06 - LOW CONTRACEPTIVE USE IN WOMEN WITH MENTAL ILLNESS IN A LOW-MIDDLE INCOME SETTING IN SOWETO, SOUTH AFRICA

Author(s):  
Lisa Galvin ◽  
Yvette Nel
2020 ◽  
Vol 22 (2) ◽  
Author(s):  
Mamakota Maggie Molepo ◽  
Faniswa Honest Mfidi

Mental illness is more than just the diagnosis to an individual – it also has an impact on the social functioning of the family at large. When a parent or relative has a mental illness, all other family members are affected, even the children. The purpose of the study was to provide insight into the lived experiences of young people who live with mental healthcare users and the way in which their daily coping can be maximised. A qualitative, descriptive, phenomenological research was undertaken to explore and describe the lived experiences of young people who live with mental healthcare users in the Limpopo province, South Africa. Audiotaped, unstructured in-depth interviews were conducted with 10 young people who grew up and lived with a family member who is a mental healthcare user in their homes, until data saturation was reached. A content analysis was used to derive themes from the collected qualitative data. Four major themes emerged as features reflective of the young people’s daily living with mental healthcare user, namely psychological effects, added responsibilities, effects on school performances, and support systems. This study recommends that support networks for young people be established through multidisciplinary team involvement and collaboration and the provision of burden-sharing or a relief system during times of need. With the availability of healthy coping mechanisms and support systems, the daily living situations and coping of young people could be maximised, thereby improving their quality of life while living with their family members with mental illness.


Author(s):  
Roberts Cynthia ◽  
Leslie Armijo ◽  
Saori Katada

The chapter analyzes the prospects for continued BRICS collective financial statecraft. Contrary to initial expectations, the BRICS (Brazil, Russia, India, China, and South Africa) have hung together by identifying common aversions and pursuing common interests within the existing international order. Their future depends not only on their bargaining power, but also on their ability to overcome domestic impediments to the sustainable economic growth that provides the basis for their international positions. To continue successfully with collective financial statecraft, the members must tackle the so-called middle-income trap, as well as their preferences for informal rules originating from their own institutional weaknesses or regime preferences. This study shows that, in the context of a global power shift, the BRICS club has operated to protect the member countries’ respective policy autonomy, while also advancing their joint voice in global governance. Recently, the BRICS have made concrete institutional gains, giving them expanded outside options to achieve specific objectives in global finance.


BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e045005
Author(s):  
Fadia Gamieldien ◽  
Roshan Galvaan ◽  
Bronwyn Myers ◽  
Zarina Syed ◽  
Katherine Sorsdahl

ObjectiveTo examine the literature on how recovery of people with severe mental illness (SMI) is conceptualised in low/middle-income countries (LMICs), and in particular what factors are thought to facilitate recovery.DesignScoping review.Data sources and eligibilityWe searched 14 electronic databases, hand searched citations and consulted with experts during the period May–December 2019. Eligible studies were independently screened for inclusion and exclusion by two reviewers. Unresolved discrepancies were referred to a third reviewer.Data extraction and synthesisAll bibliographical data and study characteristics were extracted using a data charting form. Selected studies were analysed through a thematic analysis emerging from extracted data.ResultsThe Preferred Reporting Items for Systematic Reviews and Meta-Analyses flow diagram offers a summary of the results: 4201 titles, 1530 abstracts and 109 full-text articles were screened. Ten articles were selected for inclusion: two from Turkey, two from India, and one each from China, Swaziland, Indonesia, Egypt, South Africa and Vietnam. Although most studies used qualitative methods, data collection and sampling methods were heterogeneous. One study reported on service provider perspectives while the rest provided perspectives from a combination of service users and caregivers. Three themes emerged from the data analysis. First, studies frame recovery as a personal journey occurring along a continuum. Second, there was an emphasis on social relationships as a facilitator of recovery. Third, spirituality emerged as both a facilitator and an indicator of recovery. These themes were not mutually exclusive and some overlap exists.ConclusionAlthough there were commonalities with how high-income countries describe recovery, we also found differences in conceptualisation. These differences in how recovery was understood reflect the importance of framing the personal recovery concept in relation to local needs and contextual issues found in LMICs. This review highlighted the current sparse evidence base and the need to better understand recovery from SMI in LMICs.


