Infant health: a community-based assessment and educational intervention in two rural communities in the Eastern Cape.
- Authors: Kuzeeko, Faith
- Date: 2021
- Subjects: Angus Gillis Foundation (South Africa) , Infants -- Mortality -- South Africa , Infants -- Health and hygiene -- South Africa , Breastfeeding -- South Africa -- Eastern Cape , Infants -- Care -- Equipment and supplies , Infants -- Care -- South Africa -- Eastern Cape -- Case studies , Children -- Mortality -- South Africa , High throughput screening (Drug development)
- Language: English
- Type: text , Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/170837 , vital:41964
- Description: South Africa is on track to attaining the 2030 Agenda on reducing under-five deaths to 25 deaths per 1000 live births at its current momentum, however an unacceptable amount of infants are still at risk from preventable illnesses. Malnutrition is the major underlined cause of infant mortality rates in South Africa. Exclusive breastfeeding rates are low nationwide due to low exposure to breastfeeding information, some mothers having other commitments and others having breastfeeding difficulties. Implementation and expansion of simple, cost-effective interventions, such as exclusive breastfeeding for six months to reduce and/or prevent infant mortality rates, remains low in South Africa. The aim of the study was to determine one infant health issue of major concern to participants in two rural villages in the Eastern Cape, namely Glenmore and Ndwayana. The identified infant health issue was used to design an educational intervention in the villages. This was the second phase of this study. A community-based participatory approach was utilized in which the Angus Gillis Foundation, a non-profit organization that works in these communities, was one of the stakeholders. Stock status of WHO priority medicines for infants, semi-structured interviews and focus group discussions were carried out during the baseline study. The intervention phase contained pre-2 intervention semi-structured interviews with ten pregnant women followed by an educational intervention with nine out of the ten; and finally, a post-intervention with seven out of the ten women. A questionnaire was completed by members of the Angus Gillis Foundation to provide feedback on the sustainability of the intervention. Semi-structured interviews revealed that medicines stocked at the clinic parallel those indicated in the WHO priority medicines list for infants. The results from the focus group discussions indicated that mothers do not exclusively breastfeed their infants during the first six months. Pre- and post-intervention results on exclusive breastfeeding illustrated a positive change in participants’ knowledge and intent to breastfeed exclusively for six months. They showed a better understanding of the importance of exclusive breastfeeding and indicated a more focussed intention and confidence to carry out optimal breastfeeding practices. In the questionnaire the members of the Angus Gillis Foundation stated that the intervention is sustainable as it was linked with the existing networks. These include educational programs carried out in the villages by the foundation together with positive health champions, community health workers and women self-help groups; which will be able to build on the present knowledge base. Finally, the study also included the design of a booklet on the identified infant health issue. In conclusion, participants highlighted lack of understanding regarding breastfeeding as an issue of concern during the baseline phase of the study. This community-based educational intervention improved the understanding of breastfeeding among the participants, resulting in a positive change in perception with regards to exclusive breastfeeding practices.
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- Date Issued: 2021
Development and implementation of health promotion activities for the prevention of adolescent pregnancies
- Authors: Chemuru, Nomsa Rutendo
- Date: 2017
- Subjects: Teenage pregnancy -- South Africa -- Makhanda , Teenage pregnancy -- Prevention -- South Africa -- Makhanda
- Language: English
- Type: Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/5115 , vital:20776
- Description: Of the eight Millennium Development Goals (MDGs) established in 2000 by the World Health Organisation, Millennium Development Goals 5 aimed at improving maternal health by addressing the high maternal mortality rate and increasing universal access to reproductive health by 2015.Adolescent pregnancy contributes to maternal, perinatal and infant mortality and also worsens the empowerment of young girls by negatively affecting their physical, educational, social, and economic development.This is a pressing public health concern in South Africa. The reduction of adolescent pregnancy is vital for achieving the sustainable human, health social and economic development of society at large. Culturally sensitive interventions to prevent adolescent pregnancies not only integrate the communities' norms, values, practices and behavioural patterns into the intervention's design and implementation but also the historical, social and economic contexts in which they exist. Progress has been made on the research on health promotion and education in South Africa; however communities are often not consulted on the design and conduct of health promotion research projects.The aim of the study was to develop and implement culturally sensitive and appropriate health promotion activities for the prevention of adolescent pregnancy in Grahamstown, Glenmore and Ndwayana communities in the Eastern Cape, South Africa.Two community based organisations and community care workers associated with them participated in this Community Based Participatory Research using the PEN-3 cultural model. The first phase of this study involved semi-structured interviews carried out with 14 community care workers to identify factors and consequences of adolescent pregnancies in their respective communities. The audio-recorded interviews were transcribed and coded using NVivo® 2010 software. The PEN 3 cultural model was adopted in the studyto address the socio-cultural factors contributing to adolescent pregnancy in the communities. The second phase involved a series of interactive workshops with CCWs for a participatory development of the facilitator's manual. Responses from CCWs informed the design of this study's intervention strategies. A facilitator's manual was developed to implement health promotion intervention, leading to the third phase of this study. The guided implementationof the health promotion intervention for the prevention of adolescent pregnancy was carried out over a period of 14 months and evaluated in the final phase of the study. The facilitator's manual was modified based on feedback fromCCWs, on possible improvements and cultural appropriateness. Readability testing guided the final modification of the manual. According to the community care workers, there were a number of adolescents who fell pregnant in their communities each year. The CCWs identified the influence of family members, friends and other stakeholders as contributory factors to adolescent pregnancy. They identified the lack of parental support in informing and educating adolescents about sexual health. Adolescents themselves lacked the maturity to recognise the risks and consequences of adolescent pregnancy. The negative perceptions of contraception in the community were discouraging contraceptive use amongst the adolescents. However, the results showed that enablers such as home and school visits done by the community care workers can be utilised to prevent adolescent pregnancy. Other factors included lack of health promotion materials and activities with information about preventing of adolescent pregnancy, and if available, the material is in English, that the adolescents may not comprehend. Socio-economic factors such as poverty, the Child Support Grant, cross generational relationships and coerced sex further contributed to adolescent pregnancy in the communities.CCWs identified the need for a more comprehensive health promotion intervention to prevent of adolescent pregnancy. A facilitator's manual addressing the prevention of adolescent pregnancy was developed and modified through a series participatory workshops with the community care workers.The facilitator's manual was used by CCWs to conducthealth promotion activities encouraging the prevention of adolescent pregnancies within the community's clinics, schools and during home visits. Community based participatory research methods and the PEN-3cultural model were used to develop this culturally sensitive and community specific adolescent pregnancy intervention for and by the CCWs. The participatory development of the facilitator's manual and the regular interactive workshops with the CCWs were strengthened by embedding this project into the development programs of the two non-governmental organisations contributing to sustainable development programs for women and children.
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- Date Issued: 2017
Adolescent pregnancy: a community engaged participatory approach to design and implement an educational intervention
- Authors: Siruma, Amanda Tatenda
- Date: 2014
- Language: English
- Type: text , Thesis , Masters , MPharm
- Identifier: http://hdl.handle.net/10962/54656 , vital:26597
- Description: Millennium Development Goal (MDG) 5 focuses on improving maternal health, due to global acknowledgment that no woman should have to die as a result of complications during pregnancy and childbirth. Adolescents have an increased risk of maternal death compared with older women. Adolescent pregnancy also poses a threat to the empowerment of young girls by mitigating their physical, educational, social, and economic development. In this context, maternal health promotion strategies which inclusively target adolescents are crucial, not only in improving maternal health outcomes, but also in optimising the overall transition of adolescent girls to adulthood. This study was a first time collaborative partnership of the Faculty of Pharmacy and Community Engagement Office of Rhodes University with the Angus Gillis Foundation (a non-profit community development organisation), and community participants of Glenmore and Ndwayana, two rural communities in the Eastern Cape. The aim of this study was to identify the maternal health issue of most concern to community participants and to design and implement an appropriate educational intervention for a suitable target group. During the baseline phase of this study, ten focus group discussions (FGDs) were conducted with 76 community stakeholders. Semi-structured interviews (SSIs) were conducted with two Sisters-in-Charge from each Primary Health Care (PHC) facility in the study setting. Data on the stock status of World Health Organization (WHO) identified lifesaving priority medicines for women’s health was also collected at both PHCs. Thereafter, pre- and posteducational interventions SSIs with female adolescent participants were conducted. The educational intervention was followed up with the development of a booklet on reproductive health. FGD participants identified adolescent pregnancy as the maternal health issue of most concern. They also highlighted challenges in service delivery of ambulance services for expectant mothers in urgent need of transportation to a referral hospital. A majority of preintervention SSI participants indicated coercion from both younger and older men as a factor influencing early sexual debut amongst adolescent girls in their communities. Despite availability in the PHCs, challenges in accessing contraceptives were highlighted by the participants. Additionally, a number of sexually active adolescent girls defaulted on their next allocated visit to the PHC due to myths regarding use of oral and injectable contraceptives. During the educational intervention sessions, participants recognised knowledge gaps regarding reproductive health issues and the influence of peer pressure as constraining factors in preventing adolescent pregnancy. During the post-intervention phase, participants highlighted that the educational intervention of this study had provided a forum to discuss ways of preventing adolescent pregnancy. The educational booklet developed is intended to serve as a resource tool of the educational programme on prevention of adolescent pregnancy, which is expected to be incorporated into the Angus Gillis Foundation’s existing ‘Positive Health’ Programme. The results of this study show that community-based participatory research facilitated the identification of the maternal health issue of most concern to these communities. Working synergistically with key stakeholders in designing and implementing an educational intervention for preventing adolescent pregnancy provides a good foundation for future up scaling and sustainability of this educational programme.
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- Date Issued: 2014