Browsing by Author "Doherty, Tanya M."

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    Breastfeeding advice for reality: Women's perspectives on primary care support in South Africa
    (Wiley-Blackwell, 2020) Doherty, Tanya M.; Horwood, Christiane M.; Haskins, Lyn J.
    Breastfeeding education and support are critical health worker skills. Confusion surrounding infant feeding advice linked to the HIV epidemic has reduced the confidence of health workers to support breastfeeding. High antiretroviral therapy coverage of breastfeeding women living with HIV, and an Infant Feeding policy supportive of breastfeeding, now provides an opportunity to improve breastfeeding practices. Challenges remain in restoring health worker confidence to support breastfeeding. This qualitative study presents findings from focus group discussions with mothers of young infants, exploring their experiences of health worker breastfeeding counselling and support. Analysis followed the thematic framework approach. Six researchers reviewed the transcripts, coded them independently, then jointly reviewed the codes, and agreed on a working analytical framework. Although mothers received antenatal breastfeeding messages, these appeared to focus rigidly on the importance of exclusivity. Mothers described receiving some practical support with initiation of breastfeeding after delivery, but support and advice for post-natal breastfeeding challenges were often incorrect or absent. The support also ignored the context in which women make infant feeding decisions, including returning to work and pressures from family members.
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    Building back from the ground up: The vital role of communities
    (BMJ Publishing Group, 2020) Kroon, Max; Doherty, Tanya M.; Reynolds, Louis
    Globally the COVID-19 pandemic has destabilised health systems and communities. Governments in low- and middle-income countries (LMICs) followed the approaches adopted by the Global North and advocated by international bodies such as the WHO, and instituted varying degrees of nationwide stay at home orders (lockdowns) from strict restrictions (such as in South Africa, India and Zimbabwe) to weakly enforced lockdown as in Brazil.1 Many have questioned the appropriateness of these measures in LMIC contexts2 where key preventive behaviours such as social distancing and frequent hand washing are impossible to implement in densely populated informal housing settlements.
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    Level of adult client satisfaction with clinic flow time and services of an integrated non-communicable disease-HIV testing services clinic in Soweto, South Africa: A cross-sectional study
    (Springer Nature, 2020) Doherty, Tanya M.; Hopkins, Kathryn L.; Hlongwane, Khuthadzo E.
    While HIV Testing Services (HTS) have increased, many South Africans have not been tested. Non-communicable diseases (NCDs) are the top cause of death worldwide. Integrated NCD-HTS could be a strategy to control both epidemics. Healthcare service strategies depends partially on positive user experience. We investigated client satisfaction of services and clinic flow time of an integrated NCD-HTS clinic. Methods: This prospective, cross-sectional study evaluated HTS client satisfaction with an HTS clinic at two phases. Phase 1 (February-June 2018) utilised standard HTS services: counsellor-led height/weight/blood pressure measurements, HIV rapid testing, and symptoms screening for sexually transmitted infections/Tuberculosis. Phase 2 (June 2018-March 2019) further integrated counsellor-led obesity screening (body mass index/abdominal circumference measurements), rapid cholesterol/glucose testing; and nurse-led Chlamydia and human papilloma virus (HPV)/cervical cancer screening. Socio-demographics, proportion of repeat clients, clinic flow time, and client survey data (open/closed-ended questions using five-point Likert scale) are reported. Fisher's exact test, chi-square analysis, and Kruskal Wallis test conducted comparisons.
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    Translating new evidence into clinical practice: A quasi-experimental controlled before-after study evaluating the effect of a novel outreach mentoring approach on knowledge, attitudes and confidence of health workers providing HIV and infant feeding counselling in South Africa
    (BMJ Publishing Group, 2020) Doherty, Tanya M.; Goga, Ameena Ebrahim; Manda, Samuel Om M.
    Objectives We report the effectiveness of a mentoring approach to improve health workers' (HWs') knowledge, attitudes and confidence with counselling on HIV and infant feeding. Design Quasi-experimental controlled before-after study. Setting Randomly selected primary healthcare clinics (n=24 intervention, n=12 comparison); two districts, South Africa. Participants All HWs providing infant feeding counselling in selected facilities were invited. Interventions Three 1-2 hours, on-site workshops over 3-6 weeks. Primary outcome measures Knowledge (22 binary questions), attitude (21 questions-5-point Likert Scale) and confidence (19 questions-3-point Likert Scale). Individual item responses were added within each of the attitude and confidence domains. The respective sums were taken to be the domain composite index and used as a dependent variable to evaluate intervention effect. Linear regression models were used to estimate the mean score difference between intervention and comparison groups postintervention, adjusting for the mean score difference between them at baseline.
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    Use of social media platforms by manufacturers to market breast-milk substitutes in South Africa
    (BMJ Publishing Group, 2020) Pereira-Kotze, Catherine; Doherty, Tanya M.; Swart, Elizabeth Catherina
    In South Africa (SA), exclusive breast feeding remains rare, with breast-milk substitutes (BMS) commonly being used in ways that are detrimental to infant and young child nutrition, health and survival. The use of internet, digital and mobile platforms has increased, including in low-income and middle-income countries, like SA and these platforms are avenues for BMS marketing. SA has national legislation (Regulation R991) to enforce the International Code of Marketing of BMS. This paper aims to provide pertinent examples of how BMS manufacturers in SA use social media to market their products thus violating national regulations. A digital (and social media) ethnography approach was used to study BMS organisations' activity on Facebook and Instagram.