Faculty of Community and Health Sciences

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https://hdl.handle.net/10566/9

The Faculty of Community and Health Sciences (CHS) is committed to excellence in education and training, research and community service which promotes a progressive primary health care approach in an inter-professional manner.

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A case study of transport services for physically disabled citizens in the city of Cape Town
(University of the Western Cape, 2018) Morta-Andrews, Nadheerah; Minnaar-McDonald, Marie
Access to transport is a fundamental human right for citizens in any country, and this includes people with physical disabilities. Globally, this right is enshrined in policies and legislative documents of various countries. Developed countries have made enormous strides for inclusion of people with disabilities in their social policies, planning and expansion of transport services. In South Africa, despite a multitude of policies and legislation, there has been limited research conducted on the experiences of physically disabled citizens and their right to accessible transport. The political ethics of care was used as a framework to analyse the experiences of people with physical disabilities in relation to the Dial-A-Ride special transport policy service available in the City of Cape Town. The main aim of the study was to gain an in-depth understanding of the accessible transport service programme, subsidised by the City of Cape Town by exploring the perspectives of both service users and service providers; documenting how the special transport needs of the physically disabled service users as care receivers are catered for by care givers or special transport service providers. This study addressed the research question: "What are the expectations, experiences, and needs of physically disabled transport service users in relation to the special transport service provided by the City of Cape Town?" Due to the explorative, descriptive and contextual nature the study adopted a qualitative case study research design.
A case study of transport services for physically disabled citizens in the city of Cape Town
(University of the Western Cape, 2018) Morta-Andrews, Nadheerah; Minnaar-McDonald, Marie
Access to transport is a fundamental human right for citizens in any country, and this includes people with physical disabilities. Globally, this right is enshrined in policies and legislative documents of various countries. Developed countries have made enormous strides for inclusion of people with disabilities in their social policies, planning and expansion of transport services. In South Africa, despite a multitude of policies and legislation, there has been limited research conducted on the experiences of physically disabled citizens and their right to accessible transport. The political ethics of care was used as a framework to analyse the experiences of people with physical disabilities in relation to the Dial-A-Ride special transport policy service available in the City of Cape Town. The main aim of the study was to gain an in-depth understanding of the accessible transport service programme, subsidised by the City of Cape Town by exploring the perspectives of both service users and service providers; documenting how the special transport needs of the physically disabled service users as care receivers are catered for by care givers or special transport service providers. This study addressed the research question: "What are the expectations, experiences, and needs of physically disabled transport service users in relation to the special transport service provided by the City of Cape Town?" Due to the explorative, descriptive and contextual nature the study adopted a qualitative case study research design.
A conceptual framework for nurse educationalists and professional nurses to facilitate professionalism among undergraduate learner nurses for nursing practice in the Western Cape
(University of Western Cape, 2017) Bimray, Portia Benita; Jooste, K.
Learner nurses are socialised into the professional nursing culture through a formal undergraduate nursing programme, where the professional values of nursing are instilled in them throughout their four-year training. During the four years, learner nurses are prepared by nurse educationalists (nurse educators and clinical supervisors) and professional nurses to become professional to render a quality nursing service. This is in spite of the pressures and challenges related to the ever-changing socio-economic and political climate that influence the health context within which these nurses practice. The researcher became aware of a growing number of complaints from various stakeholders in the nursing profession in the Western Cape about the unprofessional conduct of learner nurses. Nurse educators and professional nurses in practice also complained that learner nurses had not developed professionalism by the end of their 4th years of the nursing programme. Perceptions of nursing professionals were that graduate nurses did not conduct themselves in a professional manner after they had completed the formal undergraduate nurses training programme. From these problems, it became evident that a clear framework for professionalism should be developed for nurse educationalists and professional nurses to facilitate professionalism in undergraduate learner nurses for nursing practice in the Western Cape. The purpose of this study was to develop a conceptual framework for nurse educationalists and professional nurses with which they can facilitate professionalism in undergraduate learner nurses of the nursing practice in the University of the Western Cape. The study departed within the paradigm of the professionalism taxonomy of Brown and Ferrill (2009) and Dickoff, James and Wiedenbach (1968).
