scholarly journals Lockdown-Associated Hunger May Be Affecting Breastfeeding: Findings from a Large SMS Survey in South Africa

2021 ◽  
Vol 19 (1) ◽  
pp. 351
Author(s):  
Nazeeia Sayed ◽  
Ronelle Burger ◽  
Abigail Harper ◽  
Elizabeth Catherina Swart
Keyword(s):  
South Africa ◽  
Depressive Symptoms ◽  
Child Health ◽  
Health Clinic ◽  
Breastfeeding Initiation ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Early Introduction ◽  
The Impact ◽  
And Child Health

The impact that the COVID-19 pandemic has had, and will continue to have, on food security and child health is especially concerning. A rapid, Short Message Service (SMS) Maternal and Child Health survey was conducted in South Africa in June 2020 (n = 3140), with a follow-up in July 2020 (n = 2287). This was a national cross-sectional survey conducted among pregnant women and mothers registered with the MomConnect mhealth platform. Logistic regression was conducted to explore the associations between breastfeeding, maternal depressive symptoms, and hunger in the household. High breastfeeding initiation rates and the early introduction of other foods or mixed milk feeding were found. The prevalence of depressive symptoms in this survey sample was 26.95%, but there was no association between breastfeeding behaviour and depressive symptom scores (OR = 0.89; 95% CI: 0.63, 1.27). A positive correlation was found between not breastfeeding and not going to the health clinic. The odds of hungry mothers breastfeeding were significantly lower (OR = 0.66; p = 0.045). This result also holds in a multivariate framework, including covariates such as depressive symptoms, attendance of a PHC facility, and whether the infant was older than 3 months. Support for breastfeeding must include support, such as economic support, for breastfeeding mothers, to enable them to access nutritious diets. Mothers also need reassurance on the quality of their breastmilk and their ability to breastfeed and should be encouraged to continue to attend the health clinic regularly.

scholarly journals Lockdown-associated Hunger May Be Affecting Breastfeeding: Findings From a Large SMS Survey in South Africa

2021 ◽  
Author(s):  
Nazeeia Sayed ◽  
Ronelle Burger ◽  
Abigail Harper ◽  
Elizabeth C (Rina) Swart
Keyword(s):  
South Africa ◽  
Child Health ◽  
Health Clinic ◽  
Breastfeeding Initiation ◽  
Early Introduction ◽  
Critical Gap ◽  
Economic Support ◽  
Prevalence Of Depression ◽  
The Impact ◽  
And Child Health

Abstract There are growing concerns on the impact of COVID-19 on food security and child health in South Africa. A rapid SMS Maternal and Child Health survey was conducted in South Africa in June (n=3140) with a follow up in July (n=2287). Breastfeeding practices found in this survey confirmed findings from other studies: with high breastfeeding initiation rates and early introduction of other foods/mixed milk feeding. Logistic regression was conducted to explore the associations between breastfeeding, maternal depression and hunger in the household. The odds of hungry mothers breastfeeding were significantly lower (OR = 0.66; 95% CI: 0.44, 0.99). The prevalence of depression in this survey sample was 26.95%, but there was no association between breastfeeding behaviour and depression scores (OR = 0.89; 95% CI: 0.63, 1.27). A positive correlation was found between not breastfeeding and not going to the health clinic. Breastfeeding needs to be protected, promoted and supported; and mothers should be encouraged to continue to attend the health clinic. Further to communication to communities, supporting the breastfeeding mother to enable her to breastfeed and feel competent to do so is a critical gap that needs to be addressed. This support could include economic support to enable her to access a nutritious diet. Mothers also need reassurance on the quality of their breastmilk and their ability to breastfeed. Aside from the nutritional superiority, the safety and immune benefits of breastmilk may need to be asserted to counter concerns during the COVID-19 pandemic.

scholarly journals SASS: South African Simulation Survey – a review of simulation-based education

2019 ◽  
pp. 12-20
Author(s):  
R Swart ◽  
R Duys ◽  
ND Hauser
Keyword(s):  
South Africa ◽  
South African ◽  
Undergraduate Students ◽  
Online Survey ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Survey Tool ◽  
South African Society ◽  
Simulation Based ◽  
The Impact

Background: Simulation-based education (SBE) has been shown to be an effective and reproducible learning tool. SBE is used widely internationally. The current state of SBE in South Africa is unknown. To the best of our knowledge this is the first survey that describes the use and attitudes towards SBE within South Africa. Methods: An online survey tool was distributed by email to: i) the South African Society of Anaesthesiologists (SASA) members; and ii) known simulation education providers in South Africa. The respondents were grouped into anaesthesia and non-anaesthesia participants. Descriptive statistics were used to analyse the data. Ethics approval was obtained: HREC REF 157/2017. Results: The majority of the respondents provide SBE and integrate it into formal teaching programmes. There is a will amongst respondents to grow SBE in South Africa, with it being recognised as a valuable educational tool. The user groups mainly targeted by SBE, were undergraduate students, medical interns, registrars and nurses. Learning objectives targeted include practical skills, medical knowledge, critical thinking and integrated management. Amongst anaesthesia respondents: the tool most commonly used to assess the quality of learner performance during SBE, for summative assessment, was ‘expert opinion’ (33%); the most frequent methods of evaluating SBE quality were participant feedback (42%) and peer evaluation (22%); the impact of SBE was most frequently assessed by informal discussion (42%) and learner feedback (39%). In anaesthesia SBE largely takes place within dedicated simulation facilities on site (47%). Most respondents report access to a range of SBE equipment. The main reported barriers to SBE were: finance, lack of trained educators, lack of equipment and lack of protected time. A limited number of respondents report engaging in SBE research. There is a willingness in both anaesthesia and non-anaesthesia groups (96% and 89% respectively) to collaborate with other centres. Conclusion: To the best of our knowledge this publication provides us with the first cross-sectional survey of SBE in anaesthesia and a selection of non-anaesthetic respondents within South Africa. The majority of respondents indicate that SBE is a valuable education tool. A number of barriers have been identified that limit the growth of SBE within South Africa. It is hoped that with a commitment to ongoing SBE research and evaluation, SBE can be grown in South Africa.

scholarly journals The Maternal and Child Health Handbook for Improving the Continuum of Care and Other Maternal and Child Health Indicators in Angola: An Implementation Study Protocol

2021 ◽  
Vol 2 ◽  
Author(s):  
Ai Aoki ◽  
Keiji Mochida ◽  
Michiru Kuramata ◽  
Toru Sadamori ◽  
Helga Reis Freitas ◽  
...  
Keyword(s):  
Child Health ◽  
Maternal And Child Health ◽  
Intervention Group ◽  
Health Indicators ◽  
Continuum Of Care ◽  
Health Facilities ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Implementation Status ◽  
And Child Health

Background: Reducing maternal, neonatal, and infant mortality tops the health targets of sustainable development goals. Many lifesaving interventions are being introduced in antenatal, delivery, and postnatal care. However, many low- and middle-income countries (LMICs) have not reached maternal and child health targets. The Maternal and Child Health Handbook (MCH-HB) is recommended as a home-based record to promote a continuum of care from pregnancy to early childhood, and is gaining increasing attention among LMICs. Several countries have adopted it as national health policy. To effectively utilize the MCH-HB in LMICs, implementation needs to be considered. Angola is an LIMC in Sub-Saharan Africa, where maternal and child health indicators are among the poorest. The Angolan Ministry of Health adopted the MCH-HB program in its national health policy and is currently conducting a cluster randomized controlled trial (MCH-HB RCT) to evaluate its impact on the continuum of care. This study aimed to evaluate implementation status, and barriers and facilitators of MCH-HB program implementation in Angola.Methods: To evaluate implementation status comprehensively, the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework will be used. Four components other than effectiveness will be investigated. A cross-sectional survey will be conducted targeting all health facilities and officers in charge of the MCH-HB at the municipality health office in the intervention group after the MCH-HB RCT. Data from the cross-sectional survey, secondary MCH-HB RCT data, and operational MCH-HB RCT records will be analyzed. Health facilities will be classified into good-implementation and poor-implementation groups using RE-AIM indicators. To identify barriers to and facilitators of MCH-HB implementation, semi-structured interviews/focus group discussions will be conducted among health workers at a sub-sample of health facilities and all municipality health officers in charge of MCH-HB in the intervention group. The Consolidated Framework for Implementation Research will be adopted to develop interview items. Thematic analysis will be performed. By comparing good-implementation and poor-implementation health facilities, factors that differ between groups that contribute to successful implementation can be identified.Discussion: This study's findings are expected to inform MCH-HB implementation policy and guidelines in Angola and in other countries that plan to adopt the MCH-HB program.

scholarly journals The impact of COVID-19 on mental health outcomes among hospital fever clinic attendants across Nepal: A cross-sectional study

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248684
Author(s):  
Hridaya Raj Devkota ◽  
Tula Ram Sijali ◽  
Ramji Bogati ◽  
Meraj Ahmad ◽  
Karuna Laxmi Shakya ◽  
...  
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Health Outcomes ◽  
Psychological Impact ◽  
Cross Sectional Study ◽  
Mental Health Outcomes ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Mental Health Programs ◽  
The Impact

Background The COVID-19 pandemic has been creating a panic and distressing situations among the entire population globally including Nepal. No study has been conducted assessing the psychological impact of this pandemic on the general public in Nepal. The objective of this study is to assess the mental health status during COVID-19 outbreak and explore the potential influencing factors among the population attending the hospital fever clinics with COVID–19 symptoms. Methods A cross-sectional survey was conducted between May—June, 2020 with a sample of 645 participants aged 18 and above in 26 hospitals across Nepal. Telephone interviews were conducted using a semi-structured questionnaire along with a validated psychometric tool, the Depression, Anxiety and Stress (DASS-21) scale. The metrics and scores of symptoms and their severity were created and analyzed. Multivariate logistic regression was used to determine the association of potential covariates with outcome variables. Results The prevalence of anxiety, depression and stress were 14%, 7% and 5% respectively. In reference to Karnali, participants from Bagmati province reported higher level of anxiety (OR 3.44, 95% CI 1.31–9.06), while stress (OR 4.27, 95% CI 1.09–18.32) and depressive symptoms (OR 3.11, 95% CI 1.05–9.23) observed higher among the participants in Province 1. Women were more at risk of anxiety (OR 3.41, 95% CI 1.83–6.36) than men. Similarly, people currently living in rented houses reported more stress (OR 2.97, 95% CI 1.05–8.43) and those living far from family reported higher rates of depressive symptoms (OR 3.44, 95% CI 1.03–11.46). Conclusion The study identified increased prevalence of stress, anxiety and depressive symptoms during the initial stage of COVID-19 pandemic in Nepal. Considering the findings, there is urgent need to develop and implement appropriate community-based mental health programs targeting individuals who have had COVID-19 symptoms and who are prone to develop adverse mental health outcomes.

scholarly journals Determinants of timeliness in early childhood vaccination among mothers with vaccination cards in Sindh province, Pakistan: a secondary analysis of cross-sectional survey data

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e028922 ◽  
Author(s):  
Jin-Won Noh ◽  
Young-mi Kim ◽  
Nabeel Akram ◽  
Ki Bong Yoo ◽  
Jooyoung Cheon ◽  
...  
Keyword(s):  
Child Health ◽  
Maternal And Child Health ◽  
Health Program ◽  
Time Window ◽  
Tracking System ◽  
Childhood Vaccination ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Sindh Province ◽  
And Child Health

ObjectiveUntimely vaccination refers to receiving the given dose before (early) or after (delayed) the recommended time window. The purpose of this study was to assess the extent of timeliness of childhood vaccinations and examine the determinants of vaccination timeliness in Sindh province, Pakistan.DesignCross-sectional analysis of data from the 2013 and 2014 Maternal and Child Health Program Indicator Surveys.SettingCommunity-based maternal and child health surveys.ParticipantsAmong 10 200 respondents of Maternal and Child Health Program Indicator Surveys, 1143 women who had a live birth in the 2 years preceding the survey were included.OutcomesAt the participants’ home, an interviewer asked mothers to show their children’s vaccination cards, which contained information regarding vaccinations. Children’s vaccination status was categorised into timely or early/delayed compared with vaccination schedule. A logistic regression analysis using Firth’s penalised likelihood was performed to identify factors associated with timeliness of vaccinations.Results238 children (20.8% of children who received a full set of basic vaccinations) received all vaccinations on schedule among children who received a full set of basic vaccinations. The percentages of timely vaccinations ranged from 2.3% for second measles vaccination to 89.3% for bacillus Calmette-Guérin. Child’s age and place of delivery were associated with timely vaccinations. Older child age and institutional delivery were associated with decreased timely vaccination rate.ConclusionsHome-based vaccination record is a key tool to improve the timeliness of vaccinations. The redesigned vaccination cards, the new electronic registries for vaccination card information and the vaccination tracking system to remind the second/third vaccination visits may be helpful to improve timely vaccinations for children under 2 years old.

scholarly journals Local Dynamics of Collaboration for Maternal, Newborn and Child Health: A Social Network Analysis of Healthcare Providers and Their Managers in Gert Sibande District, South Africa

2021 ◽  
Author(s):  
Fidele Kanyimbu Mukinda ◽  
Sara Van Belle ◽  
Helen Schneider
Keyword(s):  
Social Network ◽  
Social Network Analysis ◽  
Network Analysis ◽  
Child Health ◽  
Healthcare Providers ◽  
Cross Sectional Survey ◽  
Collaborative Relationships ◽  
Cross Sectional ◽  
Newborn And Child Health ◽  
And Child Health

Background: Accountability for maternal, newborn and child health (MNCH) is a collaborative endeavour and documenting collaboration dynamics may be key to understanding variations in the performance of MNCH services. This study explored the dynamics of collaboration among frontline health professionals participating in two MNCH coordination structures in a rural South African district. It examined the role and position of actors, the nature of their relationships, and the overall structure of the collaborative network in two sub-districts. Methods: Cross-sectional survey using a social network analysis (SNA) methodology of 42 district and sub district actors involved in MNCH coordination structures. Different domains of collaboration (eg, communication, professional support, innovation) were surveyed at key interfaces (district-sub-district, across service delivery levels, and within teams). Results: The overall network structure reflected a predominantly hierarchical mode of clustering of organisational relationships around hospitals and their referring primary healthcare (PHC) facilities. Clusters were linked through (and dependent on) a combination of district MNCH programme and line managers, identified as central connectors or boundary spanners. Overall network density remained low suggesting potential for strengthening collaborative relationships. Within cluster collaborative patterns (inter-professional and across levels) varied, highlighting the significance of small units in district functioning. Conclusion: SNA provides a mechanism to uncover the nature of relationships and key actors in collaborative dynamics which could point to system strengths and weaknesses. It offers insights on the level of fragmentation within and across small units, and the need to strengthen cohesion and improve collaborative relationships, and ultimately, the delivery of health services.

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