vol 6 (2) ◽  
pp. e19927 ◽  
Author(s):  
Suneela Garg ◽  
Saurav Basu ◽  
Ruchir Rustagi ◽  
Amod Borle
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Infection Control ◽  
Care Facility ◽  
Health Care Facilities ◽  
Control Measures ◽  
Primary Health Care Facility ◽  
Outpatient Services ◽  
Cross Sectional ◽  
Primary Health

Background Primary health centers (PHCs) represent the first tier of the Indian health care system, providing a range of essential outpatient services to people living in the rural, suburban, and hard-to-reach areas. Diversion of health care resources for containing the coronavirus disease (COVID-19) pandemic has significantly undermined the accessibility and availability of essential health services. Under these circumstances, the preparedness of PHCs in providing safe patient-centered care and meeting the current health needs of the population while preventing further transmission of the severe acute respiratory syndrome coronavirus 2 infection is crucial. Objective The aim of this study was to determine the primary health care facility preparedness toward the provision of safe outpatient services during the COVID-19 pandemic in India. Methods We conducted a cross-sectional study among supervisors and managers of primary health care facilities attached to medical colleges and institutions in India. A list of 60 faculties involved in the management and supervision of PHCs affiliated with the community medicine departments of medical colleges and institutes across India was compiled from an accessible private organization member database. We collected the data through a rapid survey from April 24 to 30, 2020, using a Google Forms online digital questionnaire that evaluated preparedness parameters based on self-assessment by the participants. The preparedness domains assessed were infrastructure availability, health worker safety, and patient care. Results A total of 51 faculties responded to the survey. Each medical college and institution had on average a total of 2.94 (SD 1.7) PHCs under its jurisdiction. Infrastructural and infection control deficits at the PHC were reported in terms of limited physical space and queuing capacity, lack of separate entry and exit gates (n=25, 49%), inadequate ventilation (n=29, 57%), and negligible airborne infection control measures (n=38, 75.5%). N95 masks were available at 26 (50.9%) sites. Infection prevention and control measures were also suboptimal with inadequate facilities for handwashing and hand hygiene reported in 23.5% (n=12) and 27.4% (n=14) of sites, respectively. The operation of outpatient services, particularly related to maternal and child health, was significantly disrupted (P<.001) during the COVID-19 pandemic. Conclusions Existing PHC facilities in India providing outpatient services are constrained in their functioning during the COVID-19 pandemic due to weak infrastructure contributing to suboptimal patient safety and infection control measures. Furthermore, there is a need for effective planning, communication, and coordination between the centralized health policy makers and health managers working at primary health care facilities to ensure overall preparedness during public health emergencies.

scholarly journals Knowledge, Attitudes, and Practices towards COVID-19 of Pregnant Women at a Primary Health Care Facility in South Africa

2021 ◽  
Vol 3 (1) ◽  
pp. 50-55
Author(s):  
A. M. Hoque ◽  
A. M. Alam ◽  
M. Hoque ◽  
M. E. Hoque ◽  
G. Van Hal
Keyword(s):  
South Africa ◽  
Pregnant Women ◽  
Preventive Measures ◽  
Care Facility ◽  
Primary Health Care Facility ◽  
Binary Logistic Regression Analysis ◽  
Attitudes And Practices ◽  
Preventive Practices ◽  
Knowledge And Attitude ◽  
Knowledge Attitudes And Practices

COVID-19 pandemic has resulted in the death of hundreds of thousands of people globally. Several preventive measures have been recommended to reduce the spread of the disease. However, the level of knowledge, attitudes, and practices (KAP) of these preventive measures among pregnant women, are yet to be evaluated in South Africa. Therefore, the objective of this study was to determine the KAP towards COVID-19 among pregnant women. The purpose was to identify KAP gaps of pregnant women and develop educational materials and implement programmes. A questionnaire-based cross-sectional study was undertaken. Student’s t-test, ANOVA test, Pearson’s correlation test and Binary logistic regression analysis was carried out. Majority of the respondents were single (71%), unemployed (52%), and had low education (78% had either no or less than 12 years education). More than half (51.2%) had vulnerable comorbidities for COVID-19 infection and complication. Both knowledge and attitude mean of pregnant women were found to be low at 43.5% and 30% respectively. However, their practice on prevention of COVID-19 was good at 76%. Knowledge was found to be significantly positively correlated with practice towards COVID-19 (r= 0.111). Women having good knowledge were seven times more likely to practice positively regarding COVID-19 (P=0.019). Women having 1-5 years of education were 94% less likely to practice good towards COVID-19 prevention (P=0.018) compared to those having post matric education. The pregnant women in this research had inadequate knowledge and attitude of COVID-19 infection. However, preventive practices were good among them. Mass education and communication strategies are thus required to improve the knowledge and attitudes of pregnant women towards COVID-19.

scholarly journals Linkage to TB care: A qualitative study to understand linkage from the patients’ perspective in the Western Cape Province, South Africa

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260200
Author(s):  
Nosivuyile Vanqa ◽  
Graeme Hoddinott ◽  
Baxolele Mbenyana ◽  
Muhammad Osman ◽  
Sue-Ann Meehan
Keyword(s):  
South Africa ◽  
Health Care ◽  
Primary Health Care ◽  
Care Facility ◽  
Health Care Facility ◽  
Easy Access ◽  
Primary Health Care Facility ◽  
Western Cape ◽  
Tb Treatment ◽  
Primary Health

Background Delayed linkage to tuberculosis (TB) treatment leads to poor patient outcomes and increased onward transmission. Between 12% and 25% of people diagnosed with TB are never linked to a primary health care facility for continued care. The TB health program is for creating processes that promote and facilitates easy access to care. We explored how TB patients experience TB services and how this influenced their choices around linkage to TB care and treatment. Methods We enrolled 20 participants routinely diagnosed with TB in hospital or at primary health care facilities (PHC) in a high TB/HIV burdened peri-urban community in South Africa. Using the Western Cape Provincial Health Data centre (PHDC) which consolidates person-level clinical data, we used dates of diagnosis and treatment initiation to select participants who had been linked (immediately, after a delay, or never). Between June 2019 and January 2020, we facilitated in-depth discussions to explore both the participants’ experience of their TB diagnosis and their journey around linking to TB care at a primary health care facility. We analysed the data using case descriptions. Results Twelve of twenty (12/20) participants interviewed who experienced a delay linking were diagnosed at the hospital. Participants who experienced delays in linking or never linked explained this as a result of lack of information and support from health care providers. Unpleasant previous TB treatment episodes made it difficult to ‘face’ TB again and being uncertain of their TB diagnosis. In contrast, participants said the main motivator for linking was a personal will to get better. Conclusion The health care system, especially in hospitals, should focus on strengthening patient-centred care. Communication and clear messaging on TB processes is key, to prepare patients in transitioning from a hospital setting to PHC facilities for continuation of care. This should not just include a thorough explanation of their TB diagnosis but ensure that patients understand treatment processes. Former TB patients may require additional counselling and support to re-engage in care.

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