South African Family Practice (E-Journal)
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The microbiome in mind: Reflections on antibiotic prescription in primary care
No full textIn this opinion piece, the author critically reflects on his own antimicrobial stewardship practices in primary care and the complex factors influencing antibiotic prescription, specifically in children.Contribution: In light of emerging evidence of the role of the microbiome in both health and disease, this piece raises a key question: Are we doing more harm than good
COVID-19 impact on blood donation and blood product use in Mangaung Metropolitan Municipality
No full textBackground: Blood donation rates in sub-Saharan Africa are historically low. The coronavirus disease 2019 (COVID-19) pandemic amplified this challenge, leading to significant declines in blood donations.Objective: This study aimed to assess the impact of COVID-19 on blood donation and utilisation in the Mangaung Metropolitan Municipality (MMM), South Africa, between April 2018 and March 2022.Methods: A retrospective analytical study was conducted using data from the South African National Blood Service (SANBS) Business Intelligence System. Blood donations and product utilisation were analysed across different time periods, aligning with COVID-19-related restrictions.Results: A substantial decrease in blood donations was observed during the pandemic. Blood collection decreased over all age groups but was particularly notable among younger donors (aged 15–39). Conversely, blood product utilisation increased across both public and private health care sectors during the pandemic.Conclusion: The COVID-19 pandemic had a profound impact on blood donation and utilisation in the MMM. To address future blood shortages, strategies are needed to encourage blood donation, optimise blood product utilisation and ensure equitable access to blood services.Contribution: The study contributes to understanding the impact of COVID-19 on blood donation and utilisation patterns in sub-Saharan Africa, specifically in the MMM in South Africa
Table of Contents Vol 66 No 1 (2024)
No full textThis Table of Contents reflects the print compilation of peer-reviewed articles published in the journal. Each article listed was originally published online under the journal’s open access model and remains individually accessible and citable. This compilation has been created solely for print distribution, reference, and archival purposes. No new research content is introduced. The publisher affirms that all articles included in this compilation have undergone the journal’s standard editorial and peer-review processes
Final-year students’ perceptions of online integrated primary care learning
No full textBackground: Integrated primary care (IPC) is a final-year medical subject at the University of the Witwatersrand, Johannesburg, South Africa. It focusses on primary health care training. The coronavirus disease 2019 (COVID-19) pandemic exacerbated existing decentralised training challenges, including standardisation and patient exposure. This study explored IPC students’ experiences and perceptions of online learning during the COVID-19 pandemic.Methods: This explanatory-sequential mixed-methods study was informed by the technology acceptance model, community of inquiry model and self-regulated learning theory. A cross-sectional online survey was followed by focus group discussions (FGDs) (n = 2 and n = 3, respectively). All 316 medical students in the 2021 cohort were eligible to participate. Closed-ended survey responses were analysed using descriptive and inferential statistics. Open-ended responses were analysed using content analysis. The FGDs were thematically analysed.Results: The survey response rate was 52% (n = 164/316). Most students found the online content easily accessible (93.3%) and logically organised (80.0%). The course structure and organisation, and the range of online activities offered were the main features that supported learning. The main challenges included the content not being comprehensive and the difficulty of learning patient management from online content. Suggested improvements related to the course design and ways students and instructors can maximise the affordances of the online course.Conclusion: Acknowledging the limitations of learning clinical content online, the participants felt the course supported their learning. Our findings suggest that well-designed online content can augment clinical learning.Contribution: This study contributes to the discourse on the value of online learning for clinical teaching
Domestic violence: Screening and management in South Africa
No full textViolence manifests in various ways in healthcare, including trauma from an undifferentiated patient, psychosomatic illness, substance abuse or dependency and mental health challenges. Different forms of violence exist, such as intimate partner violence, gender-based violence, domestic violence, child abuse, neglect, elder abuse, sexual violence, self-directed violence and collective violence. These may be included in domestic violence or exist as standalone forms. Health practitioners play a pivotal role in managing incidents of domestic violence. This article highlights the definitions in the Amended Domestic Violence Act of 2021 and suggests screening options for domestic violence. The authors also suggest screening tools, a management flow diagram and contact numbers for resources. Domestic violence can be a generational curse that compromises biopsychosocial wellbeing. To break the perceived culture of violence, healthcare workers play a pivotal role in screening and management, as well as the mandatory reporting of domestic violence when children and the elderly are sharing such a household
Community service rehabilitation therapists’ perspectives of cross-disciplinary supervision
No full textBackground: In South Africa, graduate rehabilitation therapists undertake a compulsory community service (CS) year in public healthcare facilities, often entering this role without sufficient competency to work independently. They rely on supervision and support, which may come from senior therapists of different disciplines. This study, conducted in KwaZulu-Natal (KZN) province, explores the experiences of rehabilitation therapists regarding cross-disciplinary supervision and support during their CS year.Methods: A qualitative, descriptive, and exploratory design was employed. Virtual semi-structured interviews were conducted with seven purposively sampled participants from five KZN districts. Data were audio recorded, transcribed verbatim, and analysed thematically.Results: The findings revealed four themes and ten sub-themes, highlighting the challenges and benefits of cross-disciplinary supervision, dissatisfaction with existing support structures, and recommendations for improvement. The CS therapists, as junior staff, often lacked the experience and authority to deliver optimal patient care within resource-constrained settings.Conclusion: While discipline-specific supervision remains the preferred approach, cross-disciplinary supervision contributed positively to professional development, broadening therapists’ understanding of other rehabilitation disciplines. However, the limited availability of accessible, discipline-specific supervisors remains a significant concern. Given their frequent isolation and minimal experience, CS therapists require consistent, discipline-specific support to meet service demands.Contribution: This study emphasises need to address the experiences of CS therapists, who face high patient loads and limited support, in public health sector planning. Incorporating their insights can enhance their ability to deliver essential services, ensuring better outcomes for the populations served by the public health system