A contemporary work performance management framework for the Assistant Nurse Manager in the provincial health-care setting
(University of the Western Cape, 2017) Swartz, Beryldene Lucinda; Jooste, Karien
Performance management (PM) in a work setting is seen as process within the broader human resource management (HRM) system that involves people in the attempt to secure the best work performance from the individuals, the working groups and that of the entire work society. Various factors play a role in the performance of nurse managers in South Africa. Since the determination and the simultaneous implementation in 2007 of the occupational specific dispensation (OSD) job descriptions for nurses working in the government setting in South Africa, the understanding of what the required work performance for the Assistant Nurse Manager (ANM) was, remained unclear, as there was no PM framework that directed the work performance of the ANM in the Western Cape Province (WCP).
A human resource strategy to facilitate competencies of assistant nurse managers in the public health facilities in the Western Cape
(University of the Western Cape, 2017) Makie, Vatiswa Veronica; Jooste, K.
The health workforce provides the most important input to any health system. There are estimated to be 59.2 million full-time paid health workers worldwide. The workforce has a strong comprehensive impact on the performance of the health system. Competent nurse managers are needed, particularly in countries such as South Africa, which places nurses at the epicentre of the health delivery system. During the implementation of the Occupational Specific Dispensation in 2007, the post of Assistant Director of Nursing was amended to Assistant Nurse Manager on a higher managerial level and newly appointed ANMs were expected to be competent. A generic human resources strategy was initiated in 2010 because of complaints about the competencies of nurse managers in the South African public health sector. This attempt excluded assistant nurse managers. The aim of this study was to develop a human resources strategy for facilitating the competencies of ANMs at the public health facilities in the Western Cape.
A model for the integration of spiritual care into the nursing curriculum in Nigeria
(University of the Western Cape, 2018) Afolayan, Joel Adeleke; Frantz, José
Man is a bio-psycho-social-spiritual being, and his needs are informed by all these elements. The need for spiritual care in nursing education and practice is no longer a new concept in developed countries, nor even in some developing countries. However, in Nigeria, there is no consistent evidence of how spirituality is taught within the nursing curriculum nor how it is practised. The literature review also confirms that no existing set of rules or models for integrating spiritual care into the curriculum of nursing exists in the country. If nursing care is to be holistic, concerted attention must be paid to spiritual care, and to the training of nurses so that they can provide spiritual care within the context of holistic care for patients in the healthcare system. The main purpose of this academic work was to develop a model for the integration of spiritual care-giving into the nursing curriculum. This cross-sectional study used adapted modified Intervention Mapping (IM) strategies with a mixed method approach, to collect in-depth information.
A planetary health perspective on the translation of climate change research into public health policy and practice: A scoping review protocol
(Public Library of Science, 2024) Mulopo, Chanelle; Abimbola, Samuel; Onkoba, Nyamongo; Schmidt, Bey-Marrie
Background climate change (CC) emanating from anthropocentric human activities is a great threat to the quality of human life and well-being worldwide. The translation of CC research evidence can play a critical role in promoting the formulation of climate-sensitive policies to equip public health systems for CC-associated disaster preparedness, response, and management. This scoping review seeks to explore knowledge translation approaches for promoting, the uptake, and use of CC research evidence in public health policy and practice. Methods This scoping review will be conducted according to the guidelines of Arksey and O’Malley. A search strategy will be developed for published articles in PubMed, CINAHL, and Scopus databases and for grey literature in the world health organization, planetary health alliance, and the University of the Western Cape repositories. Discussion the proposed scoping review will gather existing evidence on the relationship between knowledge translation, CC research, and public health decision-making. This will provide insights into research and practice gaps, and recommendations will be made to ensure effective knowledge translation for CC related decision-making.
