A scoping review of the determinants of foetal alcohol spectrum disorder in South Africa: an intersectional perspective

dc.contributor.authorGeorge, Asha S
dc.contributor.authorJacobs, Tanya
dc.contributor.authorde Jong, Michelle
dc.date.accessioned2021-09-16T09:43:38Z
dc.date.available2021-09-16T09:43:38Z
dc.date.issued2021
dc.description.abstractFetal alcohol spectrum disorder (FASD) affects babies born to mothers who consume alcohol while pregnant. South Africa has the highest prevalence of FASD in the world. We review the social determinants underpinning FASD in South Africa and add critical insight from an intersectional feminist perspective. We undertook a scoping review, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Scoping Reviews guidelines. Drawing from EBSCOhost and PubMed, 95 articles were screened, with 21 selected for analysis. We used the intersectionality wheel to conceptualize how the social and structural determinants of FASD identified by the literature are interconnected and indicative of broader inequalities shaping the women and children affected. Key intersecting social determinants that facilitate drinking during pregnancy among marginalized populations in South Africa documented in the existing literature include social norms and knowledge around drinking and drinking during pregnancy, alcohol addiction and biological dependence, gender-based violence, inadequate access to contraception and abortion services, trauma and mental health, and moralization and stigma. Most of the studies found were quantitative. From an intersectional perspective, there was limited analysis of how the determinants identified intersect with one another in ways that exacerbate inequalities and how they relate to the broader structural and systemic factors undermining healthy pregnancies. There was also little representation of pregnant women’s own perspectives or discussion about the power dynamics involved. While social determinants are noted in the literature on FASD in South Africa, much more is needed from an intersectionality lens to understand the perspectives of affected women, their social contexts and the nature of the power relations involved. A critical stance towards the victim/active agent dichotomy that often frames women who drink during pregnancy opens up space to understand the nuances needed to support the women involved while also illustrating the contextual barriers to drinking cessation that need to be addressed through holistic approaches.en_US
dc.identifier.citationMichelle De Jong, Asha George, Tanya Jacobs, A scoping review of the determinants of foetal alcohol spectrum disorder in South Africa: an intersectional perspective, Health Policy and Planning, 2021;, czab101, https://doi.org/10.1093/heapol/czab101en_US
dc.identifier.urihttps://doi.org/10.1093/heapol/czab101
dc.identifier.urihttp://hdl.handle.net/10566/6693
dc.language.isoenen_US
dc.publisherOxford University Press in association with The London School of Hygiene and Tropical Men_US
dc.subjectIntersectionalityen_US
dc.subjectPregnancyen_US
dc.subjectFetal alcohol spectrum disordersen_US
dc.subjectAlcoholen_US
dc.subjectSocial determinantsen_US
dc.subjectSouth Africaen_US
dc.subjectScoping reviewen_US
dc.subjectFASDen_US
dc.subjectFeminist perspectiveen_US
dc.subjectSystematic reviewen_US
dc.subjectMeta-analysisen_US
dc.subjectAddictionen_US
dc.subjectInequalityen_US
dc.subjectMental healthen_US
dc.titleA scoping review of the determinants of foetal alcohol spectrum disorder in South Africa: an intersectional perspectiveen_US
dc.typeArticleen_US

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