Browsing by Subject "Rural"

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    A mother’s choice: a qualitative study of mothers’ health seeking behaviour for their children with acute diarrhoea
    (BioMed Central, 2016-11-21) Cunnama, Lucy; Honda, Ayako
    Background: Diarrhoea presents a considerable health risk to young children and is one of the leading causes of infant mortality. Although proven cost-effective interventions exist, South Africa is yet to reach the Sustainable Development Goals set for the elimination of preventable under-five mortality and water-borne diseases. The rural study area in the Eastern Cape of South Africa continues to have a parallel health system comprising traditional and modern healthcare services. It is in this setting that this study aimed to qualitatively examine the beliefs surrounding and perceived quality of healthcare accessed for children’s acute diarrhoea. Methods: Purposive sampling was used to select participants for nine focus-group-discussions with mothers of children less than 5 years old and 11 key-informant-interviews with community members and traditional and modern practitioners. The focus-group-discussions and interviews were held to explore the reasons why mothers seek certain types of healthcare for children with diarrhoea. Data was analysed using manual thematic coding methods. Results: It was found that seeking healthcare from traditional practitioners is deeply ingrained in the culture of the society. People’s beliefs about the causative agents of diarrhoea are at the heart of seeking care from traditional practitioners, often in order to treat supposed supernatural causes. A combination of care-types is acceptable to the community, but not necessarily to modern practitioners, who are concerned about the inclusion of unknown ingredients and harmful substances in some traditional medicines, which could be toxic to children. These factors highlight the complexity of regulating traditional medicine. Conclusion: South African traditional practitioners can be seen as a valuable human resource, especially as they are culturally accepted in their communities. However due to the variability of practices amongst traditional practitioners and some reluctance on the part of modern practitioners regulation and integration may prove complex.
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    A mother’s choice: a qualitative study of mothers’ health seeking behaviour for their children with acute diarrhoea
    (2016) Cunnama, Lucy; Honda, Ayako
    Abstract Background Diarrhoea presents a considerable health risk to young children and is one of the leading causes of infant mortality. Although proven cost-effective interventions exist, South Africa is yet to reach the Sustainable Development Goals set for the elimination of preventable under-five mortality and water-borne diseases. The rural study area in the Eastern Cape of South Africa continues to have a parallel health system comprising traditional and modern healthcare services. It is in this setting that this study aimed to qualitatively examine the beliefs surrounding and perceived quality of healthcare accessed for children’s acute diarrhoea. Methods Purposive sampling was used to select participants for nine focus-group-discussions with mothers of children less than 5 years old and 11 key-informant-interviews with community members and traditional and modern practitioners. The focus-group-discussions and interviews were held to explore the reasons why mothers seek certain types of healthcare for children with diarrhoea. Data was analysed using manual thematic coding methods. Results It was found that seeking healthcare from traditional practitioners is deeply ingrained in the culture of the society. People’s beliefs about the causative agents of diarrhoea are at the heart of seeking care from traditional practitioners, often in order to treat supposed supernatural causes. A combination of care-types is acceptable to the community, but not necessarily to modern practitioners, who are concerned about the inclusion of unknown ingredients and harmful substances in some traditional medicines, which could be toxic to children. These factors highlight the complexity of regulating traditional medicine. Conclusion South African traditional practitioners can be seen as a valuable human resource, especially as they are culturally accepted in their communities. However due to the variability of practices amongst traditional practitioners and some reluctance on the part of modern practitioners regulation and integration may prove complex.
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    Access to health care for persons with disabilities in rural South Africa
    (2017) Vergunst, R; Swartz, L; Hem, K-G; Eide, A H; Mannan, H; MacLachlan, M; Mji, G; Braathen, S H; Schneider, M
    BACKGROUND: Global research suggests that persons with disabilities face barriers when accessing health care services. Yet, information regarding the nature of these barriers, especially in low-income and middle-income countries is sparse. Rural contexts in these countries may present greater barriers than urban contexts, but little is known about access issues in such contexts. There is a paucity of research in South Africa looking at "triple vulnerability" - poverty, disability and rurality. This study explored issues of access to health care for persons with disabilities in an impoverished rural area in South Africa. METHODS: The study includes a quantitative survey with interviews with 773 participants in 527 households. Comparisons in terms of access to health care between persons with disabilities and persons with no disabilities were explored. The approach to data analysis included quantitative data analysis using descriptive and inferential statistics. Frequency and cross tabulation, comparing and contrasting the frequency of different phenomena between persons with disabilities and persons with no disabilities, were used. Chi-square tests and Analysis of Variance tests were then incorporated into the analysis. RESULTS: Persons with disabilities have a higher rate of unmet health needs as compared to non-disabled. In rural Madwaleni in South Africa, persons with disabilities faced significantly more barriers to accessing health care compared to persons without disabilities. Barriers increased with disability severity and was reduced with increasing level of education, living in a household without disabled members and with age. CONCLUSIONS: This study has shown that access to health care in a rural area in South Africa for persons with disabilities is more of an issue than for persons without disabilities in that they face more barriers. Implications are that we need to look beyond the medical issues of disability and address social and inclusion issues as well.