A qualitative exploration of the dimensions of family resilience in a rural community on the West Coast
(University of the Western Cape, 2017) Twigg, Jennifer; Florence, Maria; Isaacs, Serena
Historically, families living in disenfranchised communities were viewed as being dysfunctional. This view led to the perpetuation of the challenges and adverse situations faced by these families. It is important to view the family holistically rather than just to focus on the risk factors and/or the dysfunctional nature of the family. This study endeavoured to explore how the family functions and copes with the challenges they face. The aim of the study was to qualitatively explore the dimensions of family resilience as perceived by families in a rural community on the West Coast, South Africa. Family resilience theory was used as the theoretical framework for the research study. Three family resilience dimensions were explored. These dimensions are family belief systems, family organisation and resources, and family communication patterns. Participants were selected by means of nonprobability sampling. The local NGO in collaboration with the researcher identified the participants. The participants were homogenous in terms of being parents who participated in a parent support programme and were from the same community. Six semi-structured, oneon- one interviews were conducted as the data collection method. The interviews were transcribed and analysed using thematic analysis. Three main themes emerged, in congruence with the theoretical framework. These themes were the family's belief system, their organisational patterns when faced with adversity, as well as the communication patterns of the family. The participants all reported that their strong sense of faith was used as coping mechanisms through their adversities. They had varying reports on how their family organised themselves and how they communicated. Some participants reported that living in a small community could at times be challenging, especially when sharing adversities as they feared community gossip, which then acted as a barrier to seeking help. The researcher adhered to the ethics requirements of the study in terms of confidentiality, provided the participants with informed consent forms and informed them of their rights as participants. Participants were free to discontinue the research process at any point without prejudice.
A qualitative process evaluation of community-based participatory research and human-centered design in the ‘let’s talk about vaccines’ approach in Mozambique and Malawi
(BioMed Central Ltd, 2025) Shuro, Linda; De Man, Jeroen; Knight, Lucia; Tabana, Hanani; Schneider, Helen
Background: Ensuring full coverage of childhood vaccination programmes is a persistent challenge in low- and middle-income countries. Urgent action is required to ensure catch up of missed immunisations in children, while simultaneously building trust and demand within communities to sustainably address existing immunization gaps. This paper summarizes the findings of a process evaluation of the ‘Let’s talk about vaccines’ approach by VillageReach in Mozambique and Malawi. The approach used community-based participatory research to identify the barriers to childhood vaccination faced by caregivers and healthcare workers, with human-centered design to codesign potential interventions to improve under two immunization access and uptake. Methods: To evaluate the implementation of the ‘Let’s talk about vaccines’ approach we conducted a qualitative process evaluation guided by the Reach Effectiveness Adoption Implementation Maintenance framework and Consolidated Framework for Implementation Research (CFIR). We completed a total of 76 qualitative interviews and 85 self-administered surveys among caregivers, healthcare workers, health officials and other stakeholders involved in the approach. We transcribed the interviews verbatim and analysed them using thematic analysis and constructs of the RE-AIM and CFIR frameworks. We analysed the survey results in Excel. Results: Key elements of the approach contributing to high fidelity to community-based participatory research principles in both countries, included diverse collaborative study and project teams, involvement of eight caregiver researchers, novel and traditional participatory methods, and extensive mobilization efforts. Success factors for human-centered design in the ideation and prototyping phase included fostering equal participation and empathy, value placed on each participant’s input, mitigating inherent power differences, interactive feedback processes, and extensive iterative processes leading to tangible solutions. Challenges included adjusting to new methods and contextual realities. Factors influencing the potential adoption of the approach included locally developed solutions, participant involvement, collaboration, a major advantage over alternative approaches, ease of use of the co-created interventions, alignment with government objectives, and adaptability for system-wide integration into immunization programming. The potential sustainability of the approach was supported by the involvement of health ministries, health professionals, community representatives, and capacity building of local structures. However, resource and incentive constraints posed as a potential challenge to maintaining long-term motivation and action. Conclusion: The evaluation findings from the ‘Let’s talk about vaccines’ approach highlighted key elements for applying community-based participatory research and human-centered design to collaboratively identify immunization barriers and create tangible solutions to overcome them. By integrating these approaches into routine immunization programs, it can potentially improve vaccination efforts for children under two in low and middle-income countries, leading to lasting change. Supporting policies that prioritize community involvement in research, program design and implementation and sustainable funding enhances immunization strategies, ensuring that they are tailored to local needs.
A qualitative study exploring the experiences of Black South African vegetarians residing in the urban settings of Cape Town.
