Child health promotion during the COVID-19 pandemic: A health and welfare sector collaboration

Background: Fragmented service provision and a lack of efficient cooperation between health and welfare sectors serving children and families remain ongoing challenges in South Africa. The coronavirus disease 2019 (COVID-19) pandemic escalated this fragmentation. A community of practice (CoP) was established by the Centre for Social Development in Africa to promote collaboration between the sectors and to assist communities in their environments. Aim: To explore and describe collaboration on child health promotion between professional nurses and social workers, who formed part of the CoP during the COVID-19 pandemic. Setting: The study was conducted in five public schools from four of the seven district regions of the City of Johannesburg, Gauteng province. Methods: A qualitative, exploratory, descriptive research design was employed to conduct psychosocial and health screenings of children and their families. Focus group interviews were conducted, and field notes were used to collect and confirm data from the team. Results: Four themes emerged. Participants shared their positive and negative experiences faced during the fieldwork, their realisation of the value of collaboration between various sectors and their desire and capacity to do more. Conclusion: Participants indicated that collaboration between the health and welfare sectors is vital to support and promote the health of children and their families. The COVID-19 pandemic highlighted the need for collaboration between these sectors in the children and their families' ongoing struggles. Contribution: The importance of these sectors being engaged as a team highlighted the multisectoral influence shaping child development outcomes, supporting children's human rights and advancing social and economic justice.

The impact of public health interventions in a developing nation: an overview

Introduction: Around 80% of factors that determine population health sit outside the control of health services. It is essential we influence these factors in addition to those within the remit of health services in order to improve and protect the health of population in a developing country. Public health functions encompass working across the domains that constitute population health systems with various partners. The objective of this article is to give an overview of public health interventions that can improve the health of the population of a developing nation. Method: A descriptive study, based on a review of the literature of key public health frameworks and interventions that are likely to have significant impacts on population health. Some selected public health interventions and case studies are highlighted to illustrate the importance of priority areas in developing countries. Results: Various public health frameworks recognise the importance of wider determinants of health (socio-economic factors), effective healthcare, healthy behaviours, working with communities as critical to securing population health. Another framework adopts a life-course model of intervention starting from public health interventions during preconception period and childhood, adolescence, working life and older age. For many developing countries, the author identified some examples of priority areas for interventions such as stopping and preventing wars; improving child health, including free school meals; achieving universal healthcare through integrated primary health care; addressing commercial determinants of health; embracing new technologies; and measuring and monitoring population health. Conclusion: In order to improve the health of a population in a developing country, attention needs to go beyond health services to influence the wider determinants of health, health behaviours and adopting the World Health Organisation's roadmap on essential public health functions.

Knowledge, attitude, practice and predictors of preventive practices toward COVID-19 among healthcare workers in Ogbomoso, Nigeria: A cross-sectional study

Background: COVID-19 quickly assumed a global epidemic with its attendant health, socio-political and economic impacts. Healthcare workers are particularly at increasing risk of being infected and transmitting the virus. This study assessed knowledge, attitude, practice and predictors of preventive practices toward COVD-19 among healthcare workers in Ogbomoso, Nigeria. Study Design: Cross-sectional study. Data were collected online among health workers across health facilities in Ogbomoso. Factors associated with good practices were analyzed using Chi-square. Predictors of good preventive practices were determined by multivariate binary logistic regression. The level of statistical significance was determined to be at P < 0.05. Results: There were 132 study participants; with an average age of 31 years. Fifty-eight percent were medical laboratory scientists. Levels of good knowledge, attitude, and practices were 59.1%, 58.3%, and 38.6%, respectively. Eight-seven percent of respondents sourced COVID-19 related information via the mass media. Ninety-four percent of respondents will not stay at home if sick because of work. Age, profession, and knowledge are significantly associated with COVID-19 preventive practices. The predictors (Model II) of good COVID-19 preventive practices include being a laboratory scientist (odds ratio [OR]: 2.44 [95% confidence interval (CI): 1.05, 6.71]; P = 0.039), working in primary health facility (OR: 4.72 [95%CI: 1.08, 20.67]; P = 0.039) and having good COVID-19 knowledge (OR: 3.71 [95%CI: 1.49­9.925]; P = 0.005). Conclusion: Our study has shown the predictors of good COVID-19 preventive practices among healthcare workers and the need for policy and practice change as it relates to COVID-19 infection prevention and mitigation among healthcare workers.

This is who we are and why!: Ethnography of weddings in Ibadan,Nigeria

Background: Wedding ceremonies celebrate marital unions of two individuals/families in accordance with socially sanctioned arrangements. Among the Yoruba of south-western Nigeria, weddings of various forms exist. Elaborate and relatively grand weddings are common among the Yoruba people but studies are insufficient on these weddings. More attention is thus needed to understand the trajectories and ramifications of these weddings especially within the socio-economic conditions and rapidly changing social environments that have implications for population and development. This article is therefore an attempt to describe contemporary marriage ceremonies among the Yoruba in Ibadan, Southwestern Nigeria and the meanings associated with the ceremonies. The article is a detailed ethnographic narrative of Yoruba marriage processes. Data Sources and Method: Primary and secondary data were gathered. For the primary data, qualitative research method was used. Data collection methods were participant observations (10 different wedding venues) and 15 in-depth interviews. Interpretive research approach through interviews, observations and pictures were used because of their capacities to extract reliable contextual meanings and implicative elements of social realities. Secondary data were gathered from journal articles, books, newspaper clippings and reliable internet sources. Data analysis was done through content analysis of texts and pictures. Results: Findings reveal very original and dynamically creative ways of celebrating weddings and significance of such weddings among the Yoruba people with implications for better understanding of Africa's socio-economic and cultural systems, population and development. Conclusion: Weddings are significant social realities in context. While they preceed family formation and traditionally crucial, they are both physical and cultural just as they are systematically symbolic and demonstrative of familial and sociocultural statuses and class in Africa. Weddings in the context are indication and legitimation of identity and existencies and these have strategic implications for social change, cultural systems and population

Researching to Make a Difference: Possibilities for Social Science Research in the Age of AIDS

HIV and AIDS is recognized as one of the most devastating pandemics of sub-Saharan Africa; and South Africa in particular; with adverse effect on individuals; families; schools; communities and society at large. Research is therefore required to provide a deeper understanding of the complexities of HIV and AIDS in order to mitigate the effect of the pandemic. Much of the excellent research that has been done has been undertaken within a positivist paradigm and has focused on the biomedical aspects of HIV and AIDS; as well as the social aspects of the pandemic. This theoretical position paper draws on various projects in the field of HIV and AIDS education in rural KwaZulu-Natal to argue that more social science research should be framed within a participatory research paradigm; foregrounding participant engagement and process; and which simultaneously has a 'research-as-intervention' focus. Such research adheres to the requirement of knowledge production; but also engages the participants as knowledge producers who; through the research process; are enabled to shift towards taking up their own agency. Reflecting on the findings from the various projects suggests that visual participatory methodologies are particularly useful when working with marginalized persons whose voices are seldom heard especially when exploring topics which are difficult to discuss. Furthermore; it brings issues to the fore and opens up debate; while at the same time democratizing research and allowing universities to take up their social responsibility and to contribute towards making a difference in the communities they serve

Social Impact of HIV/AIDS on Clients Attending a Teaching Hospital in Southern Nigeria

People living with human immunodeficiency virus and acquired immune deficiency syndrome (PLWHA) face numerous social challenges. The objectives of this study were to assess the level of self-disclosure of status by PLWHA; to describe the level and patterns of stigma and discrimination; if any; experienced by the PLWHA and to assess the effect of sero-positivity on the attitude of friends; family members; health workers; colleagues and community. This was a cross-sectional descriptive study carried out among PLWHA attending the University of Uyo Teaching Hospital; Uyo; Southern Nigeria. Information was obtained using an interviewer-administered semi-structured questionnaire; which was analysed using the Epi 6 software. A total of 331 respondents were interviewed. A majority; 256 (77.3); of the respondents were within the age range of 25-44 years. A total of 121 (36.6) PLWHA were single and 151 (46.6) were married; while the rest were widowed; divorced or separated. A majority; 129 (85.4); of the married respondents disclosed their status to their spouses and 65 (50.4) were supportive. Apart from spouses; disclosure to mothers (39.9) was highest. Most clients (57.7) did not disclose their status to people outside their immediate families for fear of stigmatization. Up to 111 (80.4) of the respondents working for others did not disclose their status to their employers. Among those whose status was known; discrimination was reported to be highest among friends (23.2) and at the workplace (20.2). Attitudes such as hostility (14.5); withdrawal (11.7) and neglect (6.8) were reported from the private hospitals. Apart from disclosure to spouses; the level of disclosure to others was very low. Those whose status was known mainly received acceptance from their families but faced discriminatory attitudes such as hostility; neglect and withdrawal from friends; colleagues and hospital workers. There is a need for more enlightenment campaigns on HIV/AIDS by stakeholders to reduce stigma and discrimination and ensure adequate integration of PLWHA into the society

