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Postnatal mental distress is a public health problem and women screening positive of psychological distress who do not meet the diagnostic criteria for psychiatric disorder may be experiencing significant distress for which they might require assistance from mental health personnel. The risk of a woman experiencing psychological distress during the postnatal period can be predicted before it occurs. The study included 300 pregnant women who were selected systematically and on whom two assessments were conducted at two different points. The first assessment was conducted at 32-week gestation while the second one at six weeks following childbirth. The participants were assessed using the Edinburgh Postnatal Depression Scale (EPDS) and the General Health Questionnaire (GHQ-12). Analysis of Variance (ANOVA) was used to test the association between the EPDS and the GHQ-12 while logistic regression analysis was carried out in order to predict postnatal psychological distress. The results showed no significant difference between the socio-demographic characteristics and the EPDS score. A significant association was found between the GHQ-12 and EPDS scores (r = 0.545; p = 0.001). Logistic regression revealed that a single predictor, antenatal EPDS individual score, alone provided a highly adequate model and was statistically reliable in distinguishing between presence and absence of psychological distress in the postnatal period (−2 log likelihood = 225.634; CI (1.035 -1.173); X2 (1) 9.633, p = 0.002). The study revealed a correlation between EPDS score and GHQ-12 and that the EPDS can predict postnatal psychological distress using the data from the antenatal period. Therefore, patients who are found with antenatal psychological distress should be consistently evaluated throughout pregnancy and during the postnatal period to allow for early detection and intervention of postnatal psychological distress.

Introduction: Studies in mental health care for low-resource settings indicate that providing services at the primary care level would significantly improve the provision utilization of mental health services. Challenges related to inadequate funding were noted as significant barriers to service provision, with the contribution of low knowledge of mental health conditions and stigma in the community. Objective: This study aimed to assess and explore health-seeking behaviors and their associated factor at Chainama Hills College Hospital (CHCH), Lusaka, Zambia. The study was conducted at CHCH on clients and/or their caregivers receiving and accessing in- and outpatient (OPD) alcohol and drug detoxification and rehabilitation services at CHCH. 79 participants took part in the study taking into consideration all ethical issues. Methodology: Data was collected using the structured questionnaire administered to 79 participants and primary caregivers. Qualitative data was collected using in-depth interviews captured using the digital recorder. The quantitative data were analyzed using SPSS software and the digitally recorded responses for qualitative data were transcribed and analyzed using thematic analysis. Results: Factors influencing health-seeking behavior were related to health systems, socio-cultural, socioeconomic, and individual factors. The main system issues were related to the availability and attitudes of staff and the shortage of supplies and medicines. Conclusion: The engagement of community health workers and increasing efforts to sensitize the community about mental health would prove beneficial. Strengthening the community health systems for mental health could improve access and increase the utilization of services.

Evidence-Based Practice (EBP) in health is important for patient safety and quality care while Critical Thinking (CT) is a vital prerequisite to evidence based nursing. Despite their importance, in some settings neither EBP nor CT is taught assessed or implemented. This scoping review examined literature related to teaching, learning, assessment and implementation of EBP and application of CT by nursing students and graduates. Arksey and O'Malley framework was used to conduct the scoping review. PubMed, CINAHL, EMBASE and Joanna Briggs Institute for EBP data bases were searched for studies conducted between 2000 and 2020. Inclusion criteria were adapted from the -Population, Intervention, Professionals and Patients, Outcomes, Health Care settings (PIPOH) framework. Search terms included; evidence based practice, nursing education, nursing practice, critical thinking, methods, barriers, facilitators to teaching, learning, assessing and implementing EBP and CT. A total of 2,303 articles were retried, eventually 37 met the inclusion criteria. Use of non-traditional instructional methods for teaching EBP and CT were documented including Problem Based Learning, concept mapping, simulation, think aloud, critical incidence technique, debates and role-plays, reflective journaling, article analysis, nursing journal clubs and multidisciplinary clinical rounds. Validated tools for assessing EBP and CT Skills included; California Critical Thinking Skills Test, Upton and Upton 2006 EBP questionnaire and Yoon's 2004 Critical Thinking Disposition Inventory. Teaching, assessing EBP and applying CT skills is challenging. Therefore innovative teaching methods are required to promote learning while successful implementation require strategies to minimize detractors and sustain enablers of the process.

A number of scholars have reported high incidence of sexual abuse cases among children in the communities. However, little is known about the perceptions the community people have towards child sexual abuse cases. Therefore, this study aimed to explore the perception of the community towards child sexual abuse which hinders the disclosure and reporting of abuse cases. Data were collected through focused group discussions and indepth interviews, with sixty nine participants from nine (9) focused group discussions and nine (9) indepth interviews. Participants were the general community members and relatives to abused children. The interviews were recorded verbatim and transcribed; analysis of data was done using qualitative thematic analysis. Three themes emerged summarizing the factors associated with non-reporting of child sexual abuse cases which included, fear of family and community breakdown, relationship between the victim and the perpetrator and inadequate service provision by the police which also reflected the community's role in supporting the child. In conclusion the study therefore showed that child sexual abuse is common in Zambia and cases are still on the increase. However, there is great need to enforce laws regarding sexual abuse and in addition great change in attitude is needed to prevent occurrence of cases.