Community-based primary care approaches to supporting families of children with developmental disabilities: Experts’ perspectives using the capabilities framework
No full textBackground: Families raising children with developmental disabilities face complex, interconnected challenges requiring coordinated support across multiple professional domains. While interdisciplinary collaboration is widely endorsed in policy and practice guidelines, significant knowledge gaps exist regarding how healthcare professionals operationalise these collaborative approaches in real-world settings.Methods: A qualitative study was conducted using individual semi-structured interviews with 12 experts representing diverse disciplines. The study was grounded in the Capabilities Approach as both a theoretical lens and a methodological framework. Data were analysed using Braun and Clarke’s six-step thematic analysis, with the Capabilities Approach framework informing each analytical phase.Results: Five major themes emerged from the capability-guided analysis: facilitating emotional transformation, building system navigation competence, creating inclusive participation opportunities, strengthening family functioning and fostering adaptive identity development. Across all themes, participants consistently emphasised three critical mechanisms for effective interdisciplinary support: coordinated care delivery as capability enhancement, comprehensive emotional support as capability development and whole-family capability strengthening interventions.Conclusion: The findings highlight the significance of interdisciplinary approaches informed by the Capabilities Approach in providing comprehensive support for parents of children with developmental disabilities. Rather than traditional deficit-focused models, participants systematically described how they enhance family capabilities by functioning as capability facilitators who orchestrate conversion factors, build emotional capabilities while respecting family agency and create environmental modifications that expand family possibilities.Contribution: This study contributes a novel capability-focused framework for understanding interdisciplinary collaboration in developmental disability support, moving beyond traditional service coordination models to emphasise systematic capability enhancement approaches that build sustainable family strengths across multiple domains simultaneously
Rationalising blood tests in a resource-limited emergency unit: A quality improvement project
No full textBackground: In resource-limited emergency settings, blood testing is crucial for diagnostics but can lead to financial strain and diagnostic challenges if used indiscriminately. This quality improvement project (QIP) aimed to identify commonly requested blood tests in an emergency department (ED), assess their appropriateness, and establish evidence-based guidelines for judicious use. This project was conducted during the family medicine rotation of interns at a tertiary hospital in a semi-urban area.Methods: The Plan-Do-Study-Act (PDSA) method was employed. Pre- and post-intervention data were collected. An educational intervention, featuring informative visual aids was implemented to help guide the medical practitioners in the unit on appropriate blood test ordering.Results: The intervention led to a significant 48.7% reduction in total daily blood tests ordered, with a notable decrease in full-panel requests and an increase in individual test ordering.Conclusion: Educational interventions, aimed at guiding blood test requests, can significantly reduce unnecessary testing. Long-term data collection is necessary to confirm sustained changes in practice.Contribution: Our findings indicate that clear, evidence-based guidelines for the judicious use of blood tests can positively impact test ordering, particularly in resource-limited settings, and suggest opportunities for further long-term studies
‘Gender affirming healthcare’ is not what the family physician needs to know
No full textNo abstract available
Measuring problematic smartphone use among students using the Smartphone Addiction Scale
No full textBackground: Problematic Smartphone Use (PSU) is a growing concern, particularly among university students, due to its potential negative impacts on mental health, academic performance, and daily functioning. Characterized by compulsive smartphone use, PSU is linked to anxiety, depression, and sleep disturbances. Understanding PSU in university settings is essential for creating effective interventions. Additionally, primary care settings can play a key role in identifying and managing PSU to support overall well-being.Methods: This cross-sectional study involved 867 students from Nelson Mandela University, South Africa. Participants completed the Smartphone Addiction Scale – Short Version (SAS-SV) to assess PSU levels. The study explored associations between PSU, daily smartphone usage time, and gender using descriptive statistics and correlation analyses.Results: The findings revealed that 55% of the students exhibited PSU. A significant correlation was observed between increased daily smartphone usage and higher PSU levels. However, no significant gender differences were found. These results highlight the widespread nature of PSU among university students and its strong association with smartphone usage patterns.Conclusion: The study underscores the importance of addressing PSU in primary healthcare settings, where early detection and intervention can prevent further psychological and social consequences. Primary care providers can offer counselling, screen for PSU, and guide students towards healthier smartphone habits.Contribution: This study provides valuable insights into the prevalence and impact of PSU among university students. It emphasizes the vital role of primary care in addressing this emerging health issue to improve students’ mental health and overall quality of life