African Journal of Primary Health Care & Family Medicine

BACKGROUND: Family Medicine training commenced in Botswana in 2011, and Maun was one of the two sites chosen as a training complex. If it is to be successful there has to be investment in the training programme by all stakeholders in healthcare delivery in the district. AIM: The aim of the study was to explore the attitudes of stakeholders to initiation of Family Medicine training and their perspectives on the future roles of family physicians in Ngami district, Botswana...

BACKGROUND: There exists a major disparity in access to specialist care between patients in urban and rural areas. Specialists are a scarce resource and are concentrated in urban areas. Specialist outreach attempts to fill the gap in service provision for patients situated remotely. While there is international evidence that multifaceted specialist outreach has achieved varying levels of success, factors that influence the effectiveness of outreach have not yet been fully elucidated in South Africa...

BACKGROUND: The balance between the risks of transmission of human immunodeficiency virus (HIV) through breastfeeding and its life-saving benefits complicates decisions about infant feeding among HIV-positive mothers in the first 6 months. OBJECTIVE: The aim of this study was to assess the knowledge, attitude and practice of infant feeding among HIV-positive mothers attending the prevention of mother-to-child transmission services in Maseru, Lesotho.Method and setting: This observational cross-sectional study was done by collecting data from HIV-positive mothers attending the filter clinics of Queen Mamohato Memorial hospital in Maseru, Lesotho...

This reflection describes my funded visit to South Africa to assist in primary care research capacity building as Chair, WONCA Working Party on Research (WP-R). The trip included time at the Universities of Walter Sisulu, Limpopo and Stellenbosch to mentor postgraduate students working on master's and PhD theses. I held one-on-one and group sessions and ran interactive scientific writing workshops. I assisted with the establishment of a Stellenbosch University Family Physician Research Network of faculty academics and family physicians (FP) which will generate research questions from community stakeholders...

BACKGROUND:  A revised family physician (FP) training programme was introduced in South Africa in 2007. A baseline assessment (2011) of the impact of FP supply on district health system performance was performed within the Western Cape Province, South Africa. The impact of an increased FP supply within this province required re-evaluation. AIM:  To assess the impact of FP supply on indicators of district health system performance, clinical processes and clinical outcomes in the Western Cape Province...

BACKGROUND:  Patient-provider communication is an interpersonal interaction between a patient and a health care provider. OBJECTIVE:  This study explored patients' communication preferences and perceptions on what factors influence the patient-provider communication in primary health care settings in Rwanda. METHODS:  In-depth semi-structured interviews with 15 individuals including 8 with limited literacy. A thematic inductive analysis was used...

BACKGROUND:  Family doctors (FDs) focus on biopsychosocial components of health during consultations. However, much of the evidence employed by these doctors is produced by researchers who are not routinely involved in family practice. Family doctors competent in both clinical practice and research are essential to addressing this gap. With the growing recognition of family medicine as the specialty of choice for many young doctors, there is a scarcity of literature that describes their experiences in combining research and daily family practice...

BACKGROUND:  This article reports on the findings of a workshop held at the joint 5th World Organisation of Family Doctors (WONCA) Africa and 20th National Family Practitioners Conference in Tshwane, South Africa, in 2017. Postgraduate training for family medicine in Africa takes place in the clinical workspace at the bedside or next to the patient in the clinic, district hospital or regional hospital. Direct supervisor observation, exchange of reflection and feedback, and learning conversations between the supervisor and the registrar are central to learning and assessment processes...

BACKGROUND:  Nurses are usually the first to identify the need for and initiate cardiopulmonary resuscitation (CPR) on patients with cardiopulmonary arrest in the hospital setting. Cardiopulmonary resuscitation has been shown to reduce in-hospital deaths when received from adequately trained health care professionals. AIM:  We aimed to investigate nurses' retention of CPR knowledge and skills at district hospitals in Botswana. METHODS:  A quantitative, quasi-experimental study was conducted at three hospitals in Botswana...

BACKGROUND:  Neonatal jaundice affects one in two infants globally. The jaundice is the result of an accumulation of bilirubin as foetal haemoglobin is metabolised by the immature liver. High serum levels of bilirubin result in lethargy, poor feeding and kernicterus of the infant. AIM:  The main aim of this article was to determine the prevalence of neonatal jaundice and secondly to explore its risk factors in healthy term neonates. SETTING:  Maternity ward, National District Hospital, Bloemfontein, South Africa...

