Abel Jacobus Pienaar

Intrapartum practices to limit vertical transmission of HIV.

The need to improve health services to HIV-positive women requires a specific focus on limiting mother-to-child transmission. Vertical transmission most often takes place during the intrapartum period; hence, it is essential to alert midwives to what constitutes safe or risky intrapartum practices. Midwives in the southern region of the North West Province of South Africa were surveyed for their knowledge of safe intrapartum practices that can limit vertical transmission of HIV, consequently indicating which intrapartum practices prevail in the region. We used a quantitative survey design and collected data by means of a questionnaire and checklist. A purposeful availability sample of 31 midwives who work in all four hospitals in the province was used and a random sample of 401 obstetric records was audited. Data were analysed by means of frequency analysis, effect sizes and cross-reference. A slight majority of the midwives had sufficient knowledge to distinguish between risky and safe practices. However, safe intrapartum practices are not always carried out and this raises concerns. Accordingly, we formulate general recommendations for nursing education, future research, and midwifery practice. In particular we suggest ways the national Guidelines for Maternity Care in South Africa may be adapted and better implemented to enhance safe intrapartum practices to limit vertical transmission of HIV.

Conceptualisation of African primal health care within mental health care

Background It is believed by western education systems that the first contact should be with the nurse in primary health care. However, it is not the case. Therefore, the researcher attempts to correct this misconception by conceptualising the correct beginning of health seeking behaviour in an indigenous African community, namely African Primal Health Care (APHC). ‘Primal’ was coined during a colloquium by Dr Mbulawa and Seboka team members; however no formal conceptualisation took place, only operational definition. Due to the study scope, conceptualisation is narrowed to mental health, but this concept is applicable in the broader health context. The research purpose was to contribute to the body of indigenous knowledge systems to advocate towards co-existence of primal health care and mental health care. Aim Formulate APHC within a mental health care context. Objectives To explore philosophical grounding of APHC and describe epistemology of APHC. To analyse and crystallise the exploration to establish understanding within mental health and conceptualise APHC within mental health care to enhance co-existence. Methodology Narrative synthesis, concept analysis (qualitative design). Lekgotla was used as a method of data collection and data were analysed using Leedy and Ormrod’s five steps of data analysis. Results APHC is a health care system that existed in Africa prior to the introduction of the western health care system. It is based on the African belief system and practices. The practices come from the community, for the community and are authenticated by the community. APHC uses a holistic approach and the family and community are involved in the healing process.

A Substance Use Prevention Programme Focusing on Resilience as a Protective Factor for Adolescents in the North West Province of South Africa

ABSTRACT Adolescents’ substance use needs to be identified and addressed as soon as possible and substance use among adolescents needs to be prevented. The purpose of this study was to develop a substance use prevention programme focusing on resilience as a protective factor for adolescents in the North West Province of South Africa. The programme was developed based on the results of systematic review and qualitative, exploratory, descriptive and contextual research. A conceptual framework was used to guide the researcher to link the results of systematic review and qualitative research with the programme. The survey list of the Practice Oriented Theory was used as a guide for development of a conceptual framework and the programme. The findings of this study confirmed the content of the programme, and indicated that the programme to prevent substance use among adolescents should focus on strengthening adolescents’ resilience and on mobilizing protective factors.