Using signalling theory to assess the Government of Ghana's risk communication during the COVID-19 pandemic

Background: The proliferation of information through social media and on other communication networks during the corona virus disease 2019 (COVID-19) era altered information transfer in many countries. The content of the messages from government officials, media coverage and alternative narratives, affected the level of compliance in adhering to the various health protocols amongst the public. Aim: This article aimed to determine the relationship between the message used, media coverage, alternative narratives, the public's attitude towards staying at home and their commitment to stay at home during the COVID-19 pandemic campaign period in Ghana. Setting: A total of 352 respondents was sampled from the Kumasi metropolis. Methods: A survey sample strategy and a convenience sampling technique were used while structural equation modelling with Partial least square (PLS) version 3.0 was used for the analysis. Results: The study revealed that the nature of media coverage employed and the alternative narratives had a significant positive effect on the attitude of the respondents, whilst the content of the message had insignificant effects on the attitude of the public. Finally, the attitude of the people had a significant positive influence on their respective commitment to stay home. Conclusion: Developing countries in Africa need to fight pandemics using purely subsidised health officials or directorates rather than have government-appointed health experts and officials spearheading activities during a pandemic.

Telehealth in south africa: a guide for healthcare practitioners in primary care

The use of telehealth is becoming a prevalent feature in clinical practice worldwide, partly because of advances in medical and telecommunications technology. The coronavirus disease 2019 (COVID-19) pandemic has been a key driver in justifying the accelerated use of telehealth, leading to healthcare practitioners (HCPs) utilising virtual consultations more avidly. Although challenges remain, recent data have shown that remote consultations are feasible, safe and effective in South Africa (SA) and that HCPs should become proficient in conducting telehealth, virtual or remote consultations. These guidelines are based on the revised Health Professions Council of South Africa (HPCSA) General Ethical Guidelines for Good Practice in Telehealth (Booklet 10) and guidelines on remote or video consultations from the University of Oxford, the Royal Australian College of General Practitioners and the Royal College of Psychiatrists. These guidelines aim to equip HCPs with the basic knowledge and skills pertaining to medicolegal, communication and practical aspects of telehealth and how to practise telehealth safely and effectively in primary care settings in SA during the COVID-19 pandemic and beyond.Keywords: telehealth; virtual consultations; remote consultations; primary care; guidelines; ethics; medicolegal; communication.

Presidential communication approaches and the impact on public health: a comparative analysis of three South African presidents' communication on AIDS and COVID-19

The HIV response in the African continent over past decades demonstrates the potency that the words and actions of political leaders have in either expediting or impeding the implementation and adoption of preventive measures at the individual and community levels. The article explores the health communication approaches employed by two South African past presidents (Thabo Mbeki and jacob Zuma) in responding to the HIV epidemic, and contrasts these with the communicative approach of President Cyril Ramaphosa during the COVID-19 pandemic. Approached from this understanding, this article provides a comparative analysis of the communication approaches of these three presidencies across the two pandemics, and considers the variously trusted sources of top-down, government-driven and bottom-up, community-informed approaches to health communication. Critical lessons that emerged in South Africa during the HIV epidemic regarding the need to include communities in communicating about risks and behaviour change have not been adopted into the COVID-19 response. Political leaders are not best placed to communicate about these issues, and, in the context of pandemics, there is a clear need to reconsider top-down communication approaches that are designed without the participation of communities and ignore the interconnected nature of health and other social determinants of health.

Is social media promoting covid-19 vaccine uptake? A case of hausa language youtube videos

The importance of social media in spreading health information, COVID-19 inclusive cannot be over emphasized and YouTube as one of the social media platforms is the most popular video-sharing platform widely. Studies in other languages showed that, videos on YouTube spread misinformation about COVID-19 vaccine. Objective: To assess the nature of information in Hausa language YouTube videos on COVID-19 vaccine uptake.Materials and Methods: This was a cross-sectional descriptive study of Hausa language YouTube videos on COVID-19 vaccine uptake. A filtered search was conducted on YouTube on 19th September, 2021 using the Hausa words for Coronavirus Vaccine as search terms. The words used were "Allurar Rigakafin Coronavirus" and "Rigakafin coronavirus". Fifty-five videos were included, YouTube video information were collected and video source and video metrics categorization were also collected. The videos were assessed to determine if they were pro-vaccination and for content, by extracting data based on information on COVID-19 vaccination contained in the videos using a predesigned proforma. Data analysis was done using Microsoft Excel 2016 and SPSS version 20. Results: About 65% of the videos had views of 0-100 with no dislike and were uploaded in the last 6 months. Only about onethird (36.4%) of the videos were pro-vaccination. Factual information on COVID-19 vaccine and information on vaccine safety, efficacy, side effects and dangers of vaccine rejection were contained in 36.4% or less of the videos. Outright misinformation was contained in as much as 25.5% of the videos. Conclusion: Most of the Hausa language YouTube videos on COVID-19 vaccine uptake were not pro-vaccination, they were not sufficiently informative on COVID-19 and some contained misinformation. Such videos with questionable content should be deleted from YouTube to forestall misleading the populace

