Sedibeng District Research Articles

Patients’ perceptions on reluctance to undergo cataract surgery in Sedibeng district hospital, Gauteng province

Background: Over 50 million people are blind, and 135 million people suffer from severe visual impairments, with cataracts contributing to 51% of global blindness cases. Despite efforts to promote cataract surgery (CS), many patients remain hesitant, underscoring the importance of understanding their perspectives.Aim: This study aimed to explore and describe patients’ perceptions regarding reluctance to undergo CS to improve awareness and increase surgery uptake.Setting: The research was conducted in the Sedibeng District, Gauteng province, South Africa.Methods: A qualitative descriptive phenomenological design was employed to capture the lived experiences of patients through face-to-face, individual semi-structured interviews with 15 patients aged 38 – 72 years prior to their CS. Purposive sampling was used to select participants, and Colaizzi’s seven-step analysis was used for data analysis.Results: The findings highlight several barriers perceived by participants, including long waiting times; fear; lack of knowledge; limited financial, material and human resources; power outages; uncontrolled blood sugar levels; and coronavirus disease 2019 (COVID-19) pandemic restrictions. Nevertheless, some view it positively as a means to avert blindness and enhance vision.Conclusion: To address the challenges, the study recommends boosting the number of eye health care professionals, prioritising budget allocation, addressing electricity interruptions and conducting community outreach educational programmes to improve access to CS in the district.Contribution: The insights gained from this study can help health care providers and policymakers optimise care and support for CS patients through policy formulation and education. Addressing these knowledge gaps will likely increase surgery uptake and improve patients’ quality of life.

Community perceived barriers to uptake of health services among men at Sedibeng district in South Africa.

This qualitative study aimed to investigate the barriers that hinder men's utilisation of healthcare services in the Sedibeng district of South Africa. The study was conducted using flyers with questions posted on the Best Health Solutions' Facebook page for two weeks. A convenience sampling method was used and a total of 104 comments were collected from 64 respondents. The authors analysed the participants' self-reported data thematically on demographics, geographic area, and reasons for men not using healthcare services. The findings revealed that sociocultural norms played a significant role in men's reluctance to seek medical help, as it was perceived as a sign of weakness. The scarcity of male healthcare professionals hinders open discussions. Stigma and discrimination were identified as substantial barriers. Convenience, trust, and confidentiality concerns, along with the influence of intimate partners, also influence men's decision-making. This study highlights the complex interplay between various barriers that impact men's utilisation of healthcare services in the district. By addressing these factors, healthcare providers and policymakers can enhance healthcare access and promote better health outcomes for men in Sedibeng district. The manuscript's primary contribution lies in uncovering multifaceted barriers to men's healthcare utilisation in Sedibeng district. It explores socio-cultural norms, healthcare worker demographics, stigma, discrimination, convenience factors, trust, confidentiality concerns, and the influence of intimate partners on men's healthcare choices. These insights illuminate the complex factors affecting men's healthcare access, providing valuable knowledge for healthcare providers and policymakers.

Psychiatric nurses advocating for the human rights of mental health care users in Gauteng.

Psychiatric nurses play an important role in advocating for mental health care users such as advocating for the care, treatment and rehabilitation of mental health care users (MHCUs). Psychiatric nurses face various challenges while advocating for the human rights of MHCUs, particularly those unable to protect their rights because of the severity of their mental health conditions. This study aimed to explore and describe psychiatric nurses' lived experiences in advocating for the human rights of MHCUs in the Gauteng province. The study was conducted within the primary healthcare (PHC) setting's mental health services, Sedibeng District, Gauteng province. The study employed a qualitative, exploratory, descriptive and contextual research design. Three phenomenological focus group interviews were conducted, and audio recorded to collect data. Data were analysed using Tesch's method. Three themes emerged: (1) advocating for human rights was a strong push and an exhausting plea for psychiatric nurses in their attempts to voice and protect MHCUs' rights; (2) MHCUs and mental health services were discriminated against and excluded by various stakeholders; mental health awareness should be raised and (3) training needs to be conducted as a matter of urgency in order to destigmatise mental illness from government to societal level. Psychiatric nurses experienced feelings of disempowerment, frustration and helplessness in advocating for MHCUs' human rights. The study's findings will contribute to the body of knowledge in clinical psychiatric mental health practice on advocating for the human rights of MHCUs.

