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Wealthy nations must step up support for Africa and vulnerable countries in addressing past, present and future impacts of climate change

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Background: Caregivers are offered health information on neonatal care before they are discharged from the healthcare facilities after giving birth. However, they continue to feed and bath neonates in ways that are informed by indigenous traditions. Notably, these ways include the provision of supplementary feeds before 6 months and bathing the neonate as early as possible, which are practices that contradict the World Health Organization (WHO) recommendations of neonatal care. Objectives: This study aimed to explore and describe the indigenous neonatal feeding and bathing practices of caregivers in Vhembe District, Limpopo province. Setting: This study was conducted in Limpopo province at Vhembe District, Makhado Municipality. Methodology: A qualitative, explorative and descriptive enquiry was used to conduct 18 semi-structured individual interviews to explore and describe their indigenous neonatal feeding and bathing practices. Purposive and snowball sampling methods were used to select participants. Creswell’s method of data analysis was used to analyse data. Ethical principles were maintained. Results: Two themes with sub-themes resulted from data analysis presenting indigenous neonatal feeding practices and indigenous neonatal bathing practices. Conclusion: This study revealed that caregivers use indigenous neonatal feeding and bathing practices across age groups and social standing. Younger mothers receive guidance from older women in their families or community. Midwives should know the indigenous neonatal feeding and bathing practices of the communities they serve to offer relevant culture-sensitive health education. Contributions: This study contributes to the creation of knowledge about indigenous neonatal care practices amongst mothers and caregivers.

Background: South African maternity care guidelines stipulate that post-natal patients can be discharged within 6 h after delivery, provided that the condition of mothers and neonates do not require medical, surgical or obstetric attention. Hence in many instances post-natal care is rendered at home by traditional birth attendants (TBAs). Traditional birth attendants play a crucial role in the care of women during pregnancy, birth and puerperium within communities.Aim: To explore and describe the experiences of TBAs during the provision of post-natal care to mothers and their neonates in order to make recommendations to improve the quality of post-natal care delivered at home.Setting: The community hall of a selected rural traditional community was used as a setting for data collection.Methods: A qualitative, exploratory and descriptive design was used. Three focus groups were held with 26 TBAs whom were purposively selected. Data were analysed using qualitative content analysis.Results: The study confirmed two categories that included: lack of supportive working relationships between TBAs and midwives and lack of respect of TBAs, by post-natal women.Conclusion: It is evident that the TBAs experienced negative experiences. Therefore, initiation of teamwork, empowerment and confidence development are crucial to improve the working experiences of TBAs during the provision of post-natal care. Quality post-natal care might reduce maternal and neonatal morbidity and mortality rates. Teamwork between TBAs and midwives might be initiated. Continuity of care for post-natal women might be improved.

Background: Despite the redesigning of the Reality condom (FC) to a new version of the second generation female condom commonly known as (FC2), the users are persistently constrained and concerned about the size and shape of this new version. Condom use is aligned to the Millennium Development Goals (MDG) 3, 5 and 6, which address gender equality, improving maternal health and preventing HIV and AIDS. Aim: To explore and describe the constraints and concerns regarding the size and/or shape of the FC2. Setting: The study was conducted at Tshwane health district in Gauteng province. Methods: A qualitative exploratory descriptive design was used. Individual in-depth interviews that yielded narratives in a designated health district in South Africa were conducted. Results: From the analysis of narratives three specific themes emerged. Firstly, the specific theme was that the size and shape of FC2 is undesirable for the health care providers, which may lead women to contract HIV and AIDS. The second theme was that the size and shape of FC2 and female genitals makes insertion complicated and predisposes women to be vulnerable in sexual relationships. The third was that the size and shape of FC2 results in pain and discomfort during coitus, exposing women to unwanted pregnancies and HIV and AIDS. Conclusions: The findings indicated the need for an evocative collaborative, interdisciplinary ‘walk the talk’ sexual health and AIDS education training programme for health care providers in primary health care facilities. Such programmes, if maintained, may assist health care providers to achieve the MDG 3, 5 and 6.

