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  • 1
    Online Resource
    Online Resource
    They push their products through me: health professionals’ perspectives on and exposure to marketing of commercial milk formula in Cape Town and Johannesburg, South Africa – a qualitative study
    BMJ ; 2022
    In:  BMJ Open Vol. 12, No. 4 ( 2022-04), p. e055872-
    Details
    In: BMJ Open, BMJ, Vol. 12, No. 4 ( 2022-04), p. e055872-
    Abstract: To understand the views of public and private sector health professionals on commercial milk formula, to describe their exposure to companies that market commercial milk formula within their workplaces and to describe their awareness of South African (SA) regulations. Design A qualitative study consisting of semistructured interviews. Setting The study was conducted in Cape Town and Johannesburg, SA. Participants Forty health professionals who had regular contact with pregnant or postnatal women were interviewed between February 2020 and February 2021. Results Analysis of the interviews revealed six themes. Health professionals in the private sector reported frequent contact with industry representatives with over two-thirds reporting exposure to industry representatives to present products, provide training or sponsor educational activities. Participants held strong opinions regarding the equivalency of breastfeeding to commercial milk formula citing information from industry representatives and product packaging. Health professionals were very knowledgeable on so-called formulas for special medical purposes and these were valued as solutions to infant feeding challenges. Of the 40 health professionals interviewed, less than half (19) had ever heard of the SA regulation related to marketing of breast milk substitutes (R991). Conclusions This study demonstrates clearly that health professionals, particularly in the private sector, are exposed to and promote the use of commercial milk formula among SA women. The findings of this study should be used to catalyse policy responses, social movements, consumer and professional association action to strengthen monitoring and enforcement of the Code regulations in order to protect breastfeeding and support the optimal health and well-being of the population.
    Type of Medium: Online Resource
    ISSN: 2044-6055 , 2044-6055
    URL: Article
    DOI: 10.1136/bmjopen-2021-055872
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 2599832-8
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  • 2
    Online Resource
    Online Resource
    An exploration of pregnant women and mothers’ attitudes, perceptions and experiences of formula feeding and formula marketing, and the factors that influence decision-making about infant feeding in South Africa
    Springer Science and Business Media LLC ; 2022
    In:  BMC Public Health Vol. 22, No. 1 ( 2022-12)
    Details
    In: BMC Public Health, Springer Science and Business Media LLC, Vol. 22, No. 1 ( 2022-12)
    Abstract: Despite strong evidence showing the lifelong benefits of breastfeeding for mothers and children, global breastfeeding practices remain poor. The International Code of Marketing of Breastmilk Substitutes is an internationally agreed code of practice, adopted by the World Health Assembly in 1981, to regulate promotion of commercial formula, and is supported by legislation in many countries. However, marketing of formula remains widespread and contributes to mother’s decisions to formula feed. We present South African data from a multi-country, mixed-methods study exploring women’s decision-making about infant feeding and how this was influenced by exposure to formula marketing. Methods Using a consumer-based marketing approach, focus group discussions (FGDs) were conducted with pregnant women and mothers of children aged between 0 and 18 months in two urban sites in South Africa. Participants were purposively selected according to their child’s age, infant feeding practices and socioeconomic status. Ten FGDs were conducted during February 2020 with a total of 69 participants. Thematic analysis was used to analyse the data with NVivo v.12 software. Results Despite being encouraged by health professionals to breastfeed and intending to do so, many mothers chose to give formula in the early weeks and months of their child’s life. Mothers reported breastfeeding challenges as the most frequent reason for initiating infant formula, stating that family members and health professionals recommended formula to solve these challenges. Although participants described few advertisements for infant formula, advertisements for ‘growing-up’ formulas for older children were widespread and promoted brand recognition. Mothers experienced other marketing approaches including attractive packaging and shop displays of infant formula, and obtained information from social media and online mothers’ groups, which influenced their choice of formula brand. Mothers reported strong brand loyalty derived from previous experiences and recommendations. Health professionals frequently recommended formula, including recommending specific formula brands and specialist formulas. Conclusion Global formula companies use multifaceted marketing methods to promote a strong narrative portraying formula feeding as a positive lifestyle choice. Positive, coordinated efforts are required to counter pro-formula messaging and change the narrative to support breastfeeding as an aspirational choice. In particular, health professionals must stop supporting the formula industry.
    Type of Medium: Online Resource
    ISSN: 1471-2458
    URL: Article
    DOI: 10.1186/s12889-022-12784-y
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2041338-5
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  • 3
    Online Resource
    Online Resource
    Gaps in the prevention of mother-to-child transmission of syphilis: a review of reported cases, South Africa, January 2020–June 2022
    Oxford University Press (OUP) ; 2024
    In:  Journal of Tropical Pediatrics Vol. 70, No. 3 ( 2024-04-05)
    Details
    In: Journal of Tropical Pediatrics, Oxford University Press (OUP), Vol. 70, No. 3 ( 2024-04-05)
    Abstract: Congenital syphilis (CS) is preventable through timely antenatal care (ANC), syphilis screening and treatment among pregnant women. Robust CS surveillance can identify gaps in this prevention cascade. We reviewed CS cases reported to the South African notifiable medical conditions surveillance system (NMCSS) from January 2020 to June 2022. Methods CS cases are reported using a case notification form (CNF) containing limited infant demographic and clinical characteristics. During January 2020–June 2022, healthcare workers supplemented CNFs with a case investigation form (CIF) containing maternal and infant testing and treatment information. We describe CS cases with/without a matching CIF and gaps in the CS prevention cascade among those with clinical information. Findings During January 2020–June 2022, 938 CS cases were reported to the NMCSS with a median age of 1 day (interquartile range: 0–5). Nine percent were diagnosed based on clinical signs and symptoms only. During January 2020–June 2022, 667 CIFs were reported with 51% (343) successfully matched to a CNF. Only 57% of mothers of infants with a matching CIF had an ANC booking visit (entry into ANC). Overall, 87% of mothers were tested for syphilis increasing to 98% among mothers with an ANC booking visit. Median time between first syphilis test and delivery was 16 days overall increasing to 82 days among mothers with an ANC booking visit. Discussion Only 37% of CS cases had accompanying clinical information to support evaluation of the prevention cascade. Mothers with an ANC booking visit had increased syphilis screening and time before delivery to allow for adequate treatment.