Exploring Outcomes of Monitoring and Evaluation for Sustainable Development (MESD) Mechanisms in Sedibeng District Municipality

This paper sought to investigate the outcomes on Monitoring and Evaluation (M&E) mechanism for Sustainable development in Sedibeng District Municipality (SDM), which were recommended by the investigator in the year 2014. The reorganisation of indigenous ascendency in South Africa necessitate municipalities to assist the societies surrounded by their regions of authority. That has conveyed capability encounters for the most metropolises. They are anticipated to provide adequate ideals of amenities to the citizens. Absence of provision is stagnant deceptive in the dominant disputes by public associates exhibition their hindrance with poor provision distribution and accumulations. Moreover, metropolises were permitted as well as mandatory to articulate their particular regulations to advance the lives of public fellows, and to contrivance their legislative mandates reasonably. In directive for the metropolises to accomplish extra professionally, a transformative classical was required. The excellence of services delivered at municipal level were reviewed. Monitoring and evaluation, key elements of appraisal must be commenced. The justification after this observing and appraisal is to create the system of governance more effective by smooth handed assessment of policies, sequencers, assignments, approaches, enactment of workers, and certainty of the institute entirely. The critique is grounded on a research accompanied to deliberate on the employment of observing and appraisal apparatuses at South African metropolitan glassy. The native administration organisation necessitates additional contemplation since of noticeable talent trials. Nonetheless, there is a necessity not merely to augment the recital of workers nonetheless similarly the excellence of facilities delivered and the actual administration of metropolises as an entirely. The emphasis region of this investigation is Sedibeng District Municipality (SDM), a Category C metropolis in the Gauteng Province. The research was grounded on the notion that operative observing and appraisal apparatuses might afford maintainable progress in Sedibeng District Municipality with enhanced provision distribution. In imperative to authenticate the theory, empirically founded arranged surveys on the observing and appraisal, and service delivery were utilized. Frequency analysis, which lends itself to association breakdown, of workers’ answers and residents’ replies was directed by means of the surveys. The investigation appalled to detect breaches inside metropolitan competences to consider public necessities. The qualitative study has discovered breaches in substructure distribution related to lack of capability mainly in primary resources, viz. financial, technical and human. The competencies of Sedibeng District Municipality necessitate operative application of these main possessions, consequential in suitable principles of provision conveyance to fulfil public necessities. The metropolitan enactment to discourse public requirements was recognized, revised, highlighted and manoeuvred over a Metropolitan Impost Device, deliberated in a recommended prototypical called as Monitoring and Evaluation for Sustainable Development (MESD). The ideal was located in the metropolis in an endeavour to assistance on attaining a glassy of competence concerning maintainable growth.

Outcomes of a model for re-testing HIV-negative index contacts in Sedibeng, South Africa.

Index contact testing is an HIV case-finding approach that elicits sexual or needle-sharing partners, as well as biological children, of people living with HIV (PLHIV) and offers them HIV testing services. We aim to describe the results of an innovative project in Sedibeng District that expanded index testing by retesting previously negative contacts and incorporating status-neutral testing. We used registers to identify people who previously tested HIV-negative through index testing from March 2019 to September 2021. The individuals were telephonically traced and offered HIV retesting. Data were collected on a weekly basis using REDCap®. We monitored the number of individuals called, those who came back for retest, and their HIV results. Fifteen counsellors contacted 968 people over 12 months. Forty-eight percent (462 out of 968) of those called returned for testing. Of those, 121 (26%) tested positive. Overall, 66 out of 276 (24%) men with HIV and 55 out of 186 (30%) women with HIV were identified and linked to antiretroviral treatment (ART). Fifty-seven percent (194 out of 341) of clients who tested HIV-negative were offered, and 124 out of 194 (64%) initiated, pre-exposure prophylaxis (PrEP). All individuals who retested HIV-positive had a new diagnosis; none reported having had another positive test result between the original negative and the positive retest. Revisiting index clients with a previous negative HIV test result is worthwhile, creating an opportunity to identify undiagnosed PLHIV and high-risk people for PrEP. The high positivity rate highlights the importance of providing a sero-neutral approach to HIV testing, including integrating prevention messaging and linkage to PrEP services.

