| | https://www.sun.ac.za/si | Creating supportive environments between at risk mothers and their children. | The Western Cape Government: Health has finalised the Healthcare 2030 framework. The aim of the 2030 vision for the Western Cape Department of Health is: “Access to person-centred, quality care". The 2030 framework represents an improved health reform within the Western Cape [Department of Health, 2014). As part of the change management process taking place in the area of maternal and child health the Health Department is leading an initiative called “The First 1000 Days Theory of Change". The initiative focuses on the First 1000 days of a child's life (from conception to two years). For the First 1000 Days Initiative, A Theory of Change (ToC) approach was used to produce a systemic health framework for supporting the health of women and children as part of Health Plan 2030. The overall vision of the framework is to ensure that mothers and their babies in the first 1000 days are cared for in the following areas; health and nutrition, nurture and support as well as safety protection and stimulation. According to the framework, if opportunities are optimized within the first 1000 days, it provides for a future that is healthier and more prosperous Department of Health (Western Cape Government: Health, 2017). The focus for babies is the creation of an environment in which the baby would feel nurtured. Mothers, on the other hand, should be able to provide and create an environment for raising children who are happy, curious and resilient. To achieve this goal a number of personal, familial, environmental and contextual factors may have to be investigated and mediated. In order to determine the ability of women to create a safe and nurturing environment to their children personal factors such as the mother's resilience, mental health and inclination to interact with their children so that healthy development takes place need to be determined and facilitated. Play patterns and ways of encouraging playfulness would also have to be assessed as play is one of the main tasks for early childhood development (Bundy, Luckett, Naughton, Tranter, Wyver, Ragen, J. et al, 2008). Play for healthy development during the early childhood stages is dependent on the primary caregiver's ability to create and maintain an environment in which a child could discover her worlds safely, while meeting the developmental milestones. The environment in which a child plays also contributes to how successful the child could use play experiences to reach developmental milestones. Play as developmental takes in childhood creates opportunities for children to discover their own abilities. Play also facilitates the acquisition of basic communication and conflict handling skills. Constructive play opportunities during childhood may therefore contribute to the development of well-integrated social and coping skills as building blocks later in life. The ability of the mother to care for the child by creating play spaces in addition to providing adequate nutrition, shelter and affection is therefore of utmost importance for the comprehensive development of a child in the first thousand days since conception. There is a dearth in the literature on 'mothering' as an area of task performance for women who have children between the ages of 0-24 months. Women who are at risk of ill health due to low education levels, living in crime-ridden communities, poor access to health and social services and low socio-economic status may need additional environmental support to facilitate constructive and meaningful play experiences for their children. The focus of this study is therefore to (1) determine the performance of women in the areas of ability to create safe and conducive play environments for their children as the foundation for enhancing the health of their children during the stage of early childhood development; (2) identify the environmental support needed that would enable women to nurture conducive play environments for their children. 1.3 Problem Statement: Social interaction and the ability to communicate and relate to others in an appropriate manner is a domain that affects human development and participation in society. The foundational skills of effectively interacting with other people are instilled during the first 1000 days of a child's life. According to Bornstein, Suwalsky and Breakstone (2012) 4-month old infant experienced distress when their mothers were emotionally unresponsive. Infants learn to respond to facial expressions of the primary caregiver and are able to distinguish such facial expressions by the age of 5 months already (Goldstein, Schwade and Bornstein, 2009). The family is one of the several setting in which human development takes place (Bronfenbrenner, 1986). External systems affecting the family and the development of the child include the mesosystem, exosystem and the chronosystem. Although these systems are interlinked and influence interaction within subsequent systems this study aims to investigate factors in the mesosystem with particular focus on the interactions with the mother within the home environment in which the child interacts during the first 1000 days since conception. | 1005 | | |
| | https://www.sun.ac.za/si | Capacity Building in Leadership and Management in the Primary Health Care Sector | The annual review, since 2012 by the Office of Health Standards Compliance (OHSC) consistently demonstrates exceptionally low leadership and corporate governance and operational management performance in primary healthcare clinics across SA; two of the seven domain score measurements of healthcare in the country are affected. The 2014-15 review of 358 primary health care clinics reveal that 73.5% of these clinics were rated as clinically poor and non-compliant; the 2015-2016 review shows no improvement. Leadership and corporate governance of the clinics as a whole scored 14% and operational management 32.8%. This has a major impact on limiting the quality of service delivery at the front-line of health services across the country. Intense aggressive intervention is required to address this problem. This project thus seeks to address this challenge by providing capacity building in leadership and management for district and operational managers in the primary health care sector.An accredited short course of 60 credits offered over a year providing capacity-building in leadership and management for operational and district managers of primary health care clinics in two provinces (Northern Cape and Mpumalanga). The project will run over three years, starting with an initial group of 60 participants in 2018 and reaching a further 60 each year over 2019 and 2020 (total reach of 180 over three years). • Participants for capacity building will be identified by Department of Health provincial authorities. • The annual capacity-building intervention will use a blended education methodology; which include a five-day contact session (face-to-face tuition), telematic education broadcasts (via satellite) three times per year for three hours per session, continuous education support by lecturers via the SunLearn e-learning platform, consultation telephonically or SKYPE.• Topics covered will include: risk management, principles of management and leadership, policy formulation and policy analysis, continuous quality improvement, infection control, disaster management, human resource management, and finances. | 960 | | |
| | https://www.sun.ac.za/si | Community Mobilisation for HIV testing and linkage to care in the Cape Metropole | The South African government targets are to achieve a 90% rate of diagnosis in HIV positive individuals, to provide antiretroviral treatment (ART) to 90% of HIV diagnosed individuals and to achieve virological suppression in 90% of ART patients by 2020. To date, HIV testing uptake in South Africa are below needed levels for early identification of people who need to be linked care to access to HAART. Interventions that increase uptake and frequency of HIV testing are urgently needed, particularly those that address social and structural barriers to testing and care. Community mobilisation approaches seek to create and harness the agency of the most vulnerable groups such as young women and men between the ages of 18- 35 years; in order to build their HIV/AIDS knowledge, awareness and greater agency to seek health for their well-being. Community mobilisation of vulnerable communities is a pillar of interventions that seek to promote health awareness in poor communities. This intervention usually involves collaboration between community based NGO's, health workers and communities in activities seeking to effectively achieve universal access to testing and linkage to care; using community mobilisation as an intervention to reach communities and individuals that have disengaged from public health care systems. | 1001 | | |