Male attitudes towards family planning in the Limpopo province of South Africa

Women often do not receive support from their partners with regards to familyplanning (FP), which can lead to hesitancy and inconsistent use. This study sought tounderstand the male attitudes that contribute to this.Methods: A qualitative descriptive study was conducted in 2019 using focus group discussions (FGDs) with purposively selected men aged ≥ 25 years and in a relationship with a woman of childbearing age. An open-ended question guide was used to explore men's perceptions regarding FP. The discussions were recorded, translated and transcribed verbatim, whereafter transcripts were coded and analysed thematically. Results: Three major themes were identified, namely: (1) the advantages of FP, including financial benefits and the prevention of sexually transmitted infections and unwanted pregnancy; (2) the disadvantages of FP, including perceived adverse effects on men and women, as well as marital difficulties; and (3) the exclusion of men from FP by health workersand their partners. Conclusion: Men felt ambivalent towards FP. They were aware of the benefits thereof, but were hesitant to allow their female partners to use contraceptives, because of several misconceptions about the adverse effects. This underscores the need to involve men in FP programmes.

Nurses' perspectives about communication with patients in an intensive care setting using a communication board: a pilot study

Background: Communication in the intensive care setting (ICS) is critical for both the patient and the medical staff to provide efficient care and thus alleviate possible patient adverse effects. Persons with complex communication needs are particularly vulnerable in ICSs and therefore require additional communication support. Aim: This study focused on the perspectives of nurses about communication with patients with communication needs in ICSs using paper-based communication boards, namely the translated Vidatak EZ Board, before and after a training session. Setting: A 1650-bed public hospital with a 26-bed ICS in a semi-urban, low socio-economic area in South Africa served as the research setting. Methods: A quasi-experimental pre-test post-test group design with withdrawal and a control group was used. Data were gathered using a custom-designed questionnaire completed by ICS nurse participants recruited from a public hospital. Results: Responses of some nurses did not change in post-test 1, but their responses did change in post-test 2. Some of the nurses' perspectives changed, as expected from the pre-test to post-test 1. Nurses recommended specific adaptations to the communication board. Conclusions: Most nurses agreed that communication is crucial in ICSs and that a communication board can be implemented; however, limited success was observed implementing the board following a short training. The inter-professional collaboration between nurses and speech-language therapists to provide optimal health care to patients in ICS is emphasised

Bench, bed and beyond: communication and responsibility in decentralised tuberculosis care

Background: South Africa faces one of the world's worst drug-resistant tuberculosis epidemics. Implementing successful care in this context has proven challenging for a number of reasons. Communication is an essential yet neglected feature of care and research in the field of tuberculosis. Aim: The primary aim of this qualitative study was to explore communication facilitators and barriers at several tuberculosis care sites. In this article, we focus on communication practices across the chain of diagnosis, treatment, discharge and follow-up in decentralised care approaches and present evidence of gaps in communication. Setting: The study was conducted at three tuberculosis care sites in two South African provinces. Methods: Participants included healthcare workers, patients, community members and home-based carers. Data included 79 interviews, 4 video-recorded interactions between patients and healthcare workers, and ethnographic observations at each site. We analysed the data using thematic analysis and a qualitative sociolinguistic framework. Results: Communication in decentralised care contexts is complex because of multiple sites and role players. Responsibility for communication seems to be unduly placed on patients, treatment guidelines are not implemented consistently across sites and assumptions are made about the role of others in the chain. Patient and healthcare worker reports suggest confusion and frustration. Conclusion: Communication in the South African tuberculosis care context appears fragile and current mechanisms for detecting flaws in the care chain are not sensitive to communication issues. We make recommendations for strengthening home-based care resources, providing team training and focusing on communication processes in monitoring and evaluating systems