Conjoint tobacco and alcohol use and depression among HIV-positive patients in Sedibeng, South Africa.

Psychosocial challenges among human immunodeficiency virus (HIV)-positive patients may promote substance use disorders. This study explored the relationship between conjoint tobacco and alcohol use and depression symptoms among HIV positive patients in Sedibeng District, South Africa. In a cross-sectional study of 404 participants, a questionnaire collected information on sociodemography, tobacco and alcohol use and depression symptoms. Outcome measures included the prevalence of conjoint tobacco and alcohol use and its association with positive screen for depression. The mean participant age was 43.2 years. Most completed secondary school (62.9%), were black (99.0%), female (65.8%), unemployed (53.6%) and on antiretroviral therapy (ART) for 1 year (97.8%). Current tobacco use was reported by 23.3% (n= 94) participants with most smoking cigarette (73.7%) and having low nicotine dependence (75.5%). Current alcohol use was reported by 43.6% (n= 176) participants, and 36.9% were categorised as harmful users. Only 7.7% (n= 31) participants screened positive for depression; the prevalence of conjoint tobacco and alcohol use was 19.6% (n= 79) and this was not associated with depression (p= 0.438). Harmful alcohol users were more than five times likely to report conjoint tobacco and alcohol use (p= 0.000), but women were less likely to report it (p= 0.000). Conjoint tobacco and alcohol use is common among patients with HIV infection. Although not associated with positive screen for depression, its relationship with harmful alcohol use reiterates the need for an integrated tobacco and alcohol use screening and treatment strategy in the HIV treatment programme in primary care.Contribution:To the authors best knowledge, this study is the first published study that explored the relationship between conjoint tobacco and alcohol use, and depression among HIV-positive patients in the South African primary care settings.

Association between municipal credit management, responsiveness and service delivery

Background: Municipalities have come under fire for providing inferior services, which has sparked protests across the nation. Fraud, corruption, misappropriation of public funds and general incompetence on the part of municipal managers and their staff have been the problems that have crippled most municipalities.Aim: To investigate the association between the municipal credit management policy, responsiveness and service delivery, within a Sedibeng district municipality.Methods: This study applied quantitative analysis. The primary data were collected from residents through a self-administered questionnaire. Statistical Package for the Social Sciences (SPSS) (Version 28) was applied to perform the descriptive analysis and correlational analysis.Results: Key findings of this study revealed a significant positive correlation between credit management and service provision. The relationship between the credit management policy, responsiveness to credit management and service delivery is substantial. Therefore, the quality of service delivery increases with improved credit management.Conclusion: The study showed that there is a significant connection between credit management, credit management responsiveness and service delivery.Contribution: Based on the findings, it was advised that the municipality should implement rebates and discounts for paying customers, constantly review crucial credit policies and ensure the provision of high-quality services. The study concluded that there is an association between credit management, responsiveness and service delivery.

CHAPTER 11: the Effects of the Covid-19 Pandemic on Learner Assessment in Primary Schools in Sedibeng District

<b>CHAPTER 11:</b> the Effects of the Covid-19 Pandemic on Learner Assessment in Primary Schools in Sedibeng District

The happy learner: Effects of academic boredom, burnout, and engagement.

