Development and validation of an intervention for childhood trauma and exposure to violence in Vhembe District, South Africa

Most strategies are implemented; however, South Africa needs to evaluate and develop trauma interventions. The study aims to develop, test and validate childhood trauma exposure intervention in the Vhembe district, Limpopo province. Donabedian's structure-process-outcome model will guide the study. The study will employ multiphase mixed methods with five phases. Phase 1 will be a thorough systematic evaluation of literature on childhood trauma and exposure to violence interventions to describe existing interventions. Phase 2, stage 1: Will explore the experiences of children exposed to trauma and violence regarding their experiences of the treatment they received, using semi-structured qualitative interviews. Non-probability purposeful sampling techniques will be used to select participants. The Thoyondou Victim Empowerment's database will select participants. The researchers will conduct semi-structured and unstructured interviews with youngsters exposed to violence and trauma. Stage 2 will be a qualitative study of trauma centre managers and personnel sampled from the contact record. IPA will analyze data. Phase 3 will conceptualize Phase 1 and the empirical phase into Donabedian's SPO framework for Phase 4. Phase 4 develops the intervention using Phase 3's conceptual framework and tests and validates it.

Exploring maternal and child healthcare projects in South African communities through Ubuntu lens: an appreciative inquiry

BACKGROUND

Ubuntu, a Nguni Bantu term meaning "humanity towards other", embodies a philosophy of collectivism, interconnectedness and mutual respect, which is deeply ingrained in South African culture. Ubuntu led community-based collaborative projects enhance community engagement of several stakeholders to ensure improved health outcomes for the mothers and children in the region. Similarly, collaborations between universities are required to co-create evidence-based interventions with healthcare systems and communities to achieve healthcare objectives. This paper explores maternal and child healthcare (MCH) projects in South African communities through the Ubuntu lens, using an appreciative inquiry approach.

METHODS

A Qualitative approach based on the 5-cycle of Appreciative Inquiry (AI) as proposed by Cooperrider and Srivastava were applied. A purposive sampling method was used to select participants (n = 14) who are members of the Ubuntu MCH project. Data was gathered through workshop group discussions. The interviews were audiotaped and transcribed verbatim. Data analysis followed the six steps of narrative analysis.

RESULTS

Three main themes were identified: Academic growth of personnel; professional empowerment and Ubuntu mentorship.

CONCLUSION

This study confirms that the Ubuntu principles emphasises solidarity, cohesion, and collaboration. The study recommends leveraging on Ubuntu principles to strengthen maternal and child healthcare services, suggesting that such this approach can lead to more sustainable and impactful health improvements in South African communities.

A systematic review of the effectiveness of epilepsy education programs on knowledge, attitudes, and skills among primary school learners

Epilepsy is a common neurological condition affecting primary school learners, often leading to misconceptions, stigma, and limited social inclusion. These misconceptions transpire because of a lack of knowledge regarding the condition and may lead to high school dropouts. This systematic review aimed to evaluate the effectiveness of epilepsy education programs on epilepsy-related knowledge and understanding, values and attitudes, and skills among primary school learners. A thorough search of electronic databases was conducted to identify relevant studies published between January 2000 and September 2023. Studies that satisfied the eligibility criteria were chosen, and two reviewers conducted data extraction independently. A narrative synthesis approach was utilised to analyse the findings. The review included 10 studies that satisfied the inclusion requirements. The epilepsy education interventions varied in content, duration, and delivery method. Findings indicated that diverse delivery methods, such as classroom-based programs, hospital-based programs, and community-centred interventions, effectively enhanced epilepsy-related knowledge and understanding, values and attitudes, and skills among primary school learners. This systematic review provides evidence that epilepsy education programs can effectively enhance epilepsy-related knowledge, understanding, values, attitudes, and skills among primary school learners. These findings support developing and implementing comprehensive guidelines for teaching epilepsy in primary schools, suggesting various delivery methods and integrating cultural values to promote optimal learning outcomes and social inclusion for learners with epilepsy.

A scoping review on continuing professional development programs for midwives: optimising management of obstetric emergencies and complications

BACKGROUND

Midwives play a pivotal role in ensuring safe childbirth, particularly in the management of obstetric emergencies and complications (EmONC). Continuous Professional Development (CPD) programs are essential to keep midwives updated with the latest skills and knowledge, ensuring high-quality maternal care.

