Neonatal Cleft Lip Repair in Babies with Breastfeeding Difficulties at Polokwane Mankweng Hospital Complex

Background. A cleft lip (CL) is a congenital abnormality resulting from failure of union of the medial and nasal prominences with the maxillary prominence during embryonic development. CL may be classified as incomplete; complete; unilateral; bilateral or median. It may be associated with a cleft alveolus or a cleft palate. Definitive correction of a cleft lip is by surgery. In most African settings; the birth of a cleft lip and cleft palate (CLP) baby is associated with witchcraft and ancestral spirits. The parents; particularly mothers; are stigmatised.Objective. To repair CLs in neonates with difficulties in breastfeeding. Methods. Non-syndromic term neonates referred to Polokwane Mankweng Hospital Complex (PMHC) from primary and secondary hospitals with CLP and difficulties in breastfeeding were prospectively admitted to the neonatal unit. Our breastfeeding team supervised and assisted them with breastfeeding. The neonates whose breastfeeding was found to be unsatisfactory were considered for neonatal CL repair.Those who breastfed adequately were booked for later lip repair as per the rule of tens and discharged.Results. From June 2009 to March 2012; 60 children with CLP were referred to PMHC; including 36 neonates. Of these; 23 neonates were unable to breastfeed satisfactorily and were operated at a median age of 9 (range 3 - 28) days. The median weight was 2.8 (1.8 - 3.7) kg. The median haemoglobin was 13.1 (11.5 - 16) g/dL. Conclusion. Neonatal CL repair is an alternative for those with breastfeeding difficulties. Eagerness to breastfeed increased following the lip repair with subsequent improvement in maternal confidence and interaction with the baby. At follow up; weight gain was above the 50th centile on the road to health charts. Early surgery prevents exposure of CL to the public with highly positive possible outcome of decreasing the potential for stigmatisation

Community perception of quality of (primary) health care services in a rural area of Limpopo Province, South Africa: a qualitative study.

The aim of the study was to survey perceptions of quality of (primary) health care services provided in rural communities in the Limpopo province. Ten focus groups discussions were held with community members chosen by convenience from public places from four villages in the central region of the Limpopo Province. The sample included 42 women and 34 men (76 participants). Results indicated perceived quality discussed within the following categories: (1) conduct of staff (reception, communication, discrimination, care and compassion, respect for privacy), (2) technical care (examination, explanation of treatment, responsiveness, treatment outcomes), (3) health care facility, (4) health care organisation, (5) drugs (availability, explanation, effectiveness, payment), and (6) waiting time. The findings suggest some satisfaction with free basic and preventive health care and social services provided but there is a need to look closely into the interpersonal dimension of the services provided, provision of medication with adequate explanation to patients on the medication given, and on structural aspects, there is need for the government to give support to the clinics to provide adequate services. Improving drug availability, interpersonal skills (including attitudes towards patients) and technical care have been identified as the three main priorities for enhancing perceived quality of primary health care and health policy action.

Weight and health status of black female students.

OBJECTIVE: To examine black female students for the occurrence of risk factors associated with chronic diseases of lifestyle, namely obesity, hypertension, nicotine usage, dyslipidaemia and compromised mental health (depression). DESIGN: A cross-sectional analytical study design was used. All participants were examined within a period of 3 months during 1994. Weight, height, and hip and waist measurements were taken. Body mass index (BMI), waist-hip ratio (WHR) and waist circumference (WC) were calculated for each subject. Two systolic and diastolic blood pressure readings were taken for each participant. Questionnaires were used to determine specific risk factors related to lifestyle. The Beck Depression Inventory (BDI) was used to measure psychological well-being. Fasting blood samples were collected and analysed for serum lipids and iron status. SETTING: The University of the North in the Northern Province of South Africa. SUBJECTS: A complete data set of sociodemographic information, anthropometric measurements and blood pressure readings, as well as a psychological health test and a medical questionnaire, were obtained from 231 of the 431 first-year female students who attended the university orientation programme. Only students with a complete data set were included in the sample. RESULTS: Eighteen per cent of students were overweight (BMI 25-29.9), 6.5% were obese (BMI > or = 30), and 26.8% were underweight. Mean blood pressure, BMI, WHR and WC increased significantly with age and were highest among the > or = 24-year-olds. Only 1.6% of students had elevated blood pressure, 1.0% smoked and 4.4% took snuff. BMI, WC and WHR were positively correlated with blood pressure and age. Few students had dyslipidaemia (3.8% cholesterol > 5.2 mmol/l). However 14.5% were anaemic (Hb < 11.5 g/dl) and 24.6% had microcytosis (< 80 fl). Nearly one-fifth of students (17.7%) were classified as being moderately to severely depressed. CONCLUSIONS: Black female students younger than 24 years exhibited few risk factors associated with chronic diseases of lifestyle. However in older women (> or = 24 years) there were significant increases in BMI, WHR, WC and blood pressure. A large number of students of all ages exhibited moderate to severe depression and anaemia was prevalent.