Background: Despite progress made by other countries worldwide in achieving Millennium Development Goals (MDGs) 4, 5 and 6, South Africa is experiencing a challenge in attaining positive outcomes for these goals. Objective and setting: To describe the challenges experienced by South Africa regarding the successful implementation of MDGs 4, 5 and 6. Methods: An integrative literature review was used to identify and synthesise various streams of literature on the challenges experienced by South Africa in attaining MDGs 4, 5 and 6. Results: The integrative review revealed the following themes: (1) interventions related to child mortality reduction, (2) implementation of maternal mortality reduction strategies, and (3) identified barriers to zero HIV and TB infections and management. Conclusion: It is recommended that poverty relief mechanisms be intensified to improve the socio-economic status of women. There is a need for sectoral planning towards maternal health, and training of healthcare workers should emphasise the reduction of maternal deaths. Programmes addressing the reduction of maternal and child mortality rates, HIV, STIs and TB need to be put in place. Keywords: Millennium Development Goals; maternal and child morbidity and mortality; HIV and AIDS; STI and TB

Professional nurses working in rural, primary health-care settings are experiencing burnout due to serious shortages of personnel. This is exacerbated by the brain drain of nurses leaving the country. Rural settings are resource constrained in terms of personnel and equipment. This results in dissatisfaction among nurses due to the unbearable working conditions which result in stress and frustration. A qualitative, explorative, descriptive study was conducted to explore and describe the experiences of nurses working in a rural primary health-care setting in the greater Letaba sub district in Limpopo Province. Purposive sampling was used to identify the participants. Data was collected in the form of in-depth interviews. The study revealed that nurses working in primary health-care settings were experiencing emotional and physical strain as a result of the shortage of human resources. It was recommended that policies that meet the health-care needs of rural communities be developed, and that strategies to retain professional nurses in primary health-care settings be formulated.

Currently, the syndromic management of HIV/AIDS is based on a biomedical model that focuses on the ABC (Abstain, Be faithful, Condomise) model. The ABC model overlooks the issue of indigenous cultural practices, sexual behaviours, knowledge and attitudes of the society. A grounded theory study was used for the research. The population for the research on which this article is reporting, was selected from the Vhavenda ethnic group using purposive sampling. In-depth interviews were held at the participants’ own homes. The outcome of the study on which this article is reporting, may assist in identifying indigenous health beliefs, attitudes and practices that will assist in curbing the spread of HIV/AIDS. The findings revealed that cultural practices, such as premarital counselling, polygamy and widow inheritance, are believed to be influential in making women more susceptible to sexually transmitted diseases, including HIV/AIDS. The practice of abstinence, as emphasised at initiation schools, should be incorporated into current policies and preventative practices. The findings further demonstrate that policy-makers who formulated the HIV/AIDS strategy have limited knowledge of the health beliefs, attitudes and practices of the people they serve. They thus find it difficult to draw up promotion and prevention strategies that meet the needs of the community. It is therefore imperative that our health-care training curriculum be reviewed to make provision for the incorporation of sound and effective indigenous practices to reduce the spread of HIV/AIDS and to eliminate or refine practices that are harmful and detrimental to people’s health. The cultural practices that were proved reliable and effective will be recommended for integration into health education.

Currently, all professions are using information communication technology (ICT) innovations that are transforming the 21st century learning environment. Nursing and midwifery need to use ICT to provide evidence based care and acquire new skills to function efficiently in high impact technology environments. Business and community partnership will enhance an uptake and assist in mapping out programs. The purpose of this paper is to discuss innovative initiatives: blended learning, massive open online courses, simulation and embracing technology in a community oriented, primary care outreach program design. In addition, innovations in nursing research are discussed through the lens of chronic disease, the major cause of disability and death throughout the world. Innovations in nursing research are centered in three areas – study design, nursing theory and the use of technology. Keywords: nursing education, technology, simulation, nursing research, chronic disease

Background: The majority of South African aging population are women, who spend late adulthood experiencing natural menopause. Despite the government spending billions of rand on different services for ageing women, menopausal challenges to African women still receive little attention. Objectives: The aim of the study was to explore and describe the perceptions of African women regarding natural menopause, in order to propose recommendations for health and social support systems for women in Mamelodi, Tshwane district. Method: A qualitative, exploratory, descriptive and contextual design was used to conduct the study. The population of the study consisted of menopausal women, between the ages 45 and 60 years or more, visiting the clinics for collection of chronic medication and othe rhealth assessment. Individual face-to-face interviews were conducted, using a semi-structured interview guide to collect data. Tesch’s method of qualitative data analysis was used in the study. Results: The main theme that emerged from the study was ‘attitude toward menopause’, which was supported by cultural beliefs and experience. The African menopausal women expressed the importance of health support systems that will meet their needs within their context. Conclusion: Women’s health programs and educational health information at facilities should include menopausal education to promote and improve health of all African menopausal women during their adulthood. There is a need to establish a women’s health support group network within communities to share menopausal experiences with peers. The training and education curriculum of healthcare providers should include detailed menopause in order to provide comprehensive, congruent care.

