Background: Across the globe a large proportion of pregnancies have been reported as unintended. There are no available reports from South Africa concerning the prevalence of unintended pregnancies. This study explored the prevalence of unintended pregnancies among South African women attending a public primary health care (PHC) clinic in KwaZulu-Natal (KZN), South Africa. It also investigated the relationship between demographic factors, contraceptive use, substance abuse and unintended pregnancy in this setting. Methods: A descriptive cross-sectional survey was conducted among patients (n = 328) attending a PHC clinic. Participants were recruited by convenience sampling. Women who attended the clinic on their first antenatal visit were invited to participate. Participants filled out questionnaires in either English or isiZulu. Association between pregnancy and categorical variables was assessed. Results: Participants were mostly single (89.9%; n = 267), unemployed (70.8%; n = 222) with a monthly income of less than R 1 500 per month (63.8%; n = 81). Two-thirds of the women (64.33%; n = 211) had unintended pregnancies. There was a significant relationship between marital status and unintended pregnancy. Women who were married or living with their partners were more likely to have planned their pregnancies as compared with those who were single or divorced. Unemployed women were more likely to have had unintended pregnancies. No other socio-demographic factors were linked to unintended pregnancy. Conclusion: It is concluded that in this population of South African women with low education levels and low income, the prevalence of unintended pregnancies is high. These unintended pregnancies are linked to single status as well as unemployment.

This article reviews the women admitted to Mother Baby Psychiatric Units in 2002, in the State of Victoria, Australia, looking at characteristics of postpartum disorders with respect to admission and outcome in a region with a high number of mother-baby unit beds relative to other Australian regions and other cities. Differences among units are noted, including the differential impact of whether the unit is associated with a psychiatric service or an obstetric service. This includes length of stay and referral patterns. Details of diagnosis, admission and outcome are compared to similar admissions in the United Kingdom, with similar factors predictive of poor outcome, defined as separation from the infant. Mother-Baby Units have an important potential role in improving these outcomes, with longer-term studies of these women needed.

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Background In 2011, World Spine Care (WSC) opened their pilot clinic at the Botswana Mahalapye District Hospital (MDH) aiming to develop a low-cost model of evidence-based spine care for underserved communities. Providing sustainable, integrated, evidence-based care will require buy-in from local healthcare providers (HCPs) and the communities served. The purpose of this project was to understand how MDH HCPs perceive WSC. Methods We used a qualitative descriptive methodology to conduct individual, semi-structured interviews with MDH HCPs who had some familiarity about WSC services. Interviews were conducted in English, audio-recorded, and transcribed verbatim. We used an iterative coding process for thematic content analysis and interpretations were regularly reviewed by all co-authors. Results In March 2017, interviews with 20 HCPs, from diverse disciplines with a range in years’ experience at MDH, revealed three overlapping themes: knowledge about WSC and spinal related disorders, perceived role of WSC, and challenges for WSC integration. Participants who attended WSC conferences or self-referred for care were more informed and, generally, held positive perceptions. Participants lacked knowledge about managing spinal-related disorders, asserted hospital protocols did not meet patient needs, and perceived WSC is ‘filling a gap’ to manage these conditions. There were mixed perceptions about care received as WSC patients; some ultimately obtained relief, while others reported the treatment painful and unfamiliar, discharging themselves from care. Challenges to integrate WSC into the healthcare system were: lack of knowledge about scope of practice and unclear referral pathways; reversing the isolated care WSC provides by increasing collaboration between WSC and hospital staff; and, high turnover of WSC clinicians that undermines program sustainability. Conclusions MDH healthcare providers had adequate general knowledge about World Spine Care and spinal-related disorders, but did not understand the WSC scope of practice nor referral pathways to and from providers. Participants advocated for greater collaboration between WSC and hospital staff to increase acceptance and integration to deliver spine care services and foster wider adoption of the WSC model, particularly if WSC expands services across Botswana. Future efforts that incorporate interviews with patients and government officials also can provide valuable perspectives to achieve sustainable, integrated, evidence-based spine care. Electronic supplementary material The online version of this article (10.1186/s12998-019-0250-2) contains supplementary material, which is available to authorized users.

Background Manual therapy is a cornerstone of chiropractic education, whereby students work towards a level of skill and expertise that is regarded as competent to work within the field of chiropractic. Due to the COVID-19 pandemic, chiropractic programs in every region around the world had to make rapid changes to the delivery of manual therapy technique education, however what those changes looked like was unknown. Aims The aims of this study were to describe the immediate actions made by chiropractic programs to deliver education for manual therapy techniques and to summarise the experience of academics who teach manual therapy techniques during the initial outbreak of COVID-19 pandemic. Methods A qualitative descriptive approach was used to describe the immediate actions made by chiropractic programs to deliver manual therapy technique education during the COVID-19 pandemic. Chiropractic programs were identified from the webpages of the Councils on Chiropractic Education International and the Council on Chiropractic Education – USA. Between May and June 2020, a convenience sample of academics who lead or teach in manual therapy technique in those programs were invited via email to participate in an online survey with open-ended questions. Responses were entered into the NVivo software program and analysed using a reflexive thematic analysis by a qualitative researcher independent to the data collection. Results Data from 16 academics in 13 separate chiropractic programs revealed five, interconnected themes: Immediate response; Move to online delivery; Impact on learning and teaching; Additional challenges faced by educators; and Ongoing challenges post lockdown. Conclusion This study used a qualitative descriptive approach to describe how some chiropractic programs immediately responded to the initial outbreak of the COVID-19 pandemic in their teaching of manual therapy techniques. Chiropractic programs around the world provided their students with rapid, innovative learning strategies, in an attempt to maintain high standards of chiropractic education; however, challenges included maintaining student engagement in an online teaching environment, psychomotor skills acquisition and staff workload.