South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Many studies have shown that South African women tend to initiate antenatal care late in their pregnancies. This presents challenges in the provision of quality healthcare to both mother and child. There are several studies on the social and cultural reasons for late booking. However, understanding the factors in a woman's choice to initiate antenatal care is important in informing healthcare strategies and policies. ⋯ The identified health and household factors should inform policies and programmes geared towards improving services around antenatal care provision.
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Understanding the pattern of contraceptive use among women living with HIV is critical for formulating relevant public health interventions to improve the uptake and use of reliable methods in this population. This helps to reduce the incidence of unintended pregnancies. ⋯ This study revealed that there is still a considerable unmet need for contraception among the study population, highlighting the need to devise strategies to increase contraception uptake among women. Statistically significant differences were noted in the use of condoms, with those who are HIV-positive having a higher use of condoms compared with those who are HIV-negative. This may reflect that HIV-positive individuals have received appropriate counselling messages on the need to use barrier methods.
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Trends data up to 2018 suggest that tobacco smoking was increasing in South Africa (SA), but only limited information is available on the impact of the COVID-19 pandemic on the current pattern of use of tobacco and nicotine products (TNPs). ⋯ The use of all TNPs continued to increase in SA, particularly among women and unemployed people. These findings have policy and practice implications for addressing socioeconomic disparities in tobacco-related diseases.
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Adolescent girls and young women (AGYW) remain vulnerable to HIV, with a higher incidence rate than their male counterparts. ⋯ The study identified an unmet need for HIV testing among sexually active AGYW in SA, especially adolescent girls aged 15 - 19 years. Increasing knowledge about HIV testing, adolescent-friendly services and other offsite strategies are therefore important for this particular key population.
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The infant mortality rate (IMR) (24 per 1 000 live births) remains high in South Africa (SA), well above the recommended sustainable development goal (SDG) 3 of 12 deaths per 1 000 live births. High infant mortality is a poor indicator of the health of a population and will hamper attainment of the SDGs. ⋯ The study findings showed a reduction in the trends of infant mortality between 2007 and 2016 in SA; despite the reduction, health inequalities persist. There is a correlation evident between maternal HIV prevalence and IMR in SA. We recommend the use of disability-adjusted life expectancy in SA to measure population health and introduce robust data sets that can better inform policy.