2021 ◽  
pp. 152483802110160
Author(s):  
Seema Vyas ◽  
Melissa Meinhart ◽  
Katrina Troy ◽  
Hannah Brumbaum ◽  
Catherine Poulton ◽  
...  

Evidence demonstrating the economic burden of violence against women and girls can support policy and advocacy efforts for investment in violence prevention and response programming. We undertook a systematic review of evidence on the costs of violence against women and girls in low- and middle-income countries published since 2005. In addition to understanding costs, we examined the consistency of methodological approaches applied and identified and assessed common methodological issues. Thirteen articles were identified, eight of which were from sub-Saharan Africa. Eight studies estimated costs associated with domestic or intimate partner violence, others estimated the costs of interpersonal violence, female genital cutting, and sexual assaults. Methodologies applied to estimate costs were typically based on accounting approaches. Our review found that out-of-pocket expenditures to individuals for seeking health care after an episode of violence ranged from US$29.72 (South Africa) to US$156.11 (Romania) and that lost productivity averaged from US$73.84 to US$2,151.48 (South Africa) per facility visit. Most studies that estimated provider costs of service delivery presented total programmatic costs, and there was variation in interventions, scale, and resource inputs measured which hampered comparability. Variations in methodological assumptions and data availability also made comparisons across countries and settings challenging. The limited scope of studies in measuring the multifaceted impacts of violence highlights the challenges in identifying cost metrics that extend beyond specific violence episodes. Despite the limited evidence base, our assessment leads us to conclude that the estimated costs of violence against women and girls are a fraction of its true economic burden.


Author(s):  
Prasanthi Puvanachandra ◽  
Aliasgher Janmohammed ◽  
Pumla Mtambeka ◽  
Megan Prinsloo ◽  
Sebastian Van As ◽  
...  

Background: Child road traffic injuries are a major global public health problem and the issue is particularly burdensome in middle-income countries such as South Africa where injury death rates are 41 per 100,000 for under 5′s and 24.5 per 100,000 for 5–14-year-old. Despite their known effectiveness in reducing injuries amongst children, the rates of use of child restraint systems (CRS) remains low in South Africa. Little is known about barriers to child restraint use especially in low- and middle-income countries. Methods: We carried out observation studies and parent/carer surveys in 7 suburbs of Cape Town over a three month period to assess usage rates and explore the knowledge and perceptions of parents towards child restraint legislation, ownership and cost; Results: Only 7.8% of child passengers were observed to be properly restrained in a CRS with driver seatbelt use and single child occupancy being associated with higher child restraint use. 92% of survey respondents claimed to have knowledge of current child restraint legislation, however, only 32% of those parents/carers were able to correctly identify the age requirements and penalty. Reasons given for not owning a child seat included high cost and the belief that seatbelts were a suitable alternative. Conclusions: These findings indicate the need for a tighter legislation with an increased fine paired with enhanced enforcement of both adult seatbelt and child restraint use. The provision of low-cost/subsidised CRS or borrowing schemes and targeted social marketing through online fora, well baby clinics, early learning centres would be beneficial in increasing ownership and use of CRS.


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.


While South Africa shares some characteristics with other middle-income countries, it has a unique economic history with distinctive characteristics. South Africa is an economic powerhouse with a significant role not only at the southern African regional and continental levels, but also as a member of BRICS. However, the country faces profound developmental challenges, including the ‘triple challenges’ of poverty, inequality and unemployment. There has been a lack of structural transformation and weak economic growth. Ongoing debates around economic policies to address these challenges need to be based on rigorous and robust empirical evidence and in-depth analysis of South African economic issues. This necessitates wide-ranging research, such as that brought together in this handbook. This volume intends to provide original, comprehensive, detailed, state-of-the-art analytical perspectives, that contribute to knowledge while also contributing to well-informed and productive discourse on the South African economy. While concentrating on the more recent economic challenges facing the country, the handbook also provides historical and political context, an in-depth examination of strategic issues in the various critical economic sectors, and assembles diverse analytical perspectives and arguments that have implications for policymaking.


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