Exploring service providers’ perspectives on the prevention and management of fetal alcohol spectrum disorders in South Africa: a qualitative study

Mukumbang

Cloete

et al. 2019

IJERPH

Self Cite

Fetal alcohol spectrum disorder (FASD) has a high prevalence in South Africa, especially among the poor socioeconomic communities. However, there is no specific policy to address FASD. Using a qualitative study design, we explored the perspectives of policymakers on guidelines/policies for FASD, current practices and interventions, and what practices and interventions could be included in a policy for FASD. The data analysis was done using the Framework Method. Applying a working analytical framework to the data, we found that there is no specific policy for FASD in South Africa, however, clauses of FASD policy exist in other policy documents. Preventive services for women and screening, identification, assessment, and support for children are some of the current practices. Nevertheless, a multi-sectoral collaboration and streamlined program for the prevention and management of FASD are aspects that should be included in the policy. While there are generic clauses in existing relevant policy documents, which could be attributed to the prevention and management of FASD, these clauses have not been effective in preventing and managing the disorder. Therefore, a specific policy to foster a holistic and coordinated approach to prevent and manage FASD needs to be developed.

Section: Discussionmentioning

confidence: 67%

Policymakers’ Perspectives Towards Developing a Guideline to Inform Policy on Fetal Alcohol Spectrum Disorder: A Qualitative Study

Mukumbang

Cloete

et al. 2019

IJERPH

Self Cite

“…However, we cannot categorically say that this increase in consideration has translated to an improvement in service delivery. Services are still generic in nature with gaps in policy [18, 21, 42], particularly those involving the coordination of services, communication and collaboration among departments, as previously reported [17, 19]. Therefore, we believe that developing a multi-sectoral policy for FASD could improve communication and collaboration among the relevant departments and, consequently, the coordination of FASD-related services.…”

Section: Discussionmentioning

confidence: 78%

“…Some of the prevention strategies identified in the policy documents were efforts proposed to reduce accessibility and availability of alcohol [21]. These exertions include banning alcohol advertisement, increasing the legal drinking age, regulating alcohol trading hours and liquor outlets, and enforcement of liquor laws.…”

Section: Discussionmentioning

confidence: 99%

“…Developing a policy document is an indication of the government’s acknowledgment of a dilemma and acts as a response in the form of an action plan or a strategy to address a specific problem. The policy document usually contains stipulations on the allocation of resources, the timeframe for action and the framework for implementation [17–21]. The development of a National Strategy for HIV, tuberculosis and sexually transmitted infections is a good example of the importance of a policy document in South Africa [22–25].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

To what extent is Fetal Alcohol Spectrum Disorder considered in policy-related documents in South Africa? A document review

Mukumbang

Beytell

2019

Health Res Policy Sys

Self Cite

Background South Africa is considered to have the highest prevalence of fetal alcohol spectrum disorder (FASD) globally. Nevertheless, the extent to which the South African government has responded to the high FASD prevalence at the policy level is unclear. Herein, we aimed to identify targeted and generic clauses that could be attributed to the prevention and management of FASD in relevant South African policy documents. Methods We conducted a search of two search engines (PubMed and Google) and the websites of South African national and provincial departments from January to April 2018. A total of 33 policy documents were included in this review. Using content analysis, we sought documents that mention the terms ‘fetal alcohol syndrome’ and ‘fetal alcohol spectrum disorder’. The Framework method was also used to thematically identify specific and generic clauses attributed to the prevention and management of FASD in South Africa. Results The content analysis indicated that 12 policy documents contained the searched terms. Findings from the thematic analysis showed that targeted and generic clauses for FASD exist in various policy documents. Some of the generic clauses focused on the regulation of liquor outlets, enforcement of liquor laws, and the general management of persons with mental and educational challenges. Specific clauses focused on creating platforms to improve the awareness, screening, identification and support for individuals with FASD. Conclusions There is a noticeable increase in the number of policy documents that considered elements of FASD enacted in the last decade. Although this study revealed the existence of targeted and generic clauses that could be attributed to the prevention and management of FASD, the sustained high prevalence of FASD in South Africa, as reported in the literature, calls for more holistic and comprehensive approaches to tackle the FASD problem in South Africa. Electronic supplementary material The online version of this article (10.1186/s12961-019-0447-9) contains supplementary material, which is available to authorized users.

“…In this study, the Arksey and O'Malley (2005) framework for conducting scoping reviews was adopted [2]. This framework was considered appropriate for the aim of our study, and has been used in other studies [19,20].…”

Section: Methodsmentioning

confidence: 99%

Investigating the resurgence of malaria prevalence in South Africa between 2015 and 2018: A scoping review

Abiodun

Abiodun

et al. 2019

Preprint

Background Malaria remains a serious concern in most African countries, causing nearly one million deaths globally every year. The review aims to examine the extent and nature of the resurgence of malaria prevalence in South Africa.Method Using the Arksey and O'Malley framework, this scoping review included articles published between the year 2015 and 2018 on the resurgence of malaria prevalence in South Africa. Articles were searched from October 2018 to January 2019 using these electronic databases: CINAHL, Pubmed, Science Direct and SCOPUS. Grey literature from Google Scholar was also hand searched. Key search terms and subject headings such as climate variables; climate changes; climatic factors; malaria resurgence; malaria reoccurrence, and malaria increase over epidemic regions in South Africa were used to identify relevant articles. Articles for selection and characterization were performed by three independent reviewers. Data collected were synthesized qualitatively.Results A total number of 748 studies were identified. Among these, 24 studies met the inclusion criteria. The results were grouped by factors (four main themes) that influenced the malaria resurgence: Climatic, Epidemiological, Socio-economic, and Environmental factors. Climatic factors were found to be the major factor responsible for the resurgence of malaria, as more than 55% of the selected articles were climate focused. This was followed by epidemiological, socio-economic and environmental factors, in that order. Grey literature from Google Scholar yielded no results.Conclusion This study shows that malaria transmission in South Africa is more associated with climate. Climate-based malaria models could be used as early warning systems of malaria over the epidemic regions in South Africa. Since epidemiological factors also play significant roles in the transmission, regular and unrelaxed use of indoor residual spraying (IRS) should be encouraged in these regions. While some studies have indicated that vectors have developed resistance to insecticides, continuous research on developing new insecticides that could alter the resistance are ongoing. Individuals should also be educated on the importance and the usefulness of these deliveries. Furthermore, all efforts to eradicate malaria in South Africa must also target the epidemic neighbouring countries.