Medical Science Liaisons (MSL) in Africa: a perspective

The role of a Medical Science Liaison (MSL) is of growing importance to pharmaceutical, biotechnology, diagnostic and medical device companies. Through scientific engagement MSLs add value to clinical practice, ultimately benefiting patients. The MSL role is dynamic and encompasses in-depth product and disease knowledge together with the ability to communicate relevant, unbiased scientific information concisely and timely. Tasks are focussed on contributing towards the advancement of medical knowledge, scientific data generation and dissemination. Professional relationships are developed, fostering collaboration between external experts and typically the medical affairs departments of pharmaceutical companies through a credible liaison. Through such relationships, critical insights are shared that shape the development pipeline, promote successful clinical translation and guide the market deployment strategy of therapeutic interventions through-out their life cycle. Despite the rising number of MSLs in the field and the implicit medical value of the role, there remains a lack of understanding for what the roles of an MSL entails. In Africa, where exponential growth of the pharmaceutical industry is expected, the number of MSLs will increase rapidly. Given the complexities of the African continent, the MSLs in this burgeoning environment will face various challenges including remote locations, time-constraints, regulatory and bureaucratic hurdles and importantly physician misperception of the MSL role that collectively may thwart the goal of meaningful scientific engagement; but these challenges can be surmounted through astute proactive planning and utilization of opportunities including digital communication strategies

Understanding the concept of health insurance: An innovative social marketing tool

Health insurance scheme is relatively new in many low to middle income countries. Awareness about and knowledge of the scheme is poor among potential beneficiaries. There are some misconceptions associated with health insurance, which contributes to its low acceptance in affected nations. The aim of this work is to present an information-education and communication concept that will serve as a social marketing tool that could enhance peoples' understanding of the modus operandi of health insurance scheme, and as well as to demystify superstitious belief associated with it. This will contribute to a better understanding of the scheme among the people and enhance its uptake

Utilisation de la boule de Bichat dans le traitement de la communication bucco-sinusienne iatrogène: à propos d'un cas

La communication bucco-sinusienne fait partie des complications per et post opératoires rencontrées au cours de l'avulsion des dents antrales, notamment les deuxièmes prémolaires et les premières molaires maxillaires. Nous rapportons le cas d'une jeune patiente de 23 ans, chez la quelle l'avulsion laborieuse de la 16 (première molaire maxillaire droite) a conduit à une communication bucco-sinusienne, dont la thérapeutique de première intention par lambeau de translation vestibulaire de plein épaisseur a échoué. La reprise chirurgicale associant le lambeau vestibulaire à la boule de Bichat, a permis la fermeture hermétique de la communication. Notre résultat a été comparé aux données actuelles de la littérature

Medical students' views on the use of video technology in the teaching of isizulu communication; language skills and cultural competence

The role of communicator has been included as a key competency for health science students in South Africa. Owing to the population's diverse language and cultural backgrounds; communication between patients and healthcare professionals is challenging. In this study; the Attention; generation; Emotion and Spacing (AGES) neurocognitive model of learning was used as a framework to create videos for language teaching for the vocational needs of students. Objectives. To explore students' views on the use of videos of simulated clinical scenarios for isiZulu communication and language teaching and the development of cultural awareness. Methods. Videos were developed using first- and second-language isiZulu speakers with scripts (verified by the university's Language Board) based on authentic clinical settings. Videos were shown to a target group of students; who were then interviewed in focus group discussions. Audio recordings from the discussions were transcribed and analysed thematically in three categories; i.e. communication; language skills; and cultural awareness; using deductive coding based on the objectives of the research. Results. Students affirmed numerous benefits of the videos and commented on their use and further development. Benefits described related well to the AGES model of learning and fulfilled the learning requirements of communication teaching; language acquisition and cultural awareness. Conclusion. The videos represent an innovative teaching method for the resource-constrained environment in which we work and are relevant to the 21st century learner. Further evaluation and development of the tool using different scenarios and African languages is recommended

Commuting and communication: an investigation of taxi drivers' experiences, attitudes and beliefs about passengers with communication disorders

Background: One of the most popular means of public transport within South Africa is mini-bus taxis. Objectives: As South Africa is made up of diverse cultures, religions and beliefs, the aim of this study was to explore Johannesburg based taxi drivers' experiences of beliefs about, and attitudes towards passengers who have a communication disability. Method: Semi-structured interviews were conducted with 10 mini-bus taxi drivers. Results: Interviews revealed that almost all the taxi drivers had encountered passengers with a communication disability, and had an awareness of passengers with a hearing disability as opposed to a speech disability. Furthermore mini-bus taxi drivers generally held a positive view of their passengers with a communication disability.Conclusion: Study findings contribute to existing literature within the fields of speech pathology and audiology, advocacy groups and policy makers, particularly research studies on participation experiences of persons with communication disabilities related to transportation access. The results of the study should also provide a foundation for disability policy development initiatives with the aim of increasing levels of public awareness

