A5087755481- Global Maternal and Child Health
- HIV/AIDS Research and Interventions
- Child Nutrition and Water Access
- Breastfeeding Practices and Influences
- Adolescent Sexual and Reproductive Health
- HIV/AIDS Impact and Responses
- Poverty, Education, and Child Welfare
- Child and Adolescent Health
- Global Health Workforce Issues
- Child Nutrition and Feeding Issues
- Healthcare Systems and Reforms
- Food Security and Health in Diverse Populations
- HIV-related health complications and treatments
- HIV, Drug Use, Sexual Risk
- Primary Care and Health Outcomes
- Global Public Health Policies and Epidemiology
- Vaccine Coverage and Hesitancy
- Infant Nutrition and Health
- Employment and Welfare Studies
- Health Policy Implementation Science
- Birth, Development, and Health
- Healthcare Policy and Management
- Interprofessional Education and Collaboration
- Mobile Health and mHealth Applications
- Chronic Disease Management Strategies
South African Medical Research Council
2016-2025
University of Cape Town
2018-2025
University of the Western Cape
2016-2025
University of the Witwatersrand
2014-2023
University of Zambia
2022
Office of Adolescent Health
2020
World Health Organization
2019
South African Tuberculosis Vaccine Initiative
2018
Medical Research Council
2007-2013
Uppsala University
2006-2010
To investigate the feasibility, ease of implementation, and extent to which community health workers with little experience data collection could be trained successfully supervised collect using mobile phones in a large baseline surveyA web-based system was developed allow electronic surveys or questionnaires designed on word processor, sent to, conducted standard entry level phones.The interface permitted comprehensive daily real-time supervision CHW performance, no loss. The early...
Objective To explore how the human immunodeficiency virus (HIV) epidemic has affected infant-feeding experiences of HIVpositive mothers in South Africa.Methods This was a qualitative interview study within prospective cohort study.We purposively selected subsample 40 women from larger 650 HIV-positive for in-depth interviews.Findings The HIV changed context which choices are made and implemented.HIV-positive this -who were predominantly young, single unemployed -were struggling to protect...
The World Health Organization has produced clear guidelines for the prevention of mother-to-child transmission (PMTCT) human immunodeficiency virus (HIV). However, ensuring that all PMTCT programme components are implemented to a high quality in facilities presents challenges.Although South Africa initiated its 2002, later than most other countries, political support increased since 2008. Operational research received more attention and objective data have been used effectively.In 2010,...
Abstract Aim: To assess the quality of counselling provided to mothers through programme prevent mother-to-child transmission (PMTCT) HIV in South Africa. Methods: Structured observations consultations and exit interviews with 60 attending clinics at three purposively selected PMTCT sites across Africa were conducted. Results: Twenty-two counsellors observed. The general communication skills was very good, 73% HIV-negative informed advantages exclusive breastfeeding (EBF). However, only one...
Background: The World Health Organization (WHO) and UNICEF recommend that HIV-positive women should avoid all breastfeeding only if replacement feeding is acceptable, feasible, affordable, sustainable safe. Little known about the effectiveness of implementation these guidelines in developing country settings. Objective: To identify criteria to guide appropriate infant-feeding choices assess effect inappropriate on infant HIV-free survival. Method: Prospective cohort study 635 mother–infant...
Despite several years of implementation, prevention mother-to-child transmission (PMTCT) programmes in many resource poor settings are failing to reach the majority HIV positive women. We report on a data driven participatory quality improvement intervention implemented high prevalence district South Africa. A was consisting an initial assessment undertaken by team supervisors, workshops assess results, identify weaknesses and set targets continuous monitoring support changes. The...
Breastfeeding is a critical component of interventions to reduce child mortality. Exclusive breastfeeding practice extremely low in South Africa and there has been no improvement this over the past ten years largely due fears HIV transmission. Early cessation found have negative effects on morbidity survival several studies Africa. This paper reports determinants early among women sub group analysis community-based cluster-randomized trial (PROMISE EBF) promoting exclusive three African...
The World Health Organization released revised principles and recommendations for HIV infant feeding in November 2009. are based on programmatic evidence research studies that have accumulated over the past few years within African countries. This document urges national or subnational health authorities to decide whether services should mainly counsel support HIV-infected mothers breastfeed receive antiretroviral interventions, avoid all breastfeeding, estimations of which strategy is...
Background There is a paucity of data on the national population-level effectiveness preventing mother-to-child transmission (PMTCT) programmes in high-HIV-prevalence, resource-limited settings. We assessed PMTCT impact South Africa (SA), 2010. Methods A facility-based survey was conducted using stratified multistage, cluster sampling design. nationally representative sample 10 178 infants aged 4–8 weeks recruited from 565 clinics. Data collection included caregiver interviews, record...