(University of the Western Cape, 2017) Sedupane, George; Waggie, Firdouza
Vegetarianism is a growing global trend. Movie stars and world class athletes proudly brand themselves vegetarian. Apart from its health implications vegetarianism has been extensively studied as a social and psychological phenomenon. However the understanding that has emerged from these studies has almost exclusively reflected Caucasian Western societies. Internationally there is a paucity of research regarding vegetarianism among people of African descent. The purpose of this study was to fill this knowledge gap by exploring the development of a vegetarian identity among Black urban South Africans living in Cape Town and the contextual factors involved in their adoption and practice of vegetarianism. Bronfenbrenner’s bioecological systems theory which emphasizes the bidirectional influence between human behaviour and broader contextual factors was used as a theoretical framework for understanding vegetarianism among Black South Africans. This study used a qualitative exploratory approach to describe the perceptions and experiences of Black vegetarians. Snowball sampling was used to locate eight Black South African adult vegetarians who were interviewed in depth. The audio recorded interviews were transcribed and analysed through thematic analysis yielding three main themes. The first and central theme is that “vegetarianism is life.” This theme encapsulates the fact participants view vegetarianism as an instrument through which the highest ideals of life are attained including physical vitality, spiritual vibrancy and intellectual superiority. In the second theme the process of developing a vegetarian identity was unfolded. Contextual religio-cultural influences of Rastafarianism and Seventh day Adventism were a major influence in the development of a vegetarian identity. The last theme unfolds the experience of Black vegetarians living in meat dominated society. The study reveals that becoming a vegetarian definitely affects one’s social relations. However the gender of the vegetarians modulated the reaction of family members. Vegetarians also employed several strategies to manoeuvre difficult social situations. This study is among the first to contribute an African perspective to the global vegetarian discourse. It has highlighted the way Black Africans develop a vegetarian identity and the contextual factors acting as barriers and facilitators to this development. It has highlighted how this identity is informed by their Africanness though at times it conflicts with certain African ideals. Finally it has identified the social, cultural and psychological variables involved in the vegetarian phenomenon on the African continent.
A qualitative study exploring the experiences of Black South African vegetarians residing in the urban settings of Cape Town.
(University of the Western Cape, 2017) Sedupane, George; Waggie, Firdouza
Vegetarianism is a growing global trend. Movie stars and world class athletes proudly brand themselves vegetarian. Apart from its health implications vegetarianism has been extensively studied as a social and psychological phenomenon. However the understanding that has emerged from these studies has almost exclusively reflected Caucasian Western societies. Internationally there is a paucity of research regarding vegetarianism among people of African descent. The purpose of this study was to fill this knowledge gap by exploring the development of a vegetarian identity among Black urban South Africans living in Cape Town and the contextual factors involved in their adoption and practice of vegetarianism. Bronfenbrenner’s bioecological systems theory which emphasizes the bidirectional influence between human behaviour and broader contextual factors was used as a theoretical framework for understanding vegetarianism among Black South Africans. This study used a qualitative exploratory approach to describe the perceptions and experiences of Black vegetarians. Snowball sampling was used to locate eight Black South African adult vegetarians who were interviewed in depth. The audio recorded interviews were transcribed and analysed through thematic analysis yielding three main themes. The first and central theme is that “vegetarianism is life.” This theme encapsulates the fact participants view vegetarianism as an instrument through which the highest ideals of life are attained including physical vitality, spiritual vibrancy and intellectual superiority. In the second theme the process of developing a vegetarian identity was unfolded. Contextual religio-cultural influences of Rastafarianism and Seventh day Adventism were a major influence in the development of a vegetarian identity. The last theme unfolds the experience of Black vegetarians living in meat dominated society. The study reveals that becoming a vegetarian definitely affects one’s social relations. However the gender of the vegetarians modulated the reaction of family members. Vegetarians also employed several strategies to manoeuvre difficult social situations. This study is among the first to contribute an African perspective to the global vegetarian discourse. It has highlighted the way Black Africans develop a vegetarian identity and the contextual factors acting as barriers and facilitators to this development. It has highlighted how this identity is informed by their Africanness though at times it conflicts with certain African ideals. Finally it has identified the social, cultural and psychological variables involved in the vegetarian phenomenon on the African continent.