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    Access to health care for persons with disabilities in rural South Africa
    (BioMed Central, 2017-11-17) Vergunst, R; Swartz, L; Hem, K.-G; Eide, A H; Mannan, H; MacLachlan, M; Mji, G; Braathen, S H; Schneider, M
    Background: Global research suggests that persons with disabilities face barriers when accessing health care services. Yet, information regarding the nature of these barriers, especially in low-income and middle-income countries is sparse. Rural contexts in these countries may present greater barriers than urban contexts, but little is known about access issues in such contexts. There is a paucity of research in South Africa looking at “triple vulnerability” – poverty, disability and rurality. This study explored issues of access to health care for persons with disabilities in an impoverished rural area in South Africa. Methods: The study includes a quantitative survey with interviews with 773 participants in 527 households. Comparisons in terms of access to health care between persons with disabilities and persons with no disabilities were explored. The approach to data analysis included quantitative data analysis using descriptive and inferential statistics. Frequency and cross tabulation, comparing and contrasting the frequency of different phenomena between persons with disabilities and persons with no disabilities, were used. Chi-square tests and Analysis of Variance tests were then incorporated into the analysis. Results: Persons with disabilities have a higher rate of unmet health needs as compared to non-disabled. In rural Madwaleni in South Africa, persons with disabilities faced significantly more barriers to accessing health care compared to persons without disabilities. Barriers increased with disability severity and was reduced with increasing level of education, living in a household without disabled members and with age. Conclusions: This study has shown that access to health care in a rural area in South Africa for persons with disabilities is more of an issue than for persons without disabilities in that they face more barriers. Implications are that we need to look beyond the medical issues of disability and address social and inclusion issues as well.
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    Environmental factors associated with atopic dermatitis in children in urban and rural South Africa
    (2025) Dewar, Janine; London, Leslie; Todd, Gail
    Background: Environmental exposures related to modern urban living, and the absence of protective rural exposures, may contribute to the high prevalence of childhood atopic dermatitis (AD). Objectives: To identify environmental exposures associated with AD in children living in three residential areas of South Africa. Methods: A total of 3144 children aged 3 to 11 years participated in 1999 in a cross-sectional study involving a suburban area, peri-urban informal settlement, and several villages in a remote rural district in South Africa. Caregivers of children within a modified case control subset of 739 children, consisting of 253 cases and 486 controls, completed a researcher-led 57-point questionnaire on environmental exposures. Bivariate and multivariate logistic regression models were used to determine statistically significant associations between environmental exposures and AD. Results: A total of 387 children in the urban area, 59 in the peri-urban area and 293 in the rural district were included. Mean age of participants was 6.8 years, and 53.9% were female. Multivariate analysis found that current exposure to mould (aOR 2.79; 95% CI 1.58 – 5.00), pesticides (aOR 1.73; 95% CI 1.24 – 2.42), stress events (aOR 2.37; 95% CI 1.19 – 4.75) and home infestation with fleas (aOR 1.73; 95% CI 1.24 – 2.42) increased odds of AD in our study population, as did weaning after 4 months (aOR 1.83; 95% CI 1.31 – 2.56), compared to earlier weaning. Conclusion: Our findings underscore the need for targeted interventions addressing indoor environmental air quality, use of indoor pesticides, and the impact of psychological stressors on the development of AD.