Recent Change of locality as Risk Factor for Malaria Fever among New Residents of Ahoada East Local Government Area in Southern Nigeria

Relocation which is a well-known determinant of malaria in non-immune travelers to malarious areas; has also been found to be a risk factor for malaria among semi-immune persons who change locality within endemic regions. Further research evidence suggests that the higher transmission intensity at the travel location is an underlying factor which may indicate exposure to new variants of P falciparum for which specific immunity is lacking. This study was conducted to determine if recent change of locality increased the risk of malaria fever among semi-immune National Youth Service Corps members serving in a district in southern Nigeria.Method: Ninety six corps members who had just been posted to Ahoada-East LGA in southern Nigeria and 83 others that had been in service for six months; were followed up for malaria fever in a prospective cohort design over a 3 month period from September 2010 to December 2010. Active surveillance was used to obtain reports of fever among the cohort; followed by medical examination at designated local health facilities.Results: No significant differences in age and use of protection against malaria were found between the study groups. The incidence proportion of malaria for the recently relocated group (34) was significantly higher than that of the resident group (15.7). Recent change of locality was more associated with malaria fever (RR 2.19; 95 CI 1.243.88; AR 54.4).Conclusion: The recent change of locality within an endemic region; which serves as an indicator of exposure to new variants of P falciparum; for which specific immunity is lacking; is a significant risk factor for malaria fever. Protection against malaria is recommended for semi-immune individuals moving to new locations with significant risk of malaria transmission

The Mortality of Serving African Presidents: A Lesson for the Health Profession and the Lay Public

Although Africa has the worst mortality data in the world; the picture painted by the high mortality rate of serving Africa leaders in the last five years suggests reasons and causes far beyond poor socio-economic conditions. This study examined the causes and age at death of serving African leaders; in the last five years; and draws out the lessons; for the health profession and the general public.Material and methods: An internet search of creditable websites was carried out to determine the number; causes and age at deaths of the leaders; within the study period of 2008 to 2012. The life expectancy rates of the bereaved countries were also considered.Results: A total of 13 presidential mortalities took place in the world during the study period; with 10 (76.92) involving serving African leaders. The leaders died at an average age of 66.9 +/- 7.22 years; an average of 12.1 years above the life expectancy rate of their respective countries; but less than the world average of 68 years. Most (80.00) of the leaders died from non-communicable diseases; 3 died from cardiovascular diseases; 3 died from cancer; while two were known diabetics. The remaining two leaders were killed in a violent change of government.Conclusion: The African leaders died mainly from non-communicable diseases; at an age that is below the world average. Public enlightenment campaigns and greater emphasis on patient-centered chronic care of non-communicable diseases are hereby recommended

A Literature Review of the Impact of HIV and AIDS on the Role of the Elderly in the Sub-Saharan African Community

The status of older adults in Africa occupies a small but rapidly expanding share of the global literature on ageing. The human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) pandemic has generated a new focus on the changing role of the elderly in communities that have been affected. In sub-Saharan Africa; where millions are projected to be infected with HIV and about two million deaths are recorded annually amongst the traditionally productive adults; such loss of parents and breadwinners means children and the elderly have had to take up unusual responsibilities. A literature review on the elderly and HIV and AIDS provided the data analysed for this article. Access to databases was mainly via EBSCO (www.ebsco.co); which allowed searches in major databases and search engines useful in an academic setting for finding and accessing articles in health and health-related academic journals; repositories and archived reports. Results showed that the AIDS pandemic has direct and indirect effects which have manifested in a set of interrelated social; economic and psychological dimensions that could ultimately impact on the health and well-being of the elderly. It is concluded that more needs to be done to articulate the knowledge base of the impact of HIV and AIDS in order to inform social; economic and political policies for the purpose of alleviating the problems that the pandemic is wreaking on the elderly African population

Social Change and the Legal Construction of Child Soldier Recruitment in the Special Court for Sierra Leone

