Strengths and challenges of community-based clinical training as viewed by academics at the University of KwaZulu-Natal, Durban, South Africa

Background. Community-based education (CBE) is seen as a valuable tool in transforming health professions education by aligning clinical training with graduate competencies and needs of the health system. However, academics involved in the implementation have varied views.Objectives. To explore the experiences and views of academics involved in community-based training in the College of Health Sciences at the University of KwaZulu-Natal, Durban, South Africa. Methods. This qualitative study used interviews and focus group discussions consisting of a purposively selected sample of academics. The interviews were audio taped, transcribed and analysed using thematic analysis.Results. Three main themes emerged from the data analysis: the strengths of CBE, challenges experienced in implementation and academics' suggestions concerning challenges. The strengths included benefits to the institution, students, health system and communities. The main challenges experienced were insufficient support from the institution and the Department of Health (DoH). Suggestions were made by academics to overcome these challenges.Conclusion. The study indicates that CBE is perceived as an important pedagogical approach in transforming health professions education, as it can align clinical training with the business plan of the university and the needs of the health system. However, for the successful implementation of CBE, full support from the university and the DoH is required

The promotion of oral health within Health Promoting Schools in KwaZulu-Natal

Background. Oral health promotion is a cost-effective strategy that can be implemented at schools for the prevention of oral diseases. The importance and value of school-based interventions in children has been identified in South Africa (SA). Although oral health strategies include integrated school-based interventions, there is a lack of published evidence on whether these strategies have been translated into practice and whether these programmes have been evaluated.Objective. To assess the efficiency and sustainability of the toothbrushing programme implemented at health-promoting schools in KwaZulu-Natal Province, SA.Methods. A mixed-methods approach was used for this study, conducted at 23 health-promoting schools in KwaZulu-Natal using focus group discussions. Triangulation was used for evaluation.Results. The intervention implemented had created awareness of oral health for learners, educators and parents. Findings in this study indicate that although there were benefits obtained from this school-based intervention, many challenges, such as time constraints, large classes and a lack of adequate resources and funding, affected the sustainability of the programme.Conclusion.The school setting has the potential to deliver integrated preventive and promotive programmes provided they are supportedby adequate funding and resources

Abortion Incidence and Postabortion Care in Rwanda

Abortion is illegal in Rwanda except when necessary to protect a woman's physical health or to save her life. Many women in Rwanda obtain unsafe abortions; and some experience health complications as a result. To estimate the incidence of induced abortion; we conducted a national sample survey of health facilities that provide postabortion care and a purposive sample survey of key informants knowledgeable about abortion conditions. We found that more than 16;700 women received care for complications resulting from induced abortion in Rwanda in 2009; or 7 per 1;000 women aged 15-44. Approximately 40 percent of abortions are estimated to lead to complications requiring treatment; but about a third of those who experienced a complication did not obtain treatment. Nationally; the estimated induced abortion rate is 25 abortions per 1;000 women aged 15-44; or approximately 60;000 abortions annually. An urgent need exists in Rwanda to address unmet need for contraception; to strengthen family planning services; to broaden access to legal abortion; and to improve postabortion care. (StudieS in Family Planning 2012; 43[1]: 11-20)