Background: In an era when antiretroviral (ARV) therapy has become part of the Human Immunodeficiency Virus (HIV) prevention strategy, early testing and introduction to ARVs iscritical for improving public health outcomes in general and, in particular, the lives of people living with HIV. South Africa has the highest number of people living with HIV as compared with the rest of the world. Initiated voluntary HIV counselling and testing and provider initiated counselling and testing (PICT) are required in order to increase the uptake of HIV testing.Objectives: To explore and describe the experiences of healthcare workers who are themselves in need of HIV testing.Method: A descriptive, exploratory design was used. In-depth interviews were conducted with the 26 healthcare workers who were involved in HIV testing in the Tshwane district of South Africa. The participants were sampled purposively from two healthcare settings. A thematic framework was used for data analysis.Results: There was a complication with regard to PICT as healthcare workers felt they could not initiate HIV testing for themselves and or their work colleagues without their confidentiality being compromised. This was complicated further by both the perceived and actual fear of stigmatisation and discrimination. It was difficult for qualified staff to support and encourage the uptake of HIV testing by students nurses as this was seen, albeit incorrectly, as targeting the students in a negative manner.Conclusion: There is a need for accessible HIV testing policies for healthcare workers in order to increase access to HIV testing and prevent the progression of the disease

Background: Child-rearing remains a concern within our communities, especially because families of today lack primary parents due to multifaceted challenges such as working mothers, diseases and violence. Health-promoting school initiatives are necessary because they allow a multifaceted approach to child-rearing. They further provide a conducive environment for continued schoolchild-rearing moving from home to school.Objectives: This study promotes an integrated approach to school care using the African concept of Ubuntu – solidarity and sense of community – as a point of departure. The socio-ecological model was used, which includes the work of the school healthcare nurse in contributing to holistic health services.Method: An integrative review was conducted in January 2013, which included methodology studies, a theory review and a variety of studies related to school health. The studies were categorised according to school health, Ubuntu and the socio-ecological model.Findings: The role of school healthcare nurses entails acting as a liaison officer between a variety of stakeholders who work together to shape the future of children.Conclusion: Ubuntu, together with the socio-ecological model, can assist us to involve an entire community to raise children. This knowledge serves as a background to the planning of a school health programme. The role of the nurse in school health can also assist in collaborative efforts to formulate the programme and develop the competencies that will inform school health nurse training curricula.

The purpose of this article is to explore and describe the perceptions of traditional healers of cervical cancer care. The incidence of cervical cancer, especially among black South African females, is among the highest in the world. Women report at clinics and hospitals on a daily basis with advanced stages (stages III and IV) of cervical cancer. Black women consult traditional healers first, before they consult health-care professionals. Although cervical cancer survival rates are said to be improving across South Africa, not all women benefit from the screening programme for early detection of cervical cancer. Traditional healers perform an indispensable role in the delivery of health care, especially in rural areas where access to biomedical care is limited. The article is based on a qualitative, descriptive, and exploratory study. The study population included traditional healers who were chosen through snowball sampling. Data was collected by means of in-depth interviews. Data was analysed using Tesch's method. The findings of this study demonstrated that the traditional health practitioners have good knowledge about cervical cancer care. This was shown by the knowledge they had of naming the disease, predisposing factors and causes, of cancer care, symptoms of diseases, diagnostic measures and methods of treatment. The findings of this study provided valuable information on the perceptions of traditional healers of cervical cancer care. In view of the knowledge that the traditional healers possess, this study recommended that there be sharing of knowledge and collaboration between modern health-care practitioners and traditional healers. Collaboration may assist in early detection and treatment of cervical cancer, thereby improving the mortality rate Keywords : Traditional healers, traditional medicine, western medicine, cervical cancer, perceptions. Indilinga Vol. 7 (1) 2008: pp. 103-116