"The kind of support that matters to exclusive breastfeeding" a qualitative study.

BACKGROUND: Worldwide, only 41 % of infants are exclusively breastfed for the first six months while South Africa has an alarming figure of only 12 %. First-time mothers are inexperienced in the initiation and maintenance of exclusive breastfeeding, hence a need for support. Data on forms and quality of exclusive breastfeeding support as experienced by first-time mothers is minimal. The study explored the exclusive breastfeeding support available to first-time mothers in the Buffalo City Metro, South Africa. METHODS: A qualitative explorative, descriptive and contextual study, and a non-probability, purposive sampling was used with 10 first-time mothers within the first six months postpartum. The in-depth face-to-face semi-structured individual interviews for data collection and Creswell's steps of thematic analysis were used. RESULTS: Two themes emerged; challenges, empowerment, support and resilience during initiation of exclusive breastfeeding, and diverse support and resilience during maintenance of exclusive breastfeeding. First-time mothers received practical support majorly from nurses and other mothers during the initiation; social support was from family members, friends, and community members for the maintenance of exclusive breastfeeding. Sometimes there was a disjuncture between practical support from nurses and that from family members and the community. There were instances where the support was needed but not given or not supportive of exclusive breastfeeding. CONCLUSIONS: These findings illustrate that professional, practical and social support for first-time mothers is crucial in the initiation and maintenance of exclusive breastfeeding for the first six months. Timing and the kind of support given to these mothers is crucial for successful exclusive breastfeeding.

Perceptions of women of reproductive age towards maternal death in Qaukeni sub-District, Eastern Cape Province, South Africa: A qualitative study.

Maternal mortality is a global problem, particularly in developing countries. This study explored perceptions, knowledge and attitudes of women of reproductive age concerning maternal deaths in Qaukeni Sub-District, Eastern Cape Province, South Africa. This was a community-based qualitative study using using in-depth interviews among women of reproductive age. Data was analyzed using thematic analysis. The study found some of the mothers knew the causes, signs and symptoms of pregnancy as well as danger signs during pregnancy such as haemorrhage, sepsis, high blood pressure and complications of unsupervised home deliveries, while others had little knowledge about these signs and symptoms. The participants indicated that using herbal medications during pregnancy could result to serious complications and even maternal death. Women do not attend antenatal care because of the long distances, absence of clinics, shortage of nurses and doctors; thus, predisposing women to deliver at homes with the assistance of traditional birth attendants, who had limited knowledge related to health issues and the Prevention of Mother- to-Child-Transmission programme. The findings indicated that some women are knowledgeable about the causes of maternal deaths during pregnancy as well as the signs and symptoms of pregnancy. Health education during pregnancy and provision of better resources would help improve the maternal health of women in this rural setting.

Low awareness and use of post-exposure prophylaxis among adolescents and young adults in South Africa: implications for the prevention of new HIV infections.

The vulnerability of adolescents and young adults in South Africa to HIV and sexual violence is well documented. Post-exposure prophylaxis (PEP) is available for victims of sexual abuse in the country but awareness of this measure is required to maximise its HIV-prevention benefits. This study examined levels of PEP awareness and its correlates and the uptake of PEP among 772 students (16-24 years) in a South African university using stratified random sampling. Overall, we included more females (477) than males (295), reflecting the male-female ratio at the university. Adjusted and unadjusted logistic regression models were used to determine correlates of PEP awareness, which was low (24.1%), particularly among those who experienced sexual violence in the past year (19.8%) compared those who had not (24.8%). Only 2.6% of participants had used PEP, while 7.5% had seen it, and 14.6% knew where to get it. In the adjusted model, adequate family support (AOR: 2.22; CI: 1.54-3.20) and prior HIV testing (AOR: 2.65; CI: 1.59-4.42) were associated with a higher likelihood of PEP awareness. The study concluded that awareness of PEP was low in the study setting and especially among those who need it. Social marketing of PEP is needed in the study settings to realise the maximum benefits of PEP in preventing new HIV infections.

Medium-fidelity simulation in clinical readiness: a phenomenological study of student midwives concerning teamwork.

BACKGROUND: Teamwork during obstetric emergency ensures good outcomes for both the woman and her baby. Effective teams are characterised by mutual respect, support, and cooperation among team members. METHODS: This qualitative, interpretive, phenomenological analysis study was conducted on a purposive sample of five, fourth-year Bachelor of Nursing Science student midwives at the University of Fort Hare (UFH). In-depth semi-structured interviews were conducted. Data analysis applied the interpretative phenomenological analysis method. RESULTS: Superordinate theme demonstrated teamwork elicited four clustered themes namely delegation of duties, the importance of teamwork, team support, and confident team leader. The participants recognised that there should be a team leader who is capable of delegating duties to other team members in the management of an obstetric emergency, Participants were confident not only to assign duties but to be kept updated of the intervention. They expressed the need to work collaboratively as a team to achieve the desired goal of providing quality care to the woman. The participants maintained that the team must be supportive and be able to help in decision making during simulation of an obstetric emergency. A sense of mutual respect is echoed by some participants in the process of caring for the woman. Some participants were confident at being team leaders and could see themselves as leaders in the real-life clinical situation. CONCLUSION: The participants acknowledge the importance of teamwork in resolving obstetric emergencies. The importance of delegating duties to other team members, providing updated progress report ensures better outcomes for the woman.

Low awareness and use of pre-exposure prophylaxis among adolescents and young adults in high HIV and sexual violence prevalence settings.

South Africa has adopted pre-exposure prophylaxis (PrEP) as a preventive strategy for populations at-risk for HIV, though uptake is low among adolescents and young adults. We examined the awareness and use of PrEP among adolescents and young adults in the Eastern Cape, South Africa.This cross-sectional study was conducted between June and November 2018 among 772 adolescents and young adults (aged 16-24 years) selected using stratified random sampling in a South African university. An electronic self-administered questionnaire was used to elicit demographic information, behavioral, family-related characteristics, awareness and use of PrEP. Adjusted and unadjusted logistic regression models were used to examine the predictors of PrEP awareness.The overall level of PrEP awareness was 18.8%; however, only 1.7% of participants had used PrEP, 7.5% of had seen it, 4.8% knew how much it cost, and 14.8% knew where and how to get it. In the adjusted regression analysis, only adequate family support (AOR: 2.11; CI: 1.47-3.04) and discussions of HIV and sexually transmitted infections with sexual partners (AOR: 1.78; CI: 1.19-2.67) were associated with a higher likelihood of being aware of PrEP.The level of awareness and use of PrEP is still very low among adolescents and young adults who may need it to prevent HIV infection. Poor awareness of PrEP among adolescents and young adults in high HIV risk settings may limit its use. Thus, concerted efforts are needed to promote awareness and access to PrEP among young South African adults.