"Concern over the recruitment of child soldiers in armed conflicts has grown over the last decades. While public advocacy and media attention tend to focus public attention on the most egregious cases of child recruitment; emerging international law has actually had a more profound effect on the relationship between children and the military. What began as a relatively narrow concern with protecting children under 15 years old who served as combatants in armed forces and armed groups has evolved into an international effort to sever a broad range of connections between all persons under 18 years old and the military. Indeed; the entire legal concept of the ""child soldier"" has evolved to encompass a greater number of children engaged in a wider variety of activities than was previously the case.The drive to create a universal legal and moral standard has trumped any concerns about local understandings of child soldiers; which are treated not as legitimate expressions of local culture but rather as deviant and inhumane practices under international law. International humanitarian law is not merely ethnocentric; it is indeed intentionally ethnocentric. Its concern is not to respect local norms but rather to systematically alter them. The drafters who crafted the language of the first international treaty that barred the recruitment of children under 15 years old were keenly aware of significant cross-cultural variation in the ages of childhood; youth and adulthood. But their view that the participation of children and adolescents in combat was an ""inhumane practice"" made such considerations irrelevant. An examination of the development of international law and its application in Sierra Leone shows that as international law develops an increasingly expanded concept of the child soldier; the disjunction between the normative aspirations of law and the reality of local practice continues to grow."

Impact of Health Education on Home Treatment and Prevention of Malaria in Jengre; North Central Nigeria

Background: Malaria accounts for 1 million deaths among children under five annually. It has been shown that improving home treatment and preventing delays in seeking treatment; by teaching women to respond promptly when their children have fever; can decrease malaria related complications and mortality. This study looks at the impact of health education on knowledge of malaria: its recognition; treatment and prevention among caregivers of children under five in Jengre; North Central Nigeria. Methods: The study was a community based intervention study conducted in three stages: A pre- intervention stage; where 150 caregivers; were selected through a multistage sampling technique from the households containing children under five. Information for the baseline was collected through an interviewer administered semi-structured questionnaire. The intervention consisted of a series of health education sessions designed based on findings from the pre-intervention stage. The post-intervention impact assessment was conducted using a modified version of the questionnaire used in the pre intervention stage. Results: Malaria was recognized as one of the diseases that cause fever in community by all the respondents. Sixty-one (40.6) had adequate knowledge concerning malaria causation; transmission; prevention and treatment. Twenty eight (56) of respondents reported Self-treatment. There was a statistically significant relationship between years of formal education and first line treatment option (P=.012). Thirty-four (68) mothers acted within eight hours of onset of fever. The intervention had an effect on perception (P.001); knowledge (P.001); malaria preven- tion practice (P

Poverty and Development in Nigeria : Trailing the MDGs

Poverty levels in the developing world; especially Sub-Saharan Africa still pose major challenges to overall development in the continent and globally; against the backdrop of the millennium development goals. A critical appraisal of poverty and development theories suggests that as long as individuals and communities are caught in poverty traps (in the form of low resources; low physical and human capital); exclusions from global markets and government and market failures they cannot enjoy the economic development experienced in high income; developed countries. The MDGs were developed in good faith to assist in reducing global economic development disparities; however; an assessment of the current status of African countries reveals a trend whereby it is highly unlikely that any of the targets set by the goals will be met by 2015. Goal 4 - the reduction of infant mortality rates - which would have been met; has been threatened by civil disturbances and increasing incidence of HIV/AIDS. Within Nigeria; where 50live below the poverty line; the poverty situation is exacerbated by inequality in incomes; in assets (education and health status); in control over public resources and in access to essential services; coupled with high levels of insecurity. Growth strategies for reducing poverty levels in Sub-Saharan countries; and Nigeria in particular; must be pro-poor. Such strategies must eliminate discrimination against rural and agricultural development; invest in human capital (education and health); improve household consumption levels to reduce deprivation of basic needs by vulnerable members; particularly children; the widowed and the aged; provide access to markets and public infrastructure and facilitate the creation of new jobs. Ongoing economic and structural reforms in the country must be maintained on a sustained level that will permit poverty reduction and better quality of life

Globalisation : Implications for Health Care Delivery in Developing Countries

Globalisation entails a rapid increase in economic; technological and cultural exchange; which flows from economically and technologically dominant nations to less dominant nations. Many of the underlying principles of globalisation are contradictory to traditional values. Globalisation could aggravate marginalisation of vulnerable communities in Africa. On the other hand globalisation is regarded to provide developing and under-developed nations an opportunity to escape from a cycle of under-development; poverty; inadequate access to health care; and ill health. Health care professionals could contribute towards optimising the benefits of globalisation towards enhancing health and deve-lop-ment in their communities. This requires that they reconceptualise their roles and the nature of health sciences education programmes. The author discusses the main characteristics of globalisation; and its implications for developing countries and traditional lifestyles

Roll Back malaria (RBM): What; Why and How?