AIM

The study aimed to map and synthesize evidence on continuing professional development for midwives optimising management of obstetric emergencies and complications to reveal evidence to address the knowledge gap and implementation of policy.

METHODS

This scoping review was guided by the adapted version of Arksey and O'Malley methodological framework (2005). We searched databases from 2013 to 2023: PubMed, SCOPUS, Web of Science, EBSCOhost (CINAHL, MEDLINE and Academic search): and ProQuest central. The studies were appraised using mixed methods appraisal tool (MMAT) version 2018. Content analysis and synthesis of the findings were conducted using Nvivo 12.

RESULTS

Of the 752 articles identified through database searching, 31 articles met the inclusion criteria and reported according to the Preferred reporting items for systematic reviews and meta-analyses extension for scoping review (PRISMA-ScR) checklist. After data extraction, content analysis yielded the following 4 major themes: Types of CPD training programs, Effectiveness of CPD on management of obstetric emergencies, Barriers/Challenges with lack of implementation of CPD programs and Suggestion for implementation of CPD programs.

CONCLUSION

The findings revealed the significance of CPD programs in equipping midwives with the necessary skills and knowledge to handle obstetric emergencies effectively. The program can be offered in various approaches including simulation-based training, technology-based simulation, online modules, workshops, and interdisciplinary/interprofessional learning sessions, have shown to be effective. Each method offers unique advantages, such as hands-on practice in simulations and flexibility in online learning with smart applications such as SAFE delivery applications.

TRIAL REGISTRATION

Research Ethics reference #322/2023, date of registration: 14/02/2024.

An Inclusive Framework for Collaboration between Midwives and Traditional Birth Attendants and Optimising Maternal and Child Healthcare in Restricted Rural Communities in South Africa: Policy Considerations

Collaboration between midwives and traditional birth attendants for maternal and child healthcare is a challenge in rural South African communities due to the absence of a guiding framework. To address this, this study sought to develop and validate an inclusive framework informed by the Donabedian structure-process-outcome (SPO) framework for collaboration between these healthcare professionals.

METHOD

Key stakeholders were invited to participate in a co-creation workshop to develop the framework. Twenty (20) participants were purposively sampled based on their maternal and child healthcare expertise. A consensus design using the nominal group technique was followed.

RESULTS

Participants identified the components needed in the framework, encompassing (i) objectives, (ii) structures, (iii) processes, and (iv) outcomes.

CONCLUSION

This paper will contribute to the development of an inclusive healthcare framework, providing insights for stakeholders, policymakers, and practitioners seeking to improve maternal and child healthcare outcomes in resource-constrained, rural settings. Ultimately, the proposed framework will create a sustainable and culturally sensitive model that optimises the strengths of midwives and TBAs and fosters improved healthcare delivery to rural South African communities.

Exploring the Barriers and Facilitators in the Management of Childhood Trauma and Violence Exposure Intervention in the Vhembe District of the Limpopo Province, South Africa

Research has shown that barriers and facilitators in psychotherapy exhibit similarities. The authors of this study are of the view that to effectively address the difficulties encountered in psychotherapy for children and adolescents, it is crucial to consider the points of view of professionals who have firsthand encounters with children. The purpose of this study was to effectively explore barriers and facilitators in the treatment of children exposed to trauma and violence. Exploratory and descriptive methods, as components of a qualitative research design, were employed to investigate and articulate the barriers and facilitators involved in managing childhood trauma. An advertisement was used to recruit participants. It was developed and distributed to psychologists and social workers recommended by the Thohoyandou Victim Empowerment Programme. Seventeen professionals were individually interviewed using semi-structured interview schedules. The interviews were recorded, transcribed verbatim, and analysed using interpretative phenomenological analysis (IPA). The findings of the study indicated a lack of commitment from parents in honouring appointments, financial challenges, a fear of perpetrators associated with the poor reporting of incidences, professional boundaries, and referral route challenges. Familiar facilitators in the management of childhood trauma included continuous training and workshops for all people working with childhood trauma and violence, the employment of more victim advocates, and awareness campaigns. Additionally, the referral pathway for traumatised children presents logistical, psychological, and educational hurdles, underscoring the complex nature of meeting the needs of these vulnerable populations within the healthcare system. In conclusion, even while the currently available research supports the barriers and facilitators for this population, more investigation is required to examine how these factors affect treatment outcomes, particularly in community-based settings.