BACKGROUND:  Non-communicable diseases, mainly cardiovascular diseases, diabetes, cancer and chronic respiratory diseases, are responsible for approximately 63% of all deaths occurring worldwide in any given year. The majority of these deaths have occurred in low- and middle-income countries (LMICs). The latest World Health Organization (WHO) report shows that the increase in diabetes is also most pronounced in the LMICs. The South African Labour and Development Research Unit estimated a 9% prevalence within the adult population in 2016...

BACKGROUND:  The poor emphasis on the role of husbands in birth preparedness and complication readiness (BPCR) is a major factor that should be addressed in tackling maternal mortality. AIM:  To assess the level of husbands' participation in BPCR and associated factors. SETTING:  Wolaita Sodo town, Southern Ethiopia. METHODS:  A community based cross-sectional study was conducted among 608 husbands of pregnant women and nursing mothers...

BACKGROUND:  Little is known about the prevalence of non-communicable disease (NCD) multimorbidity among tuberculosis (TB) patients in Africa.Aim and setting: The aim of this study was to assess the prevalence of NCD multimorbidity, its pattern and impact on adverse health outcomes among patients with TB in public primary care in three selected districts of South Africa. METHODS:  In a cross-sectional survey, new TB and TB retreatment patients were interviewed, and medical records assessed in consecutive sampling within 1 month of anti-TB treatment...

BACKGROUND:  Physical exercise plays an important role in healthy ageing, but the elderly do not engage in it regularly. METHODS:  In this cross-sectional study, we sampled 139 residents of residential care facility. A questionnaire was used to obtain information on participants' demography, health problems, nature, motivators and barriers to exercise. Chi-square test examined the relationship between participants' characteristics and their engagement in regular exercise...

BACKGROUND:  Mental health legislation (MHL) is required to ensure a regulatory framework for mental health services and other providers of treatment and care, and to ensure that the public and people with a mental illness are afforded protection from the often-devastating consequences of mental illness. AIMS:  To provide an overview of evidence on the significance of MHL for successful primary care for mental health and community mental health servicesMethod: A qualitative review of the literature on the significance of MHL for successful primary care for mental health and community mental health services was conducted...

BACKGROUND:  Diabetic ketoacidosis (DKA) is a biochemical triad of hyperglycaemia, ketoacidosis and ketonaemia and one of the potentially life-threatening acute metabolic complications of diabetes mellitus. This study aimed at describing the clinical profile of patients presenting with DKA to a busy rural regional hospital in KwaZulu-Natal. METHODS:  A retrospective review of clinical notes of patients presenting with DKA to the Emergency Department was performed over a 10-month period...

BACKGROUND:  The human immunodeficiency virus and/or acquired immune deficiency syndrome (HIV/AIDS) pandemic continues to increase in prevalence worldwide, particularly in South Africa, and includes the often overlooked paediatric population. The provision of paediatric antiretroviral treatment (ART) is as essential for children as for adults, and has numerous obstacles, not least of which is lack of decentralisation of facilities to provide essential treatment. Optimising ART, care and support for HIV-positive children, and their caregivers, at public sector primary health care (PHC) clinics is crucial to improve morbidity and mortality rates in children...

BACKGROUND: Prevention of youth sexual risk behaviour among the youth in uMgungundlovu District Municipality continues to be a primary challenge for public health and health promotion. Current prevention interventions are targeted at an individual level, whilst youth behaviour is influenced by many social and environmental factors. AIM: The aim of the study was to explore the factors influencing sexual risk behaviours of the youth at different socio-ecological levels in uMgungundlovu District Municipality...

BACKGROUND: African specific studies on the factors associated with the growth pattern of children are needed to guide evidence and develop effective population-based interventions that can be tailored to the unique African context. PURPOSE: The purpose of this study was to determine the socio-economic correlates of body mass index (BMI) of primary and secondary school children in Ebonyi State, which is situated in south-eastern Nigeria. METHODOLOGY: This was a quantitative, cross-sectional study that utilised clustering and stratified sampling techniques to select 1000 learners from primary and secondary schools located in Abakaliki local government area...

BACKGROUND: Lesotho adopted primary health care in 1979, and community health workers (CHWs) were included in the programme to focus on health promotion, particularly to reach people in underserved rural areas. Although the CHW programme has been successful, the heavy burden of disease because of HIV and/or AIDS and tuberculosis shifted resources from health promotion to home-based care. AIM: The study explored the lived experience of CHWs in conducting health promotion activities in Lesotho...