This study aimed to investigate the impact of demographic and contextual variables on boredom in English and mathematics, and to test structural models of boredom, learner burnout, learner engagement, and life satisfaction. Using a cross-sectional survey design and employing a convenience sampling technique, 544 secondary school learners in the Sedibeng District, Gauteng, South Africa, took part in the study. The participants completed the Achievement Emotions Questionnaire - English, the Achievement Emotions Questionnaire - Mathematics, the Schoolwork Engagement Inventory, the School Burnout Inventory, and the Satisfaction with Life Scale. Latent variable modeling was used to test measurement and structural models of boredom, burnout, engagement, and life satisfaction. The indirect effects of boredom on life satisfaction were also computed. The results showed that Afrikaans as the home language, the final mark for English in the previous examination, caregivers that cannot help with English homework, and disliking the English teacher predicted boredom in English. Afrikaans as the home language, marks for mathematics in the previous examination, not having the ability to focus on schoolwork at home, and disliking the mathematics teacher predicted boredom in mathematics. Boredom in mathematics and English resulted in an increase in learner burnout and a decrease in learner engagement. Furthermore, boredom in mathematics and English indirectly affected life satisfaction via learner burnout and engagement.

Viral suppression among adolescents on HIV treatment in the Sedibeng District, Gauteng province.

BackgroundProgress has been made to increase access to antiretroviral therapy (ART) for adolescents living with HIV (ALHIV) to improve their survival, but ALHIV still have worse treatment adherence and viral suppression compared to adults and children.ObjectiveTo determine the prevalence of viral suppression and the associated factors among adolescents aged 10–19 years on ART at an urban public primary healthcare facility in the Sedibeng district, Gauteng.MethodA cross-sectional survey was conducted among 192 adolescents who were on ART for at least six months between 2015 and 2018. A self-developed data extraction tool was used to collect data from the Tier.Net electronic database and clinical folders. Data were captured on Microsoft Excel, and descriptive and inferential analyses were performed using SPSS 27 statistical software.ResultsThe median age at ART initiation of adolescents was 9.0 years (interquartile range [IQR]: 5.0–12.0), and the median duration on ART was 70.5 (IQR: 30.25–105.5) months. The prevalence of viral suppression (< 1000 copies/mL) among adolescents on ART was 74%, with 41% achieving full suppression (< 50 copies/mL). Those adolescents who reported optimal ART adherence were more likely to be virally suppressed compared to those who reported poor adherence (98.1% vs 25.0%; p ≤ 0.001).ConclusionAdolescent viral suppression of 74% is higher than in comparable sites, but still way too short of the UNAIDS target of 90%. We recommend adherence support for adolescents to achieve viral suppression.ContributionThe study highlights the urgent need for targeted adherence support interventions for adolescents living with HIV on antiretroviral therapy to improve rates of viral suppression to meet UNAIDS target of 95%.

Vaccine Hesitancy Drives Low Human Papillomavirus Vaccination Coverage in Girls Attending Public Schools in South Africa.

Girls aged ≥9 years attending South African public sector schools are provided with free human papillomavirus (HPV) vaccination, through a schools-based programme. HPV vaccine misinformation spread via social media in 2014, was identified as a barrier to obtaining parental informed consent in some districts, including Sedibeng District, which subsequently had the lowest HPV vaccination coverage in Gauteng Province in 2018. This study investigated vaccine hesitancy in caregivers of girls in Grade 4 to 7 aged ≥9 years attending public schools in Sedibeng District. A cross-sectional survey using a self-administered questionnaire was conducted among caregivers of age-eligible girls attending all public schools in Sedibeng District with first dose HPV vaccination coverage of <70%. The questionnaire included demographics; HPV vaccination status of girls; reasons for not being vaccinated; and a 5-item tool measuring the determinants of vaccine hesitancy (5C scale), using a 7-point Likert scale. Data were coded and captured on Microsoft Excel®. Except for collective responsibility which was reverse scored, the other 5C items (confidence, complacency, constraints, and calculation) were captured as follows: 1 = strongly disagree, 2 = moderately disagree, 3 = slightly disagree, 4 = neutral, 5 = slightly agree, 6 = moderately agree and 7 = strongly agree. Descriptive and inferential statistical analyses were conducted using Epi InfoTM. Of the principals of all schools with <70% HPV vaccination coverage, 69.6% (32/46) gave permission. The response rate from caregivers of girls present on the day of data collection was 36.8% (1,782/4,838), with 67.1% (1,196/1,782) of respondents reporting that their daughters had received ≥1 dose of HPV vaccine. Only 63.1% (370/586) of respondents with unvaccinated daughters answered the question on reasons, with 49.2% (182/370) reporting reasons related to vaccine hesitancy. Statistically significant differences between caregivers of vaccinated and unvaccinated daughters were identified for four of the five determinants of vaccine hesitancy: confidence (vaccinated group higher), complacency (unvaccinated group higher), constraints (unvaccinated group higher) and collective responsibility (vaccinated group higher). This is the first South African study to (a) report results of the 5C scale, which was found to be very useful for predicting vaccination uptake; and (b) confirm that the relatively low HPV vaccination coverage in Sedibeng District is largely driven by reasons related to vaccine hesitancy.

