Barbara Simpson

The Effectiveness of Cultural-Competence Training for Health Professionals in Community-Based Rehabilitation: A Systematic Review of Literature

AIMS To find and review studies in which investigators evaluated cultural-competence training in community-based rehabilitation settings; critique study methods, describe clinical outcomes, and make recommendations for future research. BACKGROUND A review of the effectiveness of cultural-competence training for health professionals in community-based rehabilitation settings was conducted. DATA SOURCES Research citations from 1991-2006 in CINAHL, Medline, Pubmed, PsycInfo, SABINET, Cochrane, Google, NEXUS, and unpublished abstracts were searched. METHODS Searching, sifting, abstracting, and assessing quality of relevant studies by three reviewers. Studies were evaluated for sample, design, intervention, threats to validity, and outcomes. A meta-analysis was not conducted because the studies did not address the same research question. RESULTS Five studies and one systematic review were evaluated. Positive outcomes were reported for most training programs. Reviewed studies generally had small samples and poor design. CONCLUSIONS/IMPLICATIONS The paucity of studies and lack of empirical precision in evaluating effectiveness necessitate future studies that are methodologically rigorous to allow confident recommendations for practice.

Poverty HIV/AIDS and the old age pension in Bhambayi Kwazulu-Natal South Africa.

To date the international community has tended to direct HIV prevention programmes, treatment, care and supportive services to young adults and children, with little concern about the impact on older people. Since empirical evidence on the socioeconomic impact of HIV/AIDS on households with older persons is lacking, this paper attempts to fill this gap, using data from a household-based survey conducted in Bhambayi, a mixed formal and informal settlement north of eThekwini, KwaZulu-Natal. The findings highlight the links between the uptake of the South African old age pension, poverty and HIV/AIDS in households with older persons. The paper makes recommendations for both government and non-governmental organisations in respect of community-based support systems for such households affected by HIV/AIDS.

OUTCOMES-BASED EDUCATION: IS IT RIGHT FOR SOCIAL WORK?

Outcomes-based education (OBE) has been very much in the news lately. Graeme Bloch’s book The toxic mix: what’s wrong with SA schools and how to fix it (2009) has received widespread coverage in the press, as have the results of the National Benching Tests Project (HESA, 2009), which demonstrated that a large number of entry-level students at tertiary institutions were not sufficiently competent in academic literacy, quantitative literacy or mathematics to succeed at university without substantial additional help. There are many complex reasons for the problems in the South African education system, but the suitability outcomes-based education to address the education challenges in South Africa has been seriously questioned.

A UNIVERSITY-COMMUNITY OUTREACH INITIATIVE: AN INNOVATIVE APPROACH TO SOCIAL WORK PRACTICE EDUCATION

Practice education has always been a core component of social work education and provides social work students with opportunities to “learn to practice social work by delivering social work services in agency and community settings” (Bogo, 2006). The purpose of practice education is broadly to enable students to learn to integrate theory and practice, and to develop the knowledge, skills and values necessary for professional practice. One of the issues in transferring such theory into practice is “how to overcome the assumed ‘abstract’ nature of theory in relation to the assumed ‘real’ nature of practice” (Evans, Guile, Harris & Allan, 2010:245), and it is therefore essential to provide students with opportunities to engage in social work processes in the real world. Historically social work agencies acted as the universities’ partners in the practice education of social work students – they provided placement sites and access to social work practice and their supervisors guided and mentored social work students.

CHALLENGES TO BUILDING AUTHENTIC PARTNERSHIPS: LESSONS FROM BHAMBAYI, KWAZULU-NATAL, SOUTH AFRICA

In contemporary South Africa, partnerships between service providers in government, non-governmental organisations, the private sector and community based organisations have been identified as a means to strengthen communities and the sustainability of social services. However, the unequal power relations that exists between and within these organisations often leads to fragmentation, duplication, and lack of coordination of social services. Using Fowler’s (1998) conceptualisation of authentic partnerships, this qualitative phase of a larger study explored the challenges of building authentic partnerships in Bhambayi, a predominantly informal settlement in KwaZulu-Natal, South Africa. Individual interviews and a focus group held with nine service providers revealed that intraorganisational challenges, cross-boundary and inter-organisational relations as well as political influences were obstacles to the development of authentic partnerships. The article suggests that open communication, clarity of roles and mutual trust between service providers is vital.

African marriage counselling and the relevance of Western models of counselling

This article explores the relevance of Western models of marriage counselling in the African context and specifically with Zulu couples. It argues that because of different worldviews, there are elements of western therapeutic approaches with couples that do not fit with the beliefs and values of many African people. The article examines some of the philosophies that underlie marriage in contemporary Zulu society, as well as the worldview, values and practices of Zulu people with regard to marriage. It then examines a selection of Western marriage counselling approaches in order to establish whether the Western based marriage counselling theories that are taught and practiced by social workers in South Africa today are relevant when used with Zulu couples.

Large classes in social work education: A threat to the professional socialisation of social work students?

Improved access to higher education and the increase in student numbers without a simultaneous increase in resources has given rise to numerous challenges. This reflective article considers whether large classes in social work education pose a threat to the professional socialisation of students, which requires that they internalise the values, interests, skills and knowledge of social work. Professional socialisation within social work education, the threat posed by large classes, both in the classroom and field practice education, as well as some possible solutions, are considered in this article.

Mental health legislation: does it protect the rights of people with mental health problems?

The International Federation of Social Work places a concern with human rights and social justice at the core of its definition of social work. Social work values are based on “respect for the equality, dignity and worth of all people” (IFSW, 2000), and social work practice has a special concern for vulnerable and oppressed people. People with mental health problems are amongst the most vulnerable members of society and in South Africa they comprise a considerable proportion of our society. According to the South African Stress and Health Survey (Herman, Steyn, Seedat, Heeringa, Moonal & Williams, 2009), the lifetime prevalence for any mental health problems in South Africa is 30.3% and neuropsychiatric disorders rank third in their contribution to the burden of disease in South Africa (Bradshaw, Norman & Schneider, 2007).

The effectiveness of life skills education and HIV prevention for secondary schools in South Africa: a systematic review

Review question/objective The objective of this review is to assess the effectiveness of secondary school based HIV prevention interventions in South Africa. Due to the specific nature of the context and the specific targeting of secondary schools in South Africa, the review is focused only on secondary school interventions in South Africa. It is anticipated that these findings will inform the continuing development of policy and programmes in South Africa relevant to school based HIV intervention programmes. Inclusion criteria Types of participants This review will consider studies that include South African secondary school based male and female adolescents aged 12-19 years. Types of intervention(s)/phenomena of interest This review will consider studies that evaluate school based life skills interventions that focus on HIV prevention. Comparisons groups may include: usual school programme, other types of interventions such as TV, radio and print media campaigns. To avoid heterogeneity in interventions and outcomes, and due to the very specific nature of the structure in which the life skills programmes are offered, the review will be limited to those conducted in South Africa. Types of outcomes This review will consider studies that include the following outcome measures: HIV infections rate measured as age and gender specific prevalence Knowledge on HIV measured as changes in pre- and post-tests of knowledge and attitudes Condom usage measured as intention to use and reported use of condoms Any other relevant outcomes will be noted.