A qualitative study on adolescents’ perceptions and understandings of flourishing in the Western Cape, South Africa
(Springer Science and Business Media B.V., 2024-08-22) Witten, Heidi; Savahl, Shazly; Adams, Sabirah
Adolescence is a transitional period characterised by puberty, physical growth, and the capacity to complete life tasks. During this period, adolescents are faced with various challenges in completing various life tasks. Flourishing is defined as a state in which an individual functions optimally, and has a good level of well-being in all aspects of their life. Previous studies on adolescent flourishing have focused on measuring flourishing quantitatively, which suggests a need for further research that qualitatively explores adolescent flourishing. In this study we use the conceptualisation of flourishing that encompasses hedonia and eudaimonia. It is crucial to position adolescents at the core of research endeavours, to gain insight into the unique factors, values, and goals that contribute to their flourishing. The overall aim of the study is to explore adolescents’ understandings and perceptions of flourishing in the Western Cape, South Africa. Semi-structured individual interviews were conducted to gain a comprehensive understanding of adolescents’ perceptions and understanding of flourishing. The interviews were analysed using Braun and Clarke’s theoretical thematic analysis. We found two overarching thematic categories: 1) Understanding flourishing and 2) Factors that promote flourishing. The study findings emphasise the significance of balance in different aspects of life such as mental health, self-reflection, and self-expression to support adolescents in developing their own sense of flourishing and to understand their own experiences. The central role of relationships as a support structure for adolescents was found to be significant as the participants were able to identify what is needed through these relationships, which could promote their own flourishing. Future empirical research should endeavour to include both hedonic and eudaimonic traditions in exploring adolescent flourishing.
A qualitative study on the role of alcohol in the lives of a group of sexual minority women in South Africa
(Sage, 2025) Padmanabhanunni, Anita; McKenzie, Sharon
Despite extensive research on alcohol misuse in South Africa, a significant gap remains in the literature regarding the experiences of sexual minorities, defined as individuals whose sexual orientation or gender identity differs from heteronormative expectations. International studies have confirmed that sexual minority women are at a higher risk of harmful alcohol use compared with their heterosexual counterparts. This disparity is attributed to the distinctive and chronic stressors that sexual minorities face. There remains a paucity of research in South Africa on the experience of alcohol misuse among sexual minority women. This study aimed to address this gap in the literature. Twenty-five sexual minority women from diverse backgrounds residing in Cape Town, South Africa, participated in the study. Data collection occurred through semi-structured interviews. Using Interpretative Phenomenological Analysis, the study explored participants’ lived experiences of alcohol misuse and their perspectives of the reasons for initiating such use. The findings indicate that alcohol served as an emotional regulation strategy, helping them to manage emotional distress arising from experiences of rejection, stigma, and discrimination related to their sexual minority status. Rejection and ostracism from family and religious communities were identified as salient sources of distress precipitating alcohol misuse. In addition, participants identified childhood sexual abuse and internal conflicts related to reconciling their sexual identity with cultural and religious beliefs as key drivers of their alcohol misuse. The findings underscore the importance of addressing individual, familial, and societal-level factors in efforts to reduce harmful alcohol consumption within this population.
A realist evaluation of the antiretroviral treatment adherence club programme in the metropolitan area of the Western Cape Province, South Africa
(University of the Western Cape, 2018) Mukumbang, Ferdinand C.; van Wyk, Brian
In South Africa, 7.1 million people living with HIV/AIDS (PLWHA) of whom about 56% were accessing antiretroviral therapy (ART) in 2016, accounted for approximately 20% of people on ART globally. The successful initiation of PLWHA on ART has engendered challenges of poor retention in care and suboptimal adherence to medication. While standard treatment and care schemes show the potential to retain patients in ART care, their success is challenged by congested health-care facilities, long waiting times and shortages of health-care providers. The antiretroviral adherence club intervention was rolled out in primary health-care facilities in the Western Cape Province of South Africa to relieve clinic congestion and improve retention in care, and treatment adherence in the face of growing patient loads. Evidence from the literature suggests that these models of ART service delivery are more effective than corresponding facility-based care. Nevertheless, there is little understanding of how these care models work to achieve their intended outcomes. To this end, a theory-driven approach to evaluate the adherence club intervention was proposed.