    Type of Medium: Online Resource
    ISSN: 0142-6338 , 1465-3664
    URL: Article
    DOI: 10.1093/tropej/fmae010
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2024
    detail.hit.zdb_id: 1497447-2
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  • 4
    Online Resource
    Online Resource
    Expansion of HIV testing in Eswatini: stakeholder perspectives on reaching the first 90
    National Inquiry Services Center (NISC) ; 2020
    In:  African Journal of AIDS Research Vol. 19, No. 3 ( 2020-07-02), p. 186-197
    Details
    In: African Journal of AIDS Research, National Inquiry Services Center (NISC), Vol. 19, No. 3 ( 2020-07-02), p. 186-197
    Type of Medium: Online Resource
    ISSN: 1608-5906 , 1727-9445
    URL: Article
    DOI: 10.2989/16085906.2020.1790399
    Language: English
    Publisher: National Inquiry Services Center (NISC)
    Publication Date: 2020
    detail.hit.zdb_id: 2158104-6
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  • 5
    Online Resource
    Online Resource
    Limited resources restrict the provision of adequate neonatal respiratory care in the countries of Africa
    Wiley ; 2022
    In:  Acta Paediatrica Vol. 111, No. 2 ( 2022-02), p. 275-283
    Details
    In: Acta Paediatrica, Wiley, Vol. 111, No. 2 ( 2022-02), p. 275-283
    Abstract: Over two thirds of newborn deaths occur in Africa and South Asia, and respiratory failure is a major contributor of these deaths. The exact availability of continuous positive airway pressure (CPAP) and surfactant in Africa is unknown. The aim of this study was to describe the availability of newborn respiratory care treatments in the countries of Africa. Methods Surveys, in English, French and Portuguese, were sent to neonatal leaders in all 48 continental countries and the two islands with populations over 1 million. Results Forty‐nine (98%) countries responded. Twenty‐one countries reported less than 50 paediatricians, and 12 countries had no neonatologists. Speciality neonatal nursing was recognised in 57% of countries. Most units were able to provide supplemental oxygen. CPAP was available in 63% and 67% of the most well‐equipped government and private hospitals. Surfactant was available in 33% and 39% of the most well‐equipped public and private hospitals, respectively. Availability of CPAP and surfactant was greatly reduced in smaller cities. Continuous oxygen saturation monitoring was only available in 33% of countries. Conclusion The availability of proven life‐saving interventions in Africa is inadequate. There is a need to sustainably improve availability and use of these interventions.
    Type of Medium: Online Resource
    ISSN: 0803-5253 , 1651-2227
    URL: Issue
    URL: Article
    DOI: 10.1111/apa.v111.2
    DOI: 10.1111/apa.16050
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 1492629-5
    detail.hit.zdb_id: 1501466-6
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  • 6
    Online Resource
    Online Resource
    Availability of medical abortion medicines in eight countries: a descriptive analysis of key findings and opportunities
    Springer Science and Business Media LLC ; 2023
    In:  Reproductive Health Vol. 20, No. S1 ( 2023-04-11)
    Details
    In: Reproductive Health, Springer Science and Business Media LLC, Vol. 20, No. S1 ( 2023-04-11)
    Abstract: In recent years a growing number of manufacturers and medical abortion products have entered country markets and health systems, with varying degrees of quality and accessibility. An interplay of factors including pharmaceutical regulations, abortion laws, government policies and service delivery guidelines and provider’s knowledge and practices influence the availability of medical abortion medicines. We assessed the availability of medical abortion in eight countries to increase understanding among policymakers of the need to improve availability and affordability of quality-assured medical abortion products at regional and national levels. Methods Using a national assessment protocol and an availability framework, we assessed the availability of medical abortion medicines in Bangladesh, Liberia, Malawi, Nepal, Nigeria, Rwanda, Sierra Leone and South Africa between September 2019 and January 2020. Results Registration of abortion medicines—misoprostol or a combination of mifepristone and misoprostol—was established in all countries assessed, except Rwanda. Mifepristone and misoprostol regimen for medical abortion was identified on the national essential medicines list/standard treatment guidelines for South Africa as well as in specific abortion care service and delivery guidelines for Bangladesh, Nepal, Nigeria, and Rwanda. In Liberia, Malawi, and Sierra Leone—countries with highly restrictive abortion laws and no abortion service delivery guidelines or training curricula—no government-supported training on medical abortion for public sector providers had occurred. Instead, training on medical abortion was either limited in scope to select private sector providers and pharmacists or prohibited. Community awareness activities on medical abortion have been limited in scope across the countries assessed and where abortion is broadly legal, most women do not know that it is an option. Conclusion Understanding the factors that influence the availability of medical abortion medicines is important to support policymakers improve availability of these medicines. The landscape assessments documented that medical abortion commodities can be uniquely impacted by the laws, policies, values, and degree of restrictions placed on service delivery programs. Results of the assessments can guide actions to improve access.
    Type of Medium: Online Resource
    ISSN: 1742-4755
    URL: Article
    DOI: 10.1186/s12978-023-01574-3
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2023
    detail.hit.zdb_id: 2149029-6
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