Prevalence and factors associated with malnutrition among under 5-year-old children hospitalized in three public hospitals in South Africa

Background: Malnutrition is a significant risk factor for ill health among children under five-years of age and the consequences are significant.Aim: To determine the prevalence and factors associated with malnutrition among under-5-year-old hospitalized children. Setting: Sebokeng regional and Kopanong and Heidelberg district hospitals, Sedibeng district, South Africa.Methods: A cross-sectional study of 306 hospitalized under-5-year-old children. Information on socio-demography, feeding practices, immunisation and clinical problems were obtained from caregivers and medical records. Anthropometric measurements were also performed. Results: Most participants were male (59.8%), 12 months old (52.9%), had normal birth weights (80.0%), comes from a household with a monthly income R2000 (about150 US dollars) (50.3%), up-to-date immunization (97.4%), breastfed for 6months (57.4%) and cared for by the mother (92.5%). Most participants were fed 3-4 meals/day (66.7%) and at most, one snack/day (63.4%). Acute malnutrition accounted for 9.5% (n=29) of admissions. Among these, 82.8% (n=24) had severe acute malnutrition. On test of association, monthly household income (p0.01), mother’s and father’s employment status (p0.01 p0.01), breastfeeding history (p0.01) and having diarrhoea in index admission (p0.01) were significantly associated with malnutrition admission. In multivariate regression analyses, not being breastfed (OR=3.9; 95%CI: 1.23–12.29; p=0.02) and diarrhoea at index admission were independently associated with malnutrition (OR=23.3; 95%CI: 6.85–79.43; p0.01).Conclusion: A significant proportion of participants had malnutrition and were subjected to suboptimal feeding practices. Healthcare providers in primary care need to entrench dietary education and anthropometric screening in all clinic-visits for children 5year old, particularly when they present with diarrhoea or are not being breastfed.

Business skills development for a successful fashion business in peri-urban communities, South Africa

Background: Entrepreneurs from disadvantaged backgrounds often possess low levels of education, limited qualifications and training. This also applies to survivalist fashion entrepreneurs in the Sedibeng District Municipality (SDM), Gauteng. Over a third of these entrepreneurs are not formally educated in business skills and may not possess the adequate knowledge to operate their fashion business successfully.Aim: The aim of this research was to investigate the uses and challenges pertaining to business skills amongst fashion entrepreneurs without formal, fashion-related education or training, in order to determine their business skills’ training needs.Setting: The sample population included 105 black, adult fashion entrepreneurs, operating micro, survivalist fashion enterprises within peri-urban, resource-poor communities in the Emfuleni Local Municipality (ELM) of the Sedibeng district. Data for this study were collected from the respondents whilst shopping at fabric and haberdashery stores or from their home-business environments.Methods: A quantitative study applying non-probability, purposive and snowball sampling was performed. Data were collected by means of interviewer-administered questionnaires by trained fieldworkers.Results: The results indicated that the respondents lacked skills in developing business plans and possessed only moderate skills in finance and marketing. The respondents indicated training needs for fashion business skills in all areas of investigation, including developing a business plan, conducting basic bookkeeping, determining correct product pricing, drafting quotations and invoices, developing a budget, conducting basic market research and advertising their products and services.Conclusion: Fashion business skill training programmes should be developed to target and train fashion entrepreneurs without formal fashion-related education or training, contributing to the long-term sustainability of local fashion businesses in South Africa (SA).