Perceptions of Nursing Students Regarding Responsible Use of Social Media in the Eastern Cape

Background: Social media have become a popular communication system that has transformed communication from the traditional to the Web-based model. Because social media use has no limitations to place and time; it is now used extensively at clinical facilities. Social media useis becoming a popular activity amongst students at Nursing Education Institutions (NEI) in South Africa. However; lack of accountability and unethical use of social media by nursing students in South Africa has been reported. Objectives: The aim of the study was to explore and describe the perceptions of nursing students regarding responsible use of social media.Methods: A qualitative; descriptive; explorative and contextual research design was used to explore and describe the perceptions of nursing students regarding the responsible use of social media. Twelve nursing students registered for the undergraduate nursing degree were purposely selected and interviewed individually using a semi-structured interview method. Results: The results of this research study demonstrate that nursing students use social media irresponsibly. Nursing students experience blurred boundaries between personal and professional lines and lack accountability when using social media.Conclusion: The extensive use of social media in the clinical environment; by healthcare students; requires a joint effort by Nursing Education Institutions and healthcare facilities to ensure that social media are used in an ethically acceptable manner. The implementation of the recommendations of this research study could positively influence legally and ethically acceptable use of social media at healthcare facilities

Mobile health for early retention in HIV care: a qualitative study in Kenya (WelTel Retain)

Many people newly diagnosed with HIV are lost to follow-up before timely initiation of antiretroviral therapy (ART). A randomised controlled trial (RCT); WelTel Kenya1; demonstrated the effectiveness of the WelTel text messaging intervention to improve clinical outcomes among patients initiating ART. In preparation for WelTel Retain; an RCT that will evaluate the effect of the intervention to retain patients in care immediately following HIV diagnosis; we conducted an informative qualitative study with people living with HIV (n = 15) and healthcare providers (HCP) (n = 5) in October 2012. Study objectives included exploring the experiences of people living with HIV who have attempted to engage in HIV care; the use of cell phones in everyday life; and perceptions of communicating via text message with HCP. Participants were recruited through convenience sampling. Semi-structured; qualitative interviews were conducted and recorded; transcribed verbatim and analysed using NVivo software. Analysis was guided by the Theory of Reasoned Action and the Technology Acceptance Model. Results indicate that while individuals have many motivators for engaging in care after diagnosis; structural and individual barriers including poverty; depression and fear of stigma prevent them from doing so. All participants had access to a mobile phone; and most were comfortable communicating through text messages; or were willing to learn. Both people living with HIV and HCP felt that increased communication via the text messaging intervention has the potential to enable early identification of problems; leading to timely problem solving that may improve retention and engagement in care during the first year after diagnosis

Communication characteristics of young children with HIV in South Africa as reported by some physicians

HIV has been shown to have significant effects on the development of a child. Currently; there is limited South African research regarding HIV and specific characteristics of communication development; and the treatment thereof; in the child infected with HIV. The objective of the research was to describe the communication characteristics of a group of children between the ages of 0 and 5 years infected with HIV at a hospital in Gauteng; South Africa. Clinic records of 203 children infected with HIV between the ages of 0 and 5 years were reviewed using a pre-designed checklist within the outreach clinic of a large regional hospital. A questionnaire was completed by four medical practitioners working with this population within the outreach clinic. A total of 91.62 of the infected children were diagnosed as being either in Stage III or IV of the disease (according to the WHO classification system of 2005); with all infants presenting with a CD4 count of =60. Most (75.37 of the total sample) were receiving Highly Active Antiretroviral Therapy (HAART) at the time the data were collected. According to their medical; social; communication and general development; almost all the children qualified for Early Communication Intervention (ECI) but were not recorded as being referred for such services. A large proportion of the target population presented with opportunistic infections and/or HIV associated conditions. The results highlight the developmental characteristics of children living with HIV; and identify the need for medical doctors and allied health professionals to be provided with relevant literature or training regarding the communication development of children infected with HIV. This will facilitate appropriate referrals for ECI services

Breaking bad news in clinical setting - health professionals' experience and perceived competence in Southwestern Nigeria: A Cross Sectional Study