Objectives To evaluate prevention of mother to child transmission HIV (PMTCT) implementation and integration PMTCT with routine maternal health services in two districts KwaZulu-Natal; report coverage, compare recorded reported information, describe responsibilities nurses lay counsellors. Methods Interviews were conducted mothers post-natal wards (PNW) immunisation clinics; antenatal records reviewed. counsellors primary care clinics. Results Eight hundred eighty-two interviews mothers: 398...
Sohni Dean and colleagues report their CHNRI exercise that developed health research priorities for effective pre-conception care in low- middle-income countries. Please see later the article Editors' Summary
<b>Objective</b> To assess the effect of home based HIV counselling and testing on prevalence reported behavioural changes in a rural subdistrict South Africa. <b>Design</b> Cluster randomised controlled trial. <b>Setting</b> 16 communities (clusters) uMzimkhulu subdistrict, KwaZulu-Natal province, <b>Participants</b> 4154 people aged 14 years or more who participated community survey. <b>Intervention</b> Lay counsellors conducted door to outreach offered all consenting adults adolescents...
Abstract Background Progress towards MDG 4 for child survival in S outh A frica requires effective prevention of mother‐to‐child transmission ( PMTCT ) HIV including increasing exclusive breastfeeding, as well a new focus on reducing neonatal deaths. This necessitates increased the pregnancy and early post‐natal periods, developing scaling up appropriate models community‐based care, especially to reach peri‐urban poor. Methods We used randomised controlled trial with 30 clusters (15 each...
We sought to investigate infant feeding practices amongst HIV-positive and -negative mothers (0-9 months postpartum) describe the association between HIV-free survival. Infant data from a prospective observational cohort study conducted at three (of 18) purposively-selected routine South African PMTCT sites, 2002-2003, were analysed. (previous 4 days) gathered during home visits 3, 5, 7, 9, 12, 16, 20, 24, 28, 32 36 weeks postpartum. Four groups of interest, namely exclusive breastfeeding,...
Objectives We examined uptake of prevention mother-to-child HIV transmission (PMTCT) services, predictors missed opportunities, and infant attributable to opportunities along the PMTCT cascade across South Africa. Methods A cross-sectional survey was conducted among 4–8 week old infants receiving first immunisations in 580 nationally representative public health facilities 2010. This included maternal interviews testing infants' dried blood spots for HIV. weighted analysis performed assess...
Efforts to increase awareness of HIV status have led growing interest in community-based models testing. Maximizing the benefits such programmes requires timely linkage care and treatment. Thus, an understanding its potential barriers is imperative for scale-up. This study was conducted rural South Africa. HIV-positive clients (n=492) identified through home-based counselling testing (HBHCT) were followed up assess care, defined as obtaining a CD4 count. Among 359 eligible clients, we...
For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality care is challenging. This often complicated by clinical guidance that out of date, inconsistent and informed evidence from high-income countries ignores LMIC resource constraints burden disease. The Knowledge Translation Unit (KTU) University Cape Town Lung Institute has developed, implemented evaluated systems intervention South Africa, localised it to Botswana, Nigeria, Ethiopia Brazil,...
Population-level effectiveness of PMTCT Option A on early mother-to-child (MTCT) transmission HIV in South Africa: implications for eliminating MTCT Background Eliminating (EMTCT), defined as ≤50 infant infections per 100 000 live births, is a global priority.Since 2011 policies to prevent (PMTCT) shifted from maternal antiretroviral (ARV) treatment or prophylaxis contingent CD4 cell count lifelong ARV (cART).We sought measure progress with (4-8 weeks postpartum) prevention and elimination,...
Disrespect and abuse in maternity services South Africa has been described over several decades are rooted the country's complex socio-political landscape unequal health system which places strain on public sector professionals. Strategies to improve quality of care typically involve once-off didactic teaching or outside technical consultants focused improving specific programmes. These approaches fail encourage self-reflection establish learning cultures. Participatory processes, embedded...
It is three years since the government of South Africa began implementing a PMTCT programme. Over this period time attempts have been made to scale up programme across all provinces under routine health service conditions.To report on uptake and performance Africa's national pilot for preventing mother child HIV transmission (PMTCT) identify system constraints optimal coverage.Routine data were collected from antenatal records delivery registers at sites interviews conducted with workers...
This community situational analysis determined factors impacting the utilization of maternal health services in South Africa. Quantitative and qualitative research methods were used, including semistructured household interviews, case studies women with no antenatal care and/or home birth, verbal/social autopsies infant deaths, conducted three diverse sites across country. Data used quantitative statistics for interviews a thematic content approach autopsies. Each component was analyzed...
Objective: Previous studies on the operational effectiveness of programmes to reduce transmission HIV from mother-to-child (PMTCT) in Africa have generally been hospital-based pilot with short follow-up periods. Method: Prospective cohort study evaluate routine South African National PMTCT Programme, primarily measured by HIV-free survival at 36 weeks post-delivery. Three eighteen sites participating programme were selected as they reflected differences circumstances, such prevalence,...