Assessing purchasing technical skills as a precondition for effective purchasing management within Sedibeng District Municipality, South Africa

Assessing purchasing technical skills as a precondition for effective purchasing management within Sedibeng District Municipality, South Africa

THE ROLES OF SOCIAL AUXILIARY WORKERS IN DROP-IN-CENTRES: ADDRESSING THE BIOPSYCHOSOCIAL NEEDS OF CHILDREN LIVING WITH HIV

South Africa bears the largest burden of children living with HIV in Sub-Saharan Africa. These children battle with multiple vulnerabilities in their lives. This qualitative study explored the roles of ten purposively sampled social auxiliary workers in addressing the biopsychosocial needs of children living with HIV at drop-in centres in Sedibeng District Municipality, South Africa. The study concluded that many of the biopsychosocial needs that children living with HIV face are not being comprehensively addressed. The study proposes the capacitation of social auxiliary workers on paediatric HIV and the biopsychosocial approach as well as improved funding for drop-in centres to increase the depth of services rendered to, and address the growing needs of, children living with HIV.&nbsp;

The impact of backyard gardening on livelihoods of households in Sedibeng District Municipality in Gauteng Province, South Africa

The study was conducted to evaluate the impact of backyard gardening on the livelihoods of households in Sedibeng District Municipality in Gauteng Province, South Africa. Data were drawn from 60 household vegetable producers. A structured questionnaire was used to conduct one-on-one interviews to gather data which were then analysed to compare variables and the level of livelihoods of household vegetable production. The results suggested that variables such as gender, household size, marital status and household income influence vegetable production. Women, as the primary caretakers of children, were found to be more involved in vegetable production than men. The vegetable production increased when households were headed by females. Households indicated that the implementation and evaluation of the programme under study, which was successfully undertaken with the assistance of Agricultural Advisors from Gauteng’s Department of Agriculture and Rural Development (GDARD), did impact their livelihoods positively. In conclusion, the study found that household vegetable projects can assist in alleviating poverty, create job opportunities and improve livelihoods of the community of Sedibeng District Municipality.

The correlation between various demographic variables and risk management : the case of SMEs in the Sedibeng district

The correlation between various demographic variables and risk management : the case of SMEs in the Sedibeng district

Factors affecting South African small and medium enterprises risk identification and management

It is indicated that 75% of small businesses fail within the first five (5) years of business operations. Small businesses can be blindsided by risks that management has failed to account for. However, risk management has the capacity to reduce business failure rates by relating good management practices across a business to risk events and aiding in the production of a consolidated response from the entire business. Still, small businesses are often hesitant in voluntarily complying with risk standards. Small businesses often fail to employ risk management because of the opportunity cost thereof in business or operational terms. Considering this, the aim of this article was to identify the factors affecting South African Small and Medium Enterprises (SME's) risk identification and management practices. In order to determine what relationship small businesses have with risk management the small businesses were surveyed in the Sedibeng District Municipal Area (SDMA). The survey determined which risks they could identify and how closely their actions to address those risks matched theoretical best practice. A quantitative approach was used and a structured questionnaire was employed to extract the required information. Exploratory factor analysis (EFA), reliability and descriptive analysis were the quantitative methods used to extract the knowledge presented. What was found is that small business owners were risk adverse and had limited awareness of the risks their businesses were exposed to. Experience drove both risk awareness and risk response in their businesses. Small businesses focus on business risk and operational risk but are not cognisant of many of the other risk types. Risk management was consequently lacking, and amounted to limited crisis management, and the processes that embody small business risk management factored into the three (3) steps of risk identification, risk treatment, and the revision of feedback from employees. The implication of the findings is that small businesses are especially vulnerable to risk events and require a means through which to address risk exposures in a way that is tailored to their limitations.

