We were unable to show that facility-based MSGs improved retention in care at 12 months among HIV-exposed infants. Selective enrollment of mothers more likely to be retained-in-care may have contributed to lack of effect. Methods to increase the impact of MSGs on retention including targeting of high-risk mothers are discussed.

The article explores the link between trauma and spirituality, and investigates whether and how spirituality can be used as a resource to address the needs of people in traumatic situations. The authors address the following questions: Why is it that spirituality and God himself may seem to make little or no sense to people who are experiencing trauma? Is spirituality an abstract concept that lacks practical relevance in crisis situations? Do peoples’ understanding of God and what they believe about his nature and power affect their spirituality and determine how they understand God’s intervention in coping with trauma? To answer these questions, the authors make use of the life history research method to analyse the case of Nokwazi Chiya, a Zulu woman who abandoned God and all spiritual support systems after the traumatic death of her fiancé. The findings demonstrate how traumatic events destroy not only the psychosocial aspects, but also the survivor’s faith in a natural or divine order and cast the survivor into a state of existential crisis. The findings further show the role spirituality plays in enhancing the healing, recovery and developing resilience of trauma survivors. The study subsequently argues for an integrated approach to working through trauma, which brings spirituality into the psychotherapeutic dialogue – particularly in the South African context, where the majority of the population is exposed to various types of trauma. This integrated psychotherapy approach will have implications for the disciplines of practical theology and psychology or psychiatry, especially with regard to how we understand, assess and treat the needs of different people exposed to trauma and other existential crises.

The role of communities in health care has gained prominence in the last few years. Churches as community structures have been identified as instrumental in health-care delivery. Whilst it is widely acknowledged that churches provide important health services, particularly in countries where there are poorly-developed health sectors, the role of churches in health care is poorly understood and often overlooked. This article discusses some causes of this lacuna and makes suggestions for repositioning churches for a meaningful contribution to health care. Firstly, the article provides a context by reviewing literature on the church and health care. Secondly, it clarifies the nature of interventions and the competencies of churches. Thirdly, it discusses the operational meaning of church and churches for assessing health-care contributions. Fourthly, it explores the health-care models that are discerned in church and health-care literature. Fifthly, it discusses the contribution of churches within a multidisciplinary health team. Sixthly, it proposes an appropriate motivation that should drive churches to be involved in health care and the ecclesiological design that underpins such health care interventions.

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The extended family (community) in Africa plays a crucial role in the process of healing. However, while the role of the community is invaluable, many scholars overlook its other side. This article argues for a critical consideration of the healing role of the community in Africa and offers a critique of African community healing in the light of pastoral healing. Pastoral healing as a spiritual and faith perspective is juxtaposed with the healing process within African traditional communities. Since these two communities operate from different perspectives, in many cases they are competing forces in the process of healing – a difference that aggravates pain. This article thus carefully describes the process of healing both within a faith community (with its acts of “koinonia”) and the African traditional community, and concludes by proposing a healthy integration of these systems.