Background: Community health workers (CHWs) are a component of the system in many countries, providing effective community-based services to mothers and infants. However, implementation CHW programmes at scale has been challenging settings.Aim: To explore acceptability CHWs conducting household visits infants during pregnancy after delivery, from perspective community members, professional nurses themselves.Setting: Primary care clinics five rural districts KwaZulu-Natal, South...

Exclusive breastfeeding (EBF) for the first six months of life is most important determinant child health and development, recommended feeding practice all mothers. However, EBF rates remain low in South Africa. This study aimed to prospectively explore enablers or barriers success among mothers who planned exclusively breastfeed their infants life, KwaZulu-Natal, Africa.A qualitative, longitudinal cohort design was adopted. Women were recruited during pregnancy from catchment area two...

Electronic decision-making support systems (CDSSs) can clinicians to make evidence-based, rational clinical decisions about patient management and have been effectively implemented in high-income settings. Integrated Management of Childhood Illness (IMCI) uses algorithms provide guidelines for sick children primary health care clinics is widely low income countries. A CDSS based on IMCI (eIMCI) was developed South Africa.We undertook a mixed methods study prospectively explore experiences...

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...

Background: Surveillance programmes for prevention of mother-to-child transmission HIV (PMTCT) fail to quantify numbers infant infections averted, often because poor postnatal follow-up. Additionally, infected infants are not identified early and only gain access comprehensive care treatment late in their disease. Methods: Anonymous, unlinked, prevalence testing was conducted on dried blood spot (DBS) samples from all attending 6 week immunization clinics at seven primary health offering...

Integrated Management of Childhood Illness (IMCI) is a strategy to reduce mortality and morbidity in children under 5 years by improving case management common serious illnesses at primary health care level, was adopted South Africa 1997. We report an evaluation IMCI implementation two provinces Africa.Seventy-seven trained workers were randomly selected observed 74 facilities; 1357 consultations between May 2006 January 2007. Each worker for up 20 with sick presenting consecutively the...

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...

Community health workers (CHWs) play key roles in delivering programmes many countries worldwide. CHW can improve coverage of maternal and child services for the most disadvantaged remote communities, leading to substantial benefits mothers children. However, there is limited evidence effective mentoring supervision approaches CHWs. This a cluster randomised controlled trial investigate effectiveness continuous quality improvement (CQI) intervention amongst CHWs providing home-based...

Rates of pregnancy and HIV infection are high among South African adolescents, yet little is known about rates mother-to-child transmission (MTCT) in this group. We report a comparison the characteristics adolescent mothers adult mothers, including prevalence MTCT rates.We examined patterns health service utilization during antenatal early postnatal period, amongst (<20-years-old) (20 to 39-years-old) with infants aged ≤16 weeks attending immunization clinics six districts KwaZulu-Natal...

Increasing the rate of exclusive breastfeeding (EBF) to 50% in first six months life is one major global targets set by United Nations Decade Nutrition, and essential achieve sustainable development goals eradicate hunger end malnutrition 2030. A survey using multistage random sampling design included 99 primary health care (PHC) clinics all 11 districts KwaZulu-Natal (KZN). All mothers caregivers infants 14 weeks age attending study period were requested participate a structured interview...

Integrated Management of Childhood Illness (IMCI) is a strategy to reduce mortality and morbidity in children under-5 years by improving management common illnesses at primary level. IMCI has been shown improve health worker performance, but constraints have identified achieving sufficient coverage child survival, implementation remains sub-optimal. At the core clinical guideline whereby workers use series algorithms assess manage sick child, give counselling carers. taught using structured...

Community health workers (CHWs) provide maternal and child services to communities in many low middle-income countries, including South Africa (SA). CHWs can improve access important interventions for isolated vulnerable communities. In this study we explored the performance of providing at household level quality CHW-mother interaction. A qualitative design was employed using observations in-depth interviews explore content interactions, experiences perceptions mothers CHWs. Fifteen 30...

There is a high global burden of neonatal mortality, with many newborn babies dying preventable and treatable conditions, particularly in low middle-income countries. Improving quality care could save the lives thousands babies. Quality (QoC) complex multifaceted construct that difficult to measure, but patients' experiences are an important component any measurement QoC. We report findings qualitative study exploring observations health workers (HWs) mothers units South Africa.A case...

Abstract Background Worldwide, over 740 million women make their living in the informal economy and therefore lack formal employment benefits, such as maternity leave, that can improve infant feeding practices. Returning to work is one of biggest challenges face maintaining breastfeeding. This study aimed explore attitudes perceptions towards breastfeeding environment among male female workers. Methods The used a qualitative research design. Purposive snowball sampling was employed. Focus...

Although women working in the informal economy are a large and vulnerable group, little is known about infant feeding childcare practices among these women. The aim of this study was to explore mothers work.

Abstract Background The child support grant (CSG) is the largest unconditional cash transfer program in Africa and aims to alleviate poverty improve health nutrition low-income families South Africa. Among informal working women, CSG an important source of income after childbirth when workers are unable work, but reports suggest that women experience delays accessing CSG. We explore experiences challenges among Durban, Methods undertook a longitudinal mixed-methods cohort study. Women were...

Achieving long-term retention in HIV care is an important challenge for management and achieving elimination of mother-to-child transmission. Sustainable, affordable strategies are required to achieve this, including strengthening community-based interventions. Deployment health workers (CHWs) can improve outcomes but there a need identify systems support maintain high-quality performance. Quality-improvement have been successfully implemented quality coverage healthcare facilities could...

The nutritional status of infants born to teenage mothers can be sub-optimal compared those older mothers. One contributing factor is inappropriate feeding practices adopted by Little known about how infant decisions are made among mothers, particularly in under resourced settings. In this study we prospectively explored autonomy and decision-making a rural urban setting KwaZulu-Natal, South Africa. This qualitative longitudinal design. Thirty pregnant participants were recruited the cohort,...

A nutritious and healthy diet during pregnancy is essential for the health of both mother baby. Inadequate dietary intake contributes to maternal malnutrition can have lifelong effects on child. Maternal common in many low-income countries, including Democratic Republic Congo (DRC). Kwango province, DRC, has a high prevalence among all population groups, macro micronutrient deficiencies pregnant women. The study aimed explore knowledge practices woman this area.This adopted qualitative...

Abstract Background Electronic clinical decision-making support systems (eCDSS) aim to assist clinicians making complex patient management decisions and improve adherence evidence-based guidelines. Integrated of Childhood Illness (IMCI) provides guidelines for sick children attending primary health care clinics is widely implemented globally. An electronic version IMCI (eIMCI) was developed in South Africa. Methods We conducted a cluster randomized controlled trial comparing with eIMCI the...