A scoping review of male victims of intimate partner violence: a social constructionist analysis
(University of the Western Cape, 2023) Julies, Robin
Intimate partner violence (IPV) is regarded as a global public health issue. Amidst a global COVID-19 pandemic, incidents of IPV increased dramatically and has been labelled as a pandemic within itself. While a great deal of work has been done focusing on IPV, the extent of work focusing on men’s experiences and help-seeking behaviours as victims of IPV are limited. Typically, men are viewed and view themselves in specific contexts which are informed by their socialisation. This perception influences how men behave, process life - including crises and responses to said crises. This study aimed to determine the scope of knowledge that exists and identifies the extent of IPV where males are the victims and how social constructions of masculinity are reflected in peer reviewed literature around helpseeking behaviour of male victims of IPV. A scoping review methodology was used to address the aim of the study utilising the framework proposed by Arksey and O’Malley for scoping reviews as well as the PRISMA Extension for Scoping Reviews. The UWC library system was accessed: The Ebscohost meta-database was used, and the following databases were selected; Academic Search Complete; APA PsycArticles; ERIC; SAGE journals as well as Taylor and Francis online journals. Additionally, unpublished dissertations also available on the UWC research repository were searched and reviewed for inclusion.
A scoping review of the trauma interventions for children in South Africa
(University of the Western Cape, 2024) Lukic, Hannah; Isaacs, Serena
For many South African children, exposure to many traumatic events and experiences, such as maltreatment, physical and sexual abuse, and community violence, is commonplace in their daily lives. Despite this, there is a scarcity of research that explores the nuances of the South African trauma landscape, as well as the interventions which are implemented to address it. This scoping review aimed to address both gaps by providing an outline of the unique characteristics of childhood trauma in South Africa and a synthesis of the interventions implemented to date. The search terms that were utilised to do so, were: trauma AND intervention OR treatment OR therapy OR “randomised controlled trial” AND child OR adolescent OR teenager OR youth AND “South Africa” OR “South African”. The electronic databases consulted for this review were EBSCOhost Web (Academic Search Complete, APA PsychArticles, CINHL Plus with Full Text, ERIC, Health Source: Nursing/Academic Edition and MEDLINE) and PubMed. This search yielded 2165 outputs, of which 19 were included in this review and subject to quantitative and narrative analysis. This study found that three distinct descriptors were used to describe childhood trauma in South Africa, namely: an exceptionally high prevalence of trauma, poly-victimisation and the inherently ongoing nature of trauma exposure. Each of these presented unique complexities for treatment. Of the interventions reviewed in this study, art and play therapies emerged as the most commonly utilised treatment approach, followed by trauma-focused cognitive-behavioural therapy (TF-CBT). While this study provides an overview of existing South African literature, it also aims to encourage future research in this field by highlighting its scarcity.
A systematic review of digital mental health interventions for students during the COVID-19 pandemic
(Universty of the Western Cape, 2024) Kader, Zainab; Padmanabhanunni, Anita
Students are vulnerable to mental health conditions, due to the pressures associated with tertiary learning. Disruptions in the academic processes caused by the COVID-19 pandemic added to the pressure, which raised concern for students’ mental health, and the development of digital interventions to address their needs. Several digital interventions have come into existence, since the onset of the pandemic in 2019. Therefore, this current study was aimed at systematically reviewing existing digital mental health interventions for students during the COVID-19 pandemic, using a RE-AIM Framework, to evaluate their properties, and determine their efficacy. Consequently, the researcher employed a systematic review methodology to identify English, peer reviewed studies, published between January 2020 and April 2023, and focused on digital mental health interventions for students during the COVID 19 pandemic. Seven databases were accessed, namely, (1) Academic Search Complete, (2) Health Source: Nursing/Academic Edition, (3) Medline, (4) APA PsycArticles, (5) SosIndex with full text, (6) Sabinet and (7) PubMed. The following three levels of review were utilised to determine relevance and inclusion: (1) title screening; (2) abstract screening; and (3) full texts screening. Full text articles were critically appraised, using the RE-AIM appraisal tool. Eleven studies were deemed eligible for this current study.