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    Fighting the sprawl: restructuring the seam between the rural and urban landscapes through consolidation, integration and intensifcation in Cape Town
    (2025) Louw, Pieter; Ewing, Kathryn
    The central theme of this research project is the relationship between humanity and the environment. Specifcally where this relationship is at its biggest confict, where settlements and open space meet, on the peripheries of cities. Traditionally, the settlement form of the Cape maintained a dynamic balance between the landscapes of society, wilderness, rural and urban. This balance was disrupted through Modernism and Apartheid planning which lead to segregated, fragmented and low-density urban landscapes. Through outdated planning policies, engineering standards and speculative development models, this balance is still increasingly disrupted, manifested in the form of lateral sprawl. The urban landscape, which is considered by the status-quo as the dynamic landscape, places growing pressure on the rural and wilderness landscapes. The need to restrict the lateral growth of cities is globally recognised and one unsuccessful tool utilised in the Greater Cape Town Metro to prevent urban sprawl, is the urban edge policy. This research project argues that a line that exists only on paper, such as an urban edge policy which promotes compaction, is not a suffcient mechanism to address urban sprawl. Compaction is only one aspect of mitigating sprawl. It argues that the edge is a landscape, not a line and explores the notion that a spatial proposition is necessary that consolidates and integrates the rural and urban interface zone and restructures the peripheral urban landscape. That this landscape could, through consolidation, integration and intensifcation, target and mitigate the drivers of sprawl
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    High rates of undiagnosed hypoalbuminaemia in orthopaedic trauma patients at a rural hospital
    (2025) Maimin, Dane Gary; Laubscher, Maritz
    Background: The deleterious effects of hypoalbuminaemia in the peri-operative period are well documented. We aimed to review serum albumin levels in a cohort of orthopaedic trauma patients to determine the prevalence of hypoalbuminaemia. Secondarily, we aimed to identify factors associated with an increased risk of hypoalbuminaemia. Methods: A retrospective cross-sectional study was performed of data collected prospectively at a regional hospital serving primarily a rural population in South Africa. Results Two hundred ninety-five patients were included in the study. Twenty-nine per cent of the cohort was found to have hypoalbuminaemia. Femur neck fractures (p < 0.001), intertrochanteric fractures (p = 0.004), tibial plateau fractures (p = 0.034) and polytrauma (p = 0.013) were associated with hypoalbuminaemia. The mean albumin level was lower in HIV-positive patients when compared to HIV-negative patients (35.7 g/L vs 37.5 g/L, p = 0.007). The presence of comorbidities other than HIV, like diabetes mellitus (p = 0.001), previous pulmonary tuberculosis (p = 0.034) and chronic renal failure (p = 0.007) was associated with hypoalbuminaemia. Conclusion: In this cohort of orthopaedic trauma patients from rural South Africa, we found a 29% prevalence of hypoalbuminaemia at the time of presentation. High-risk subgroups include patients with pre-existing comorbidities and increased age, as well as patients presenting with polytrauma, femoral neck, intertrochanteric femur or tibial plateau fractures.
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    Sexual behaviour of women in rural South Africa: a descriptive study
    (2016) Dubbink, Jan Henk; van der Eem, Lisette; McIntyre, James A; Mbambazela, Nontembeko; Jobson, Geoffrey A; Ouburg, Sander; Morré, Servaas A; Struthers, Helen E; Peters, Remco P H
    Abstract Background Sexual behaviour is a core determinant of the HIV and sexually transmitted infection (STI) epidemics in women living in rural South Africa. Knowledge of sexual behaviour in these areas is limited, but constitutes essential information for a combination prevention approach of behavioural change and biomedical interventions. Methods This descriptive study was conducted in rural Mopani District, South Africa, as part of a larger study on STI. Women of reproductive age (18–49 years) who reported sexual activity were included regardless of the reason for visiting the facility. Questionnaires were administered to 570 women. We report sexual behaviour by age group, ethnic group and self-reported HIV status. Results Young women (34 years); there was no difference for condom use during last sex act (36 % overall). Sotho women were more likely to report concurrent sexual partners whereas Shangaan women reported more frequent intravaginal cleansing and vaginal scarring practice in our analysis. HIV-infected women were older, had a higher number of lifetime sexual partners, reported more frequent condom use during the last sex act and were more likely to have a known HIV-infected partner than women without HIV infection; hormonal contraceptive use, fellatio, and a circumcised partner were less often reported. Conclusions This study provides insight into women’s sexual behaviour in a rural South African region. There are important differences in sexual behaviour by age group and ethnicity and HIV status; these should be taken into account when designing tailor-made prevention packages.