Magister Scientiae (Physiotherapy) - MSc(Physio) / Maternal and child-health and health education are three major concerns of public health organisations and researchers throughout the world. Health education for mothers is a strategy many countries have adopted to improve maternal and child-health. The present study was carried out in Uganda with the objective of exploring the factors influencing the utilisation of postnatal services at Mulago and Mengo hospitals, a government and private hospital. Both hospitals are located in Kampala district in Uganda. The survey, was completed by 330 women who responded to a structured questionnaire that was given to them six to eight weeks after delivery. Questions that were asked generated demographic information about the mothers; mothers’ knowledge about postnatal services; mothers’ socio-economic status and barriers to utilisation of the postnatal services. The participants included all women who delivered in Mulago and Mengo hospitals in November 2003 except for those who had had a neonatal death. The data was analysed using descriptive and inferential statistics. Some of the key findings of the study were that most women lacked awareness about postnatal services and those who knew about these services only knew about immunisation and family planning services. The majority of the mothers did not know about other services, such as physiotherapy, counselling, growth monitoring, and physical examination. Lack of money for transport or service costs, distance from the health care facility, not being aware of the services, lack of somebody to take care of the child at home were some of the main barriers to utilisation of postnatal services. Others included, lack of education, lack of employment, lack of decision-making powers, and lack of time to go back for the service. The ministry of health should educate women and communities about the importance of postnatal care, its availability, and the importance of women having decision-making power over their own health. The health service organization should improve on the quality of care by ensuring that services are provided at convenient hours with privacy, confidentiality and respect and it should evaluate the services periodically from the users perspective to maintain the quality of service. / South Africa

Master of Public Health - MPH / Each year approximately 600 000 infants, most of them in Sub-Saharan Africa are born with HIV infection as a result of mother to child transmission of HIV. Whereas significant progress has been made in reduction of mother to child transmission of HIV in developed countries, the situation remains desperate in developing countries. Progress has been hampered by shortage of staff, facilities, limited access to voluntary counselling and testing and lack of support for women by their partners and communities. The challenge is to increase voluntary counselling and testing uptake during antenatal care. Onandjokwe district in Northern Namibia is currently introducing the Prevention of Mother to Child Transmission Program (PMTCT). It has been found the previous PMTCT programs have failed because they adopted a top down approach where there was no community consultation. This study was conducted to explore the community perceptions, knowledge and attitudes regarding mother to child transmission of HIV through focus group discussions and in-depth interviews of key community members. / South Africa

Magister Scientiae (Medical Bioscience) - MSc(MBS) / Tobacco smoking remains one of the leading causes of death worldwide. Despite all the efforts made by governments, researchers and communities to educate women about the dangerous effects of tobacco smoke and nicotine, smoking during pregnancy continues to be a common habit and accounts for a significant percentage of fetal morbidity and mortality. The offspring is, as a result, exposed to nicotine through the blood and the milk of the mother. Nicotine is therefore expected to interact with the developing fetus and the offspring of mothers who smoke or use Nicotine Replacement therapy for smoking cessation, resulting in the interference with normal fetal lung development. Maternal cigarette smoke or nicotine exposure produces adverse effects in the lungs of offspring, these include; intrauterine growth retardation, low birth weight, premature birth, reduced pulmonary function at birth, and a high occurrence of respiratory illnesses after birth. The main objectives of this study were to determine: 1) the effects of maternal nicotine exposure during gestation and lactation on lung development in the offspring, 2) if there is evidence of premature aging of the lungs of the lungs of the nicotine exposed offspring, and 3) whether tomato juice can have protective effects on the fetal lung development and function in the offspring. From the study, it was established that maternal nicotine exposure had no significant effect on the growth parameters of the offspring. However, it results in the late onset of gradual parenchymal damage which resembles premature aging. The study also found that the consumption of tomato juice may have protective effects on the premature aging of the lungs of the offspring. / South Africa

Philosophiae Doctor - PhD / The aim of this study was to prospectively, evaluate the effectiveness of an individually designed home-based physical activity programme in combination with massage therapy, on motor and cognitive development in children infected with HIV. This study used a randomized controlled trial design. One hundred and twenty-eight infants and toddlers (children) were recruited between March 2010 and September 2010 and randomly allocated to receive either an individually designed home-based physical activity programme in combination with massage therapy or standard treatment and massage on a 1:1 ratio. Motor and cognitive development was measured using the Bayley Scales of Infant Development third edition (Bayley-III)

