Background: Pregnancy decision-making is complicated for HIV-positive women because they have to contend with unpredictable symptoms, potential vertical transmission, and often a problematic life context including poverty, abuse, and stigma. Purpose: The purpose of the study was to explore the views of HIV-positive women attending a support group at a clinic in the Mpumalanga Province, on becoming pregnant. Methods: A qualitative, descriptive, and phenomenological research design was adopted to conduct one-on-one interviews using a semi-structured interview guide. Purposive sampling aided the selection of fifteen HIV-positive women who were members of the HIV/AIDS support group at the clinic. Data saturation was reached at participant number 15. Lincoln and Guba's four criteria for ensuring the trustworthiness of data were applied. Data were analysed using the open coding technique. Results: The following categories emerged: Mitigating fears of becoming pregnant through the prevention of mother-to-child transmission (PMTCT) programme; relationship between becoming pregnant and stigma attached to HIV/AIDS; cultural and social norms about becoming pregnant and the relationship between support groups and becoming pregnant. Conclusion:The study concluded that the desire to become pregnant amongst HIV-positive women is influenced by several aspects such as knowledge about the prevention of mother to child transmission, cultural values and social norms, and belonging to support groups where they were able to share experiences. Furthermore, becoming pregnant was viewed as an obligation to satisfy their partners/husbands and security to maintain marriages.

Background Maternal and child health (MCH) is a global health concern, especially impacting low- and middle-income countries (LMIC). Digital health technologies are creating opportunities to address the social determinants of MCH by facilitating access to information and providing other forms of support throughout the maternity journey. Previous reviews in different disciplines have synthesized digital health intervention outcomes in LMIC. However, contributions in this space are scattered across publications in different disciplines and lack coherence in what digital MCH means across fields. Objective This cross-disciplinary scoping review synthesized the existing published literature in 3 major disciplines on the use of digital health interventions for MCH in LMIC, with a particular focus on sub-Saharan Africa. Methods We conducted a scoping review using the 6-stage framework by Arksey and O’Malley across 3 disciplines, including public health, social sciences applied to health, and human-computer interaction research in health care. We searched the following databases: Scopus, PubMed, Google Scholar, ACM Digital Library, IEEE Xplore, Web of Science, and PLOS. A stakeholder consultation was undertaken to inform and validate the review. Results During the search, 284 peer-reviewed articles were identified. After removing 41 duplicates, 141 articles met our inclusion criteria: 34 from social sciences applied to health, 58 from public health, and 49 from human-computer interaction research in health care. These articles were then tagged (labeled) by 3 researchers using a custom data extraction framework to obtain the findings. First, the scope of digital MCH was found to target health education (eg, breastfeeding and child nutrition), care and follow-up of health service use (to support community health workers), maternal mental health, and nutritional and health outcomes. These interventions included mobile apps, SMS text messaging, voice messaging, web-based applications, social media, movies and videos, and wearable or sensor-based devices. Second, we highlight key challenges: little attention has been given to understanding the lived experiences of the communities; key role players (eg, fathers, grandparents, and other family members) are often excluded; and many studies are designed considering nuclear families that do not represent the family structures of the local cultures. Conclusions Digital MCH has shown steady growth in Africa and other LMIC settings. Unfortunately, the role of the community was negligible, as these interventions often do not include communities early and inclusively enough in the design process. We highlight key opportunities and sociotechnical challenges for digital MCH in LMIC, such as more affordable mobile data; better access to smartphones and wearable technologies; and the rise of custom-developed, culturally appropriate apps that are more suited to low-literacy users. We also focus on barriers such as an overreliance on text-based communications and the difficulty of MCH research and design to inform and translate into policy.

Background: Implanon is one of the contraceptives that protects women from falling pregnant for a period of 3 years. Levonorgestrel implants are perfect for adolescents who wish to have lengthy protection against pregnancy and for those who are not consistent in taking Oral Contraceptive Pills (OCP). Objective: The objective of the study is to investigate the views of adolescent girls on the use of Implanon as a birth control method. Methods: A qualitative explorative and descriptive study was conducted to explore and describe the views of adolescent girls regarding the use of Implanon as a birth control method at a primary health clinic in Limpopo Province. In-depth interviews were conducted with 15 adolescent girls who had previously used the Implanon and voluntarily agreed to participate in the study. Data were analyzed using the Tesch’s open coding analysis and the following themes emerged: views of adolescent’s girls on the use of Implanon, experiences of adolescent girls while using Implanon, health professionals and the insertion of Implanon and other chronic treatments. Results: The study reveals that the lack of trained health professionals, competency in performing Implanon insertion and poor counseling skills by health professionals prompted fear amongst the adolescent girls, which contributed to the low uptake of adolescent girls of the Implanon contraceptive. Conclusion: There is a need for more training of health professionals on counseling skills, insertion, and removal of Implanon. Furthermore, awareness campaigns or dialogues must be hosted annually to engage the public to talk about Implanon.

Background: The COVID-19 pandemic resulted in many universities suspending their academic activities, making virtual learning an option for saving the disrupted academic year. The pandemic presented an opportunity to assess the implementation of virtual learning at this university, thus forcing rural-based universities to enhance their learning management system, including their clinical disciplines. This paper explores the use of virtual learning amongst learner nurses in a rural-based university by following the el-CDDO framework. Method: A quantitative descriptive design was applied to describe the barriers experienced to virtual learning, in a rural university. The purposive convenience sampling method was used to select learner nurses from the Faculty of Healthcare Sciences. An electronic survey questionnaire with both open and closed-ended questions sent via WhatