scholarly journals The Magnitude and Determinants of Missed Opportunities for Childhood Vaccination in South Africa

Vaccines ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 705
Author(s):  
Duduzile Ndwandwe ◽  
Chukwudi A. Nnaji ◽  
Charles S. Wiysonge
Keyword(s):  
South Africa ◽  
Antenatal Care ◽  
Health Facility ◽  
Contextual Factors ◽  
Clinic Visit ◽  
Childhood Vaccination ◽  
Missed Opportunities ◽  
Mpumalanga Province ◽  
Services Delivery ◽  
Nationally Representative

Missed opportunities for vaccination (MOV) may be among the factors responsible for suboptimal vaccination coverage in South Africa. However, the magnitude and determinants of MOV in the country are not known. Thus, this study seeks to assess the prevalence and determinants of MOV in the country. South Africa is sub-divided into nine administrative provinces. We used nationally representative data from the 2016 South African Demographic and Health Survey. We considered MOV to have occurred if a child aged 12–23 months old had not taken all scheduled basic vaccine doses despite having any of the following contacts with health services: delivery in a health facility; postnatal clinic visit; receipt of vitamin A; and any child-related treatment at a health facility. Multilevel logistic regression was used to determine factors associated with MOV. The national prevalence of MOV among children aged 12–23 months was 40.1%. Children whose mothers attended facility-based antenatal care were considerably less likely to experience MOV than those whose mothers did not attend antenatal care: odds ratio (OR) 0.41, 95% confidence interval (CI) 0.19 to 0.88. Conversely, the independent predictor of an increased MOV among children was residence in either the Gauteng province (OR 2.97, 95% CI 1.29 to 6.81) or Mpumalanga province (OR 2.32, 95%CI 1.04 to 5.18); compared to residence in the Free State province. Our findings suggest a high burden of MOV among children in South Africa and that MOV may be associated with individual and contextual factors. The findings also underscore the need for further exploration of the contextual factors contributing to MOV in South Africa.

scholarly journals Factors that Influence Teenage Antenatal Care Utilization in John Taolo Gaetsewe (JTG) District of Northern Cape Province, South Africa: Underscoring the Need for Tackling Social Determinants of Health

2016 ◽  
Vol 5 (2) ◽  
pp. 134-145
Author(s):  
Eshetu Bekele Worku, PhD ◽  
Selamawit Alemu Woldesenbet, PhD
Keyword(s):  
South Africa ◽  
Antenatal Care ◽  
Social Determinants Of Health ◽  
Health Facility ◽  
Adolescent Mothers ◽  
Social Determinants ◽  
Teenage Pregnancy ◽  
Determinants Of Health ◽  
Care Utilization ◽  
Reproductive Health Services

Background and Objectives: In resource-limited settings, the uptake of antenatal care visits among women, especially teenage pregnant women, is disturbingly low. Factors that infl uence the uptake of ANC services among teenage women is largely understudied and poorly understood in John Taolo Gaetsewe (JTG), a predominantly rural and poor district of South Africa. The aim of this study was to determine the factors that infl uence uptake of ANC services among teenage mothers in JTG district. Methods: A cross-sectional health facility-based study utilising mixed method was conducted in all public health facilities (n=44) at JTG district. Mother-infant pairs (n=383) who brought their infants for six-week first DPT immunisation during the study period were enrolled in the study. Structured questionnaires were used to collect data on demographic, socio-economic and uptake of ANC indicators. Results: Out of 272 respondent mothers, 18.68% were adolescent mothers (13-19 years). The logistic regression analysis shows that mother’s age (OR=2.11; 95%CI = 1.04 - 4.27); distance to the nearest health facility (OR=3.38; 95%CI = 1.45-7.87); and client service satisfaction (OR=8.58; 95%CI =2.10-34.95 are significantly associated with poor uptake of ANC services. Conclusion and Global Health Implications: There is a need to improve the quality of adolescent reproductive health services tailored to their health and developmental needs. Moreover, addressing the social determinants of health that affect individual’s healthy life style and health seeking behavior is critical. Key words: Antenatal Care Visits • Teenage Pregnancy • Social Determinants of Health • John Taolo Gaetsewe Copyright © 2016 Worku and Woldesenbet. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The Role of Archives on the Incorporation of the Former Kangwane Homeland to Mpumalanga Province

2018 ◽  
Vol 47 (2) ◽  
Author(s):  
Nkholedzeni Sidney Netshakhuma
Keyword(s):  
South Africa ◽  
Qualitative Methodology ◽  
Management Policy ◽  
Records Management ◽  
Record Keeping ◽  
Mpumalanga Province ◽  
Specific Objective ◽  
National Archives ◽  
And Control

This study was conceptualised in order to assess the strategies used to incorporate the homeland of KaNgwane into Mpumalanga province after the cessation of apartheid in 1994. The specific objective of the study was to investigate the compliance of records and archives with the National Archives and Records Service of South Africa Act (Act No 43 of 1996), during the incorporation of the homeland of KaNgwane into Mpumalanga. The study adopted a qualitative methodology through document analysis, interviews and observations. The key findings revealed that the archives of the former homeland of Kangwane were not aligned with the requirements of the National Archives and Records Service of South Africa Act (Act No.43 of 1996.) Institutions seem to lack experience when it comes to the challenges of storing records and implementing arrangement and control systems. The frequent lack of a records management policy and few to no staff with record-keeping and archival backgrounds was also a concern. A shortage of space to store records safely was also one of the major issues that the study uncovered. There appears to be no concerted effort to retain important historical records. Many records are stored in several different locations in government buildings.  I conclude that archives play an essential role to the nation as the institutional memory.

scholarly journals A mixed reception: perceptions of pregnant adolescents’ experiences with health care workers in Cape Town, South Africa

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Ronel Sewpaul ◽  
Rik Crutzen ◽  
Natisha Dukhi ◽  
Derrick Sekgala ◽  
Priscilla Reddy
Keyword(s):  
South Africa ◽  
Health Care ◽  
Antenatal Care ◽  
Health Care Workers ◽  
Cape Town ◽  
Pregnant Adolescents ◽  
High Quality ◽  
Care Workers ◽  
Antenatal Clinics ◽  
Antenatal Services

Abstract Background Maternal mortality among adolescent mothers in South Africa is higher than many middle-income countries. This is largely attributable to conditions that can be prevented or managed by high quality antenatal care. The way in which pregnant adolescents are treated at antenatal clinics influences their timely utilization of antenatal services. This qualitative study reports on the experiences of pregnant adolescents with health care workers when accessing antenatal care. Methods Pregnant girls aged 13–19 (n = 19) who attended public health care facilities that provide Basic Antenatal Care (BANC) services in Cape Town, South Africa were recruited. Four face to face in-depth interviews and four mini focus group discussions were undertaken, facilitated by a topic guide. Thematic analyses were used to analyse the data. Results Experiences that reinforce antenatal attendance, such as respectful and supportive treatment, were outweighed by negative experiences, such as victimization; discrimination against being pregnant at a young age; experiencing disregard and exclusion; inadequate provision of information about pregnancy, health and childbirth; clinic attendance discouragement; and mental health turmoil. Conclusions There is evidence of a discordant relationship between the health care workers and the pregnant adolescents. Adolescents feel mistreated and discriminated against by the health care workers, which in turn discourages their attendance at antenatal clinics. Maternal health care workers need to receive support and regular training on the provision of youth friendly antenatal care and be regularly evaluated, to promote the provision of fair and high quality antenatal services for adolescent girls.

Congenital Toxoplasmosis: Missed Opportunities for Diagnosis and Prevention

2020 ◽  
Author(s):  
Raquel Aitken Soares Mueller ◽  
Ana Cristina Cisne Frota ◽  
Daniela Durão Menna Barreto ◽  
Daniela Pires Ferreira Vivacqua ◽  
Gabriela Bueno Loria ◽  
...  
Keyword(s):  
Antenatal Care ◽  
Congenital Toxoplasmosis ◽  
First Trimester ◽  
University Hospital ◽  
Serological Testing ◽  
Missed Opportunities ◽  
Clinic Appointment ◽  
History Of ◽  
Acute Toxoplasmosis ◽  
Made In

Abstract Objectives Identify missed opportunities for the prevention and early diagnosis of congenital toxoplasmosis (CT) in infants followed up in a reference center for pediatric infectious diseases (PID) in Rio de Janeiro between January 2007 and December 2016. Methods Descriptive study including infants with CT, diagnosis established based on Brazil’s Ministry of Health’s criteria. All data regarding the infants and their mother’s prenatal care were collected from the medical records of the Instituto de Puericultura e Pediatria Martagão Gesteira (IPPMG)—a tertiary public pediatric university hospital. The study enrolled infants aged between 0 and 12 months followed up in the PID department of IPPMG and with confirmed infection by Toxoplasma gondii in the period between January 2007 and December 2016. All patients with diagnosis of CT registered in the PID database of the IPPMG and admitted in the above-mentioned period were included in the study. Patients whose records were not available, or who went to just one clinic appointment were excluded. Results The obstetric history of all 44 women, whose infants (45) were diagnosed with CT, was analyzed. Their median age was 22 years. None had undergone preconception serological testing for toxoplasmosis. Only 20 (45%) of them started antenatal care during the first trimester of gestation, a total of 24 (55%) had more than six antenatal care visits, and 16% of those did not undergo serological testing for toxoplasmosis. None were adequately informed of preventive measures. The diagnosis of acute toxoplasmosis was made in 50% of these pregnancies but 32% of the women were not treated. Only 10 children of these mothers were adequately screened and treated at birth. Conclusion Despite the existence of national recommendations, several opportunities were missed to prevent CT during the antenatal period and to diagnose and treat this condition in the neonatal period.

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