Moving from medical to health systems classifications of deaths: extending verbal autopsy to collect information on the circumstances of mortality
Background: Verbal autopsy (VA) is a health surveillance technique used in low and middle-income countries to establish medical causes of death (CODs) for people who die outside hospitals and/or without registration. By virtue of the deaths it investigates, VA is also an opportunity to examine social exclusion from access to health systems. The aims were […]
Perceptions and experiences of frontline health managers and providers on accountability in a South African health district
Objective: Public primary health care and district health systems play important roles in expanding healthcare access and promoting equity. This study explored and described accountability for this mandate as perceived and experienced by frontline health managers and providers involved in delivering maternal, newborn and child health (MNCH) services in a rural South African health district. […]
Migration and first-year maternal mortality among HIV-positive postpartum women: A population-based longitudinal study in rural South Africa
Background In South Africa, within-country migration is common. Mobility affects many of the factors in the pathway for entry to or retention in care among people living with HIV. We characterized the patterns of migration (i.e., change in residency) among peripartum women from rural South Africa and their association with first-year postpartum mortality. Methods and […]
“If I don’t use a condom … I would be stressed in my heart that I’ve done something wrong”: Routine Prevention Messages Preclude Safer Conception Counseling for HIV-Infected Men and Women in South Africa
Intended conception likely contributes to a significant proportion of new HIV infections in South Africa. Safer conception strategies require healthcare provider–client communication about fertility intentions, periconception risks, and options to modify those risks. We conducted in-depth interviews with 35 HIV-infected men and women accessing care in South Africa to explore barriers and promoters to patient–provider […]
A randomized trial of two postexposure prophylaxis regimens to reduce mother-to-child HIV-1 transmission in infants of untreated mothers
Background: Single-dose nevirapine (NVP) prophylaxis to mother and infant is widely used in resource-constrained settings for preventing mother-to-child transmission (MTCT) of HIV-1. Where women do not access antenatal care or HIV testing, post-exposure prophylaxis to the infant may be an important preventative strategy. Methods: This multicentre, randomized, open-label clinical trial (October 2000 to September 2002) […]
“Safe anaesthesia” for the South African rural obstetric patient in Kwazulu-Natal
Background: The South African National Committee for Confidential Enquiries into Maternal Deaths has shown that anaesthesia-related maternal deaths continue to increase at district hospitals. This has been attributed to substandard anaesthesia care and resuscitation. This study investigated the anaesthesia practices, work circumstances, support structure and access to training by doctors involved in obstetric anaesthesia in […]
Behavior and psychological functioning of young children of HIV-positive mothers in South Africa
Adults with HIV are living longer due to earlier diagnosis and increased access to antiretroviral medications. Therefore, fewer young children are being orphaned and instead, are being cared for by parents who know they are HIV positive, although they may be asymptomatic. Presently, it is unclear whether the psychological functioning of these young children is […]
Measuring socioeconomic status in multicountry studies: Results from the eight-country MAL-ED study
Background: There is no standardized approach to comparing socioeconomic status (SES) across multiple sites in epidemiological studies. This is particularly problematic when cross-country comparisons are of interest. We sought to develop a simple measure of SES that would perform well across diverse, resource-limited settings.Methods: A cross-sectional study was conducted with 800 children aged 24 to […]
Infant feeding counselling for HIV-infected and uninfected women: Appropriateness of choice and practice
Objective: To examine infant feeding intentions of HIV-infected and uninfected women and the appropriateness of their choices according to their home resources; and to determine their adherence to their intentions in the first postnatal week. Methods: Feeding intentions of pregnant women were compared against four resources that facilitate replacement feeding: clean water, adequate fuel, access […]
Determinants of Campylobacter infection and association with growth and enteric inflammation in children under 2 years of age in low-resource settings
Campylobacter species infections have been associated with malnutrition and intestinal inflammation among children in low-resource settings. However, it remains unclear whether that association is specific to Campylobacter jejuni/coli. The aim of this study was to assess the association between both all Campylobacter species infections and Campylobacter jejuni/coli infections on growth and enteric inflammation in children […]