Magister Public Health - MPH / Background: Every year, about 20 million infants are born with low birth weight globally, putting a heavy burden on health care and social systems, especially in developing countries as they are often understaffed and/or lack optimally functional equipment. In 1978, Dr E. Rey proposed the Kangaroo Mother Care (KMC) programme which was further developed by coworkers at one of the largest obstetric facilities in Santa Fe de Bogotá, Colombia. KMC was introduced as an alternative to the expensive and seldom used traditional methods to care for low birth weight infants. KMC is currently not practised at Tsumeb district hospital despite many infants born with low weight in the district. Aim: The aim of the study was to explore perceptions regarding the implementation of Kangaroo Mother Care in the maternity ward of Tsumeb district hospital. Study design: This was a qualitative exploratory study. Study population and sampling: The study population are doctors and nurses working in Tsumeb district, the Chief Medical Officer (CMO) as well as the health programme administrators in the family health division of the Ministry of Health and Social Services (MOHSS), Oshikoto region. Purposive sampling was used to select participants. Results: Perceptions were grouped into three main themes namely the parent-related, health worker-related and baby-related. Parent-related perceptions include self-trust, increased competency, less frustration, and active involvement of parents in baby care, which are similar to the literature and regarded as benefits of KMC. Health worker-related perceptions included both reduced workload and an increased workload. Baby-related perceptions are reduced morbidity, increased bonding and improved care. The study also revealed the barriers to KMC implementation as well as factors that can make KMC implementation a success. Conclusions: Three broad themes emerged from the study, parent-related, health worker-related and baby-related. Most of the health workers’ perceptions are similar to the benefits of KMC found in the literature but, some health workers have negative perceptions regarding KMC.

South Africa is a developing country and children in South Africa are at a high risk for developing communication disorders with more than 10% of children under three likely to have communication disorders. The ideal is to prevent as many of these communication disorders as possible. This requires the identification of factors within specific communities which may increase the risk for or resilience against developing communication disorders. Providing information on communication development is a form of primary prevention which has proven to be highly successful. There is a continuum of communities in the South African context that range from the developing to the developed and at each level parents have specific requirements regarding the need for information on communication development. Considering the large number of South African infants who are at risk for developing communication disorders and in recognition of the many different communities in the South African context, the need for prevention tools which are developed to meet the needs of specific communities, becomes apparent. This study aimed to develop a tool for parents of a specific South African community, identified as Pretoria East, for the stimulation of communication skills in infants that is valid in terms of content and is judged by parents to be practical and empowering. In order to achieve this aim three phases of research were planned. Phase one aimed to identify the needs of parents and professionals in terms of the informational content and format of a tool for the stimulation of communication in infants. Phase two aimed to develop a tool for the stimulation of communication in infants based on the needs and preferences expressed by parents and professionals, the active involvement of parents from the community in focus group discussions as well as on sound theoretical underpinnings of infant development. Phase three aimed to validate the tool by determining whether the tool fulfilled the needs of parents in terms of informational content and format. The results of this research indicated that a need was identified in parents and professionals alike for a tool for parents on the stimulation of communication skills in infants. A video was indicated as the most popular choice of format. The content of the stimulation tool which was developed in phase two reflected the needs and preferences of the community and included the following topics, namely: discussions and demonstrations on the normal development of communication skills in infants, techniques that would facilitate normal development, risk factors and resilience factors which may influence communication development as well as information on locating a professional. In phase three parents from the community evaluated the video tool as practical and empowering, therefore achieving the main objective of the research. This research highlighted the need within a specific community for information on the facilitation of communication development in young children, implying the need for further research in order to determine the needs of other South African communities. Recommendations were also made regarding the need for speech-language therapists to increase their involvement in prevention initiatives and community work. / Thesis (PhD (Communication Pathology))--University of Pretoria, 2005. / Speech-Language Pathology and Audiology / unrestricted

No description available.

Research shows that maternal depression has adverse effects on mother-infant attachment and subsequent infant development (Cogill, Caplan, Alexandra, Robson & Kumar, 1986). The mechanisms through which this comes about are unclear. Murray & Cooper (1997) suggest an impaired pattern of mother-infant communication is responsible. Within this, Murray proposes that maternal speech may be a key factor. This study constitutes a preliminary exploration into the mechanisms through which maternal depression effects mother-infant interaction in South Africa. 147 predominantly Xhosa-speaking mother-infant dyads that took part in a broader epidemiological study on post-partum depression in Khayelitsha (Cooper, Tomlinson, Swartz, Woolgar, Murray & Molteno, 1999) made up the subjects. Maternal depression was assessed according to the Structured Clinical Interview for DSMIV (SCID). Maternal speech recorded from standard, five-minute, face-to -face mother-infant interactions was translated and analysed according to a coding system developed by Murray (Murray, Kempton, Woolgar & Hooper, 1993). The speech of depressed mothers to their two month old infants was compared to the speech of non-depressed mothers on dimensions of focus, affect and agency, and the role of infant gender was assessed. Results revealed no significant group differences for depression. Maternal speech to male infants was found to hold significantly less ascription of agency than to female infants. Findings suggest that maternal speech may be too narrow a marker of maternal depression in this context and that broader indices are needed. It is recommended that future research control for measures of social adversity, factor in cultural and language particularities, and consider contextual aspects of mother-infant interaction / attachment processes, in investigating the mechanisms through which post-partum depression leads to negative infant outcome in the developing world.