A systematic review of recent interventions for women who misuse alcohol
(University of the Western Cape, 2023) Samuels, Michelle; Munnik, Erica
The use and misuse of alcohol among women has become a major public health concern globally. Interventions that assist women to overcome the various challenges they face, is therefore of vital importance. A systematic review methodology was used that drew on quantitative studies. Filtration was done in line with the Preferred Reporting Items for Systematic reviews (PRISMA) guidelines, combining title and abstract searches through identified University of the Western Cape library databases such as ScienceDirect, PsycARTICLES (Ebscohost), SA ePublications (Sabinet) Academic Search Complete, MasterFILE Premier, SocINDEX, MEDLINE, and PubMed. Title searches resulted in the identification of 247 articles based on the combination of keywords. Among these, 26 articles were found to meet the inclusion criteria and were included for abstract review. During the screening phase, 19 articles were excluded. Subsequently, seven articles were deemed eligible to proceed to the appraisal phase using the Smith, Franciscus, Swartbooi (SFS) critical appraisal tool designed for intervention studies. All articles successfully achieved a threshold score of 61%, allowing them to progress to the summation phase. Summation was done by means of narrative synthesis; synthesising information extracted from the primary studies make for relevant, meaningful contributions that extend beyond the original study. All ethical principles pertaining to systematic reviews were adhered to.
A systematic review of the effectiveness of lifestyle and medication: interventions in the management of hypertension in pregnancy
(University of the Western Cape, 2017) Kutumbuka, Benjamin Kukatula; Phetlhu, D.R.
Pregnancy induced hypertension is one of the causes of maternal, fetus and neonatal morbidity and mortality. It is the condition in which a pregnant woman develops hypertension because of physiological changes that result during pregnancy and both mother and fetus can be affected. According to the World Health Organization (WHO), the first target of the third United Nations Sustainable Development Goals (SDG-3) is to reduce the maternal mortality rate (MMR) to less than 10 per 100.000 live births by 2030 (WHO, 2017). This is because globally, about 350 000 women die every year from pregnancy related causes (Hogan, Foreman, & Naghavi, 2010). According to the WHO (2015), these conditions namely post-partum hemorrhage, hypertension in pregnancy, infections, unsafe abortion and other delivery-related complications cause three quarters of all maternal deaths in the World. Hence the needs to prevent or successfully treat conditions that contribute to this scourge (WHO, 2011). The two main interventions that are used to prevent or treat hypertension in pregnancy are medication and lifestyle adjustment. However, it is important to understand the intervention that is most suited to a context and its patient and compare the effects of these interventions on management of hypertension in pregnant women as a patient outcome.
Ability to manage diabetes – community health workers’ knowledge, attitudes and beliefs
(SEMDSA (Society for Endocrinology, Metabolism and Diabetes of SA), 2006) Hughes, Gail; Puoane, Thandi; Bradley, Hazel A.
BACKGROUND: Diabetes constitutes a significant health problem in South Africa. Early detection and good management can prevent or delay complications, with national guidelines for diabetes treatment now available to facilitate this. However, problems are being encountered with their implementation and there is evidence that preventive care is still inadequate in South Africa. Community health workers (CHWs) are lay personnel employed to serve as a link between professional health care staff and the community. They visit homes and can be a powerful force for diabetes prevention and adherence to treatment regimens, given appropriate knowledge. METHOD: We conducted a study to evaluate the knowledge, beliefs and attitudes of a group of CHWs serving a poor urban area, using focus groups and personal interviews. RESULTS: The CHWs did not have the requisite knowledge, attitudes and beliefs to make a positive impact on prevention and management of diabetes. For example, they cited eating sugar as a cause of diabetes. They advised folk remedies that purportedly diluted the blood sugar. Their patients took prescribed medication irregularly. Obesity was not considered an important risk factor. Poverty, however, was recognised as an obstacle to proper treatment. CONCLUSION: Training is clearly needed to empower the CHWs with skills to work within their communities to identify risk factors for diabetes and other non-communicable diseases, with emphasis on diet and physical activity.

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