Prevalence and factors associated with malnutrition among under 5-year-old children hospitalised in three public hospitals in South Africa.

BackgroundMalnutrition is a significant risk factor for ill health among children under 5 years of age and the consequences are significant.AimThe aim of this study was to determine the prevalence and factors associated with malnutrition among under-5-year-old hospitalised children.SettingThis study was set at Sebokeng, Kopanong and Heidelberg hospitals, Sedibeng district, South Africa.MethodsThis was a cross-sectional study comprising 306 hospitalised under-5-year-old children. Information on socio-demography, feeding practices, immunisation and clinical problems was obtained from caregivers and medical records. Anthropometric measurements were also performed.ResultsMost participants were male (59.8%), had normal birth weights (80.0%), come from a household with a monthly income R2000 (about 150 US dollars) (50.3%), up-to-date immunisation (97.4%), breastfed for 6 months (57.4%) and were fed 3–4 meals/day (66.7%) and, at most, one snack/day (63.4%). Acute malnutrition accounted for 9.5% (n = 29) of admissions. Among these, 82.8% (n = 24) had severe acute malnutrition. On test of association, monthly household income (p = 0.01), mother’s and father’s employment status (p = 0.01; p = 0.01), breastfeeding history (p = 0.01) and having diarrhoea in index admission (p = 0.01) were significantly associated with malnutrition admission. In multivariate regression analyses, not being breastfed (odds ratio [OR] = 3.9; 95% confidence interval [CI]: 1.23–12.29; p = 0.02) and diarrhoea at index admission were independently associated with malnutrition (OR = 23.3; 95% CI: 6.85–79.43; p = 0.01).ConclusionA significant proportion of participants had malnutrition and were subjected to suboptimal feeding practices. Healthcare providers in primary care need to entrench dietary education and anthropometric screening in all clinic visits for children 5 years old, particularly when they present with diarrhoea or are not being breastfed.

Menstrual health management and schooling experience amongst female learners in Gauteng, South Africa: a mixed method study

BackgroundThere has been increased attention to the menstrual health management (MHM) needs of girls and young women in Eastern and Southern Africa, relating to dignity, and to the potential link between the lack of access to sanitary products and school absenteeism. In the South Africa, there is inadequate evidence to guide appropriate national responses. This study explored the extent of access to modern sanitary products amongst female high school learners and the range of needs and challenges that they face in managing their menses in school settings in Gauteng, South Africa.MethodsWe collected mixed method data from 10 schools in Sedibeng district between June and August 2018. The qualitative component consisted of in-depth interviews with female learners (n = 30), educators (n = 8) and mothers of female learners (n = 9) and focus group discussions (FGDs) with male learners (n = 7) and female learners (n = 10). Five hundred and five female learners were recruited into the quantitative component consisting of a self-administered survey focussing on factors associated with access to sanitary products.ResultsThe median age of survey participants was 17 years (interquartile range 16–18 years) and average age at menarche was 13.36 years. One in seven female learners reported not having enough sanitary products for every period in the last 3 months and this was reflected across the school quintiles. There was a complex interaction between menstrual-related challenges (physical discomfort, teasing, and feeling distracted in class) experienced by female learners, often amplified or compounded by factors in the school environment (unhygienic sanitation facilities and inadequate rest areas), and schooling participation and attendance. Girls who did not have enough products for every period in the last 3 months more likely reported missing school than those who reported sufficient products (46.27% vs 22.49% respectively, p < 0.001). However, there was no statistically significant difference between the groups in number of days missed.ConclusionsProvision of sanitary products is important but only one component of a comprehensive MHM response. Ongoing attention over the link between product access and absenteeism risks overlooking complex systemic and structural factors which can negatively impact the sexual and reproductive health of learners in the school context, and more broadly.