African journal of reproductive health
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Afr J Reprod Health · Dec 2012
Female genital mutilation in Sierra Leone: who are the decision makers?
The objectives of this study were to identify decision makers for FGM and determine whether medicalization takes place in Sierra Leone. Structured interviews were conducted with 310 randomly selected girls between 10 and 20 years in Bombali and Port Loko Districts in Northern Sierra Leone. The average age of the girls in this sample was 14 years, 61% had undergone FGM at an average age of 7.7 years (range 1-18). ⋯ The traditional excisors (Soweis) performed 80% of all operations, health professionals 13%, and traditional birth attendants 6%. Men may play a more important role in the decision making process in relation to FGM than previously known. Authorities and health professionals' associations need to consider how to prevent further medicalization of the practice.
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A new model of reproductive health care delivery is unfolding, driven by emerging health issues, expanding technology and increasing public expectations. Additional imperatives in service provision for women's health compel reforms to undergraduate medical education using reproductive health as the basis for restructuring curriculum contents. ⋯ A three-pronged approach based on reproductive health, problem-based learning and evidence-based medicine, has much potential for improving subsequent clinical practice and the overall reproductive health of the community. Appropriate changes to existing curricula will facilitate integration of the principles of reproductive health and the new philosophy of doctor-patient relationship into clinical supervision and training of students.
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Afr J Reprod Health · Aug 2004
ReviewAntenatal HIV screening and treatment in South Africa: social norms and policy options.
South Africa has one of the highest prevalence of HIV and AIDS in the world, with mother-to-child transmission being an important route for spread of the infection. For years, AIDS scientists and activists locally and internationally have been working desperately for the people of South Africa to have access to treatment for HIV and AIDS. ⋯ The social fabric of South African society is markedly different from that of Western countries. In this paper, the author analyses the likely implications of antenatal testing and treatment of pregnant women in South Africa, in light of the socio-economic and cultural status of women in that society.
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Afr J Reprod Health · Apr 2006
The challenge of improving perinatal care in settings with limited resources. Observations of midwifery practices in Mozambique.
The aim of this study was to observe and analyse midwifery care routines related to asphyxia and hypothermia during the perinatal period and to investigate the effect of an in-service education program. A direct non-participant pre- and post-intervention observation study of midwifery a performance during childbirth was conducted at a labour ward in Maputo. The observed groups consisted of 702 and 616 midwifery-attended deliveries. ⋯ The quality of midwifery care related to prevention and early detection of asphyxia and hypothermia was found to be inadequate and the intervention had no significant effect upon the midwives' performances. This could be attributed to the quality of the intervention itself or to failure of implementing managerial decisions such as transfer of partograph documentation from obstetricians to midwives. Change in professional performance does not automatically follow awareness of evidence-based midwifery practices, but requires behavioural change, which may be more difficult to achieve.