Bakgrund: Inom neonatal intensivvård vårdas prematura barn med sina föräldrar och personalen bör ha ett helhetsperspektiv på barnet och dess familj. Två metoder som används för att bland annat skapa förutsättningar för föräldra- barnkontakt, är Newborn Individualized Development Care and Assessment Program (NIDCAP) och känguruvård. Det finns ett flertal hinder som kan försvåra föräldra- barnkontakten när ett barn föds prematurt och sjuksköterskan har en central roll i att främja kontakten. Syfte: Syftet med denna studie är att belysa upplevelsen av att bli förälder till ett prematurt barn i behov av neonatal intensivvård. Metod: Datainsamlingen har skett genom semistrukturerade intervjuer. Totalt intervjuades fem föräldrar/föräldrapar. Materialet har analyserats med inspiration av kvalitativ innehållsanalys. Resultat: I berättelserna om föräldrarnas upplevelser identifierades ett övergripande tema, Mitt barns liv vilar i era händer, baserat på både positiva och negativa upplevelser från deras tid inom neonatal intensivvård. Detta tema bygger på sex kategorier: Trygg med personalen, Att få bli barnets förälder, Nöjd familj, Otrygg med personalen, Svårigheter att bli barnets förälder och Brist på samtal. Slutsats: När ett barn föds prematurt och är i behov av neonatal intensivvård finns det faktorer som personalen kan påverka för att underlätta den tidiga föräldra- barnkontakten. Klinisk betydelse: Med en ökad medvetenhet hos personal inom neonatal intensivvård om vad föräldrarna upplever som positivt/negativt i vården kan denna utvecklas och förbättras. En del i detta är att göra föräldrarna mer delaktiga i vården. / Background: In the Neonatal Intensive Care Unit premature infants and their parents are cared for, the staff´s holistic approach to the infant and their family is essential. Two methods used to create opportunities for contact between the parent and the infant are NIDCAP and kangaroo care. There are several obstacles that may hinder this contact when an infant is born prematurely and the nurse has a key role in promoting this contact. Purpose: The purpose of this study is to enlighten the experience of being the parent of a premature infant in need of Neonatal Intensive Care. Methods: Data collection was made through semi-structured interviews. Five parents /couple of parents were interviewed. The material has been analyzed with the inspiration of qualitative content analysis. Result: In the interviews with the parents an overarching theme were identified, My infant's life rests in your hands, based on both the positive and negative experiences during their time in Neonatal Intensive Care Unit. The theme is based on six categories: Secure with the staff, Becoming a parent, Happy family, Insecurity with the personnel, Difficulties to become the infant's parent, and Lack of dialogue. Conclusion: When an infant is born prematurely and in the need of Neonatal Intensive Care there are factors that the staff can affect in order to facilitate the early parent-child contact. Clinical significance: With an increased awareness among the neonatal intensive care staff what parents perceive as the positive/ negative, the care can be developed and improved. A part of this is to make parents more involved in the care of their infants.

There is a limited understanding of the practices provided by interventionists under the Individuals with Disabilities Education Act Part C, and there is no knowledge of how providers deliver services for children who have challenging behaviors. In particular, few studies have examined the extent to which Part C interventionists use evidence-based practices. Decreasing occurrences of challenging behaviors in early childhood is particularly important, as there are many negative ramifications associated with untreated challenging behaviors, including troubled peer and adult relationships, academic failure, and increased antisocial behaviors in adulthood. Research has shown that Positive Behavior Supports and the Pyramid Model are empirically supported frameworks for treatment of challenging behaviors among young children. Thus, interventionists should be utilizing PBS when serving young children with challenging behaviors. The purpose of this study was to gain a preliminary understanding of Part C interventionists’ knowledge and understanding of evidence-based practices for young children with challenging behaviors and to identify interventionists’ process of intervention identification and implementation. Also examined were the challenges associated with service-delivery and the role of Part C in alleviating such challenges. This understanding was gained through semi-structured interviews with a sample of 10 interventionists who served young children with challenging behaviors. A thematic analysis resulted in 15 themes and two subthemes. In addition, interventionists were evaluated using a 4-point rating scale, which provided additional insight regarding the level of evidence-based practice utilized by interventionists. Themes and ratings revealed interventionists have a limited understanding of best practice associated with identifying appropriate evidence-based interventions for young children with challenging behavior. Moreover, a number of barriers hindered consistent implementation of behavioral interventions. Results indicated a need for a wider scale study of Part C interventionists’ practices. In addition, results demonstrated a critical need for ongoing professional development for Florida Part C interventionists.