Malaria continues to be the leading public health problem in Africa. There is evidence of a worsening global malaria situation. Mortality rates in Africa are rising. The malaria prasite is increasingly resistant to the commonly used antimalarial drugs. New epidemics are reported - some of them in countries that have; until recently; been free of the disease. In many countries; resources for malaria control programmes are stretched to the limit. Malaria contributes to widespread human suffering; particularly among the poorest. It is a major constraint to economic and social development that has a negative impact on Africa's growth. Background to RBM movement: In 1997 the total of malaria was US$ 2;000 million and was projected to reach US$ 3;600 million per year by 2000 in Africa. This observation prompted the OAU Heads of States to adopt a Declaration in 1997; requiring member states to intensfy the fight against malaria. WHO; established the Roll Back Malaria (RBM) movement in July 1998. RBM in Africa builds on earlier initiatives to control malaria; namely: The Regional Strategy for Malaria Control (1991); The Accelerated Implementation of Malaria Control (1995); The African Initiative for Malaria (AIM) Control in the 21sth Century (April 1998). The RBM movement in Africa was given another boost by the abuja Declaration (April 2000). What is Roll Back Malaria (RBM) and how does it work? the RBM partnership is not a project or a programme. it is a social movement that is part of a broader societal action for health and human development and is characterised by the various actors working in harmony. The RBM movement emphasises and depends on up-to-date technical systems and expertise for malaria control; for surveillance; for controlling mosquito vectors; for promoting the use of effective medicines for integrated management of childhood diseases and for encouraging the development of new diagnostic; treatment and preventive measures. It also depends on building partnerships at various levels: regional; national; district and community. The RBM strategy builds on past experience; is evidence-based; and focuses on outcomes. Its implementation is multisectoral; involving governments; civil society; development agencies; NGO's the private sector; researchers; the media and other interested parties including local communities. The RBM movement tries to get the best possible results with existing malaria control tools; through better functioning health services as well as focussing on intense action against malaria at community level; with high level political backing; the attention on strengthening the health systems. The interests of the people; particularly people in poor communities - and especially children and women - are at the centre of the RBM movement. It supports the development and adaptation of new tools: These are needed to ensure that gains are sustained. RBM in Africa: The mission is to control malaria in Africa as a contribution to Africa's health and overall socio-economic development. Target of RBM: The RBM partners have set a 10-year target to reduce by 50the world's malaria burden by 2010 and by 75by 2015; of the figure for 2000. To achieve this: . 60of people with malaria should get correct treatment within 24 hours of recognition by 2005; . 60of people at risk should be using effective preventive measures by 2005; . 60of pregnant women should be getting intermittent presumptive treatment (IPT) by 2005; etc. All these will be achieved through creating a social movement that enables countries to take effective and sustainable action against the diseases

Building a shared vission among leaders across sectors and professions

Many attempts have been made to give responsibility for leadership in health to community committees or inter-sectoral bodies. Often such attempts have failed due to lack of common understanding; vision and direction. The article provides a tool that can explore difference is in perception and facilitate the creation of a shared vision among leaders who have different backgrounds and insights with regards to health and community development. Through a test case at the University Teaching Hospital in Zambia this article provides an example of how the tool can be used in the change processes which are essential in any health reform. The test case describes the use of a Hospital Management Board; but the tool will be useful for any board; committee or group that is heterogeneous in respect of knowledge; view and insights

Principes directeurs applicables aux etudes de l'impact social et economique du VIH/sida

Ce document presente les concepts fondamentaux pouvant aider a reflechir sur les consequences economiques et sociales du sida mais aussi sur des idees et techniques pour planifier les ripostes a apporter a l'impact social et economique du VIH/sida a moyen et long termes.Il comprend trois parties. La premiere constitue une introduction expliquant en quoi le sida est unique pour meriter des etudes impact. La deuxieme partie expose les principes directeurs de base sur la maniere de conduire une evaluation des effets sociaux et economiques du VIH/sida. La troisieme partie presente un cadre conceptuel applicable a de telles etudes