Global issues in obstetric anaesthesia: perspectives from South Africa, Japan, China, Latin America and North America
South Africa is classified as a low- and middle-income country, with a complex mixture of resource-rich and resource-limited settings. In the major referral hospitals, the necessary skill level exists for the management of complex challenges. However, this contrasts with the frequently-inadequate skill levels of anaesthesia practitioners in resource-limited environments. In Japan, obstetricians administer anaesthesia for […]
Near-miss maternal morbidity from severe haemorrhage at caesarean section: A process and structure audit of system deficiencies in South Africa
Background. A rising caesarean section rate and substandard peri-operative care are believed to be the main reasons for recent increases in maternal deaths from bleeding during and after caesarean section (BDACS) in South Africa (SA). The Donabedian model assumes that clinical outcomes are influenced by healthcare workers and the healthcare system. Objectives. To evaluate near-miss […]
Exploring the functional dynamics of innovation for inclusive development innovation systems: a case study of a large scale maternal mHealth project in South Africa
In the developing country healthcare context, inequalities often exist due to systematic exclusions through poverty, unemployment, poor infrastructure and lack of access. This article reflects on the use of an Innovation for Inclusive Development Systems approach within a healthcare context to systematically (i) evaluate the dynamic factors that drive inclusion and exclusion in healthcare innovation […]
Maternal mental health in primary care in five low- and middle-income countries: A situational analysis
Background: The integration of maternal mental health into primary health care has been advocated to reduce the mental health treatment gap in low- and middle-income countries (LMICs). This study reports findings of a cross-country situation analysis on maternal mental health and services available in five LMICs, to inform the development of integrated maternal mental health […]
A Qualitative study of language barriers between South African health care providers and cross-border migrants
Background: Communication with health care providers represents an essential part of access to health care for the over 230 million cross-border migrants around the world. In this article, we explore the complexity of health communication from the perspective of cross-border migrants seeking antenatal care in Cape Town, South Africa in order to highlight the importance […]
Community health workers impact on maternal and child health outcomes in rural South Africa – a non-randomized two-group comparison study
Background: Home visits by paraprofessional community health workers (CHWs) has been shown to improve maternal and child health outcomes in research studies in many countries. Yet, when these are scaled or replicated, efficacy disappears. An effective CHW home visiting program in peri-urban Cape Town found maternal and child health benefits over the 5 years point […]
WHO 2010 guidelines for prevention of mother-to-child HIV transmission in Zimbabwe: Modeling clinical outcomes in infants and mothers
Background: The Zimbabwean national prevention of mother-to-child HIV transmission (PMTCT) program provided primarily single-dose nevirapine (sdNVP) from 2002-2009 and is currently replacing sdNVP with more effective antiretroviral (ARV) regimens. Methods: Published HIV and PMTCT models, with local trial and programmatic data, were used to simulate a cohort of HIV-infected, pregnant/breastfeeding women in Zimbabwe (mean age […]
An early infant HIV risk score for targeted HIV testing at birth
BACKGROUND: Early HIV testing is needed for treatment success in young infants, but universal testing is expensive. In this study, we examined the feasibility of early infant HIV risk scores for targeted polymerase chain reaction (PCR) testing and early HIV diagnosis. METHODS: A cross-sectional cohort of newborns exposed to HIV was enrolled and PCR tested […]
Home gardens focusing on the production of yellow and dark-green leafy vegetables increase the serum retinol concentrations of 2-5-y-old children in South Africa
Background: Production of yellow and dark-green leafy vegetables at the household level may provide economically deprived households with direct access to provitamin A-rich foods. Objective: The aim of the study was to determine whether the dietary intake of yellow and dark-green leafy vegetables and the serum retinol concentrations of children improve with a home-gardening program. […]
Lower Respiratory Tract Infections in Children in a Well-vaccinated South African Birth Cohort: Spectrum of Disease and Risk Factors
Childhood lower respiratory tract infections (LRTIs) cause substantial morbidity and under-5 child mortality. The epidemiology of LRTI is changing in low- and middle-income countries with expanding access to conjugate vaccines, yet there are few data on the incidence and risk factors for LRTI in these settings. Methods: A prospective birth cohort enrolled mother-infant pairs in […]