Background: Communication skills are vital in clinical settings because the manner in which bad news is delivered could be a huge determinant of responses to such news; as well as compliance with beneficial treatment option. Information on training; institutional guidelines and protocols for breaking bad news (BBN) is scarce in Nigeria. We assessed the training; experience and perceived competence of BBN among medical personnel in southwestern Nigeria. Materials and Methods: The study was a cross-sectional descriptive study conducted out among doctors and nurses in two healthcare institutions in southwestern Nigeria using an anonymous questionnaire (adapted from the survey by Horwitz et al.); which focused on the respondents training; awareness of protocols in BBN; and perceived competence (using a Five-Point Likert Scale) in five clinical scenarios. We equally asked the respondents about an instance of BBN they have recently witnessed. Results: A total of 113 of 130 selected (response rate 86.9) respondents were studied. Eight (7.1) of the respondents knew of the guidelines on BBN in the hospital in which they work. Twenty-three (20.3) respondents claimed knowledge of a protocol. The median perceived competence rating was 4 out of 5 in all the clinical scenarios. Twenty-five (22.1) respondents have had a formal training in BBN and they generally had significant higher perceived competence rating (P = 0.003-0.021). There is poor support from fellow workers during instances of BBN. Conclusion: It appears that the large proportion of the respondents in this study were unconsciously incompetent in BBN in view of the low level of training and little or no knowledge of well known protocols for BBN even though self-rated competence is high. Continuous medical education in communication skills among health personnel in Nigeria is advocated

Communication training for centre-based carers of children with severe or profound disabilities in the Western Cape, South Africa

The purpose of this paper is to provide a preliminary, qualitative review of an approach to training centre-based carers in supporting basic communication development and providing communication opportunities for the children with severe and profound disabilities in their care. In South Africa, these children are often the most neglected in terms of planning and providing appropriate interventions. For those with severe communication disabilities, an additional lack is in the area of the basic human right to meaningful interactions and communication. Sustainable strategies to provide opportunities for basic communication development of these children are urgently sought. Several effective international and local parent training programmes have been developed, but the urgent need remains to train centre-based carers who are taking care of groups of diversely disabled children in severely under-resourced settings. Non-profit organisations (NPOs) have been exploring practical centre-based approaches to skills sharing in physical rehabilitation, activities for daily living, feeding and support for basic communication development. As a freelance speech therapist contracted by four NPOs to implement hands-on training in basic communication for centre-based carers of non-verbal children, the author describes a training approach that evolved over three years, in collaboration with the carers and centre managements. Implications for training (for speech therapists and for community-based rehabilitation workers) and for further research are identified

Motor Neuron Disease: The Impact of Decreased Speech Intelligibility on Marital Communication

Background: The onset of motor neuron disease (MND); a neurodegenerative disease; results in physical and communication disabilities that impinge on an individual's ability to remain functionally independent. Multiple aspects of the marital relationship are affected by the continuously changing roles and responsibilities. Communication is one of the most constructive ways of dealing with emotions that are elicited by these changes. decreased speech intelligibility; the relationship between the deteriorating speech and the couples' perception of marital communication was not statistically significant.Conclusion: Overall; the results proved that the supposition that communication between couples will invariably deteriorate as a result of progressively reduced speech intelligibility is not necessarily valid. The fundamental importance of effective communication in marriage is highlighted. It is well established that augmentative and alternative communication strategies can preserve the ability to develop and maintain intimate rewarding relationships; even in the face of profound physical disabilities. Method: This study explored the association between the deteriorating speech of persons with MND and couples' perception of marital communication. Fourteen couples participated in this non-experimental correlational research study. Data were collected over a 12-month period through the administration of objective and subjective measures.Results: Results showed that despite

Predictors of Parent-Child Communication among a Nationally Representative Sample in Nigeria

This study explores what constructs are associated with parent-adolescent communication about AIDS/sexually transmitted infections (STIs) and sexual relationships in Nigeria. The analyses use data from the 2007 National HIV/AIDS and Reproductive Health Survey on 2593 men and women who had at least one child over the age of 12 years. The respondents were classified as low; medium; or high communicators. Low communicators were parents who did not talk to their child about either AIDS/STIs or sexual relationships. Medium communicators were parents who discussed only one topic with at least one child. High communicators were parents who discussed both topics with at least one child. Logistic regression was used to compare high communicators with low/medium communicators. There are commonalities and differences among men andwomen in the factors associated with parent-adolescent communication. Age; religion; and knowing where to obtain information about HIV/AIDS were associated with the extent of communication; regardless of the parent's gender. Perceived social support was an important correlate for fathers; while knowledge of female STI symptoms showed a significant association only for mothers. Programmatic and communication implications of the findings include addressing men and women differently; developing strategies to specifically reach younger parents and Muslims; and increasing general awareness of HIV/AIDS information resources. Further research is needed to understand the context; content; and timing of parent-adolescent conversations about AIDS/STIs and sexual relationships and how these factors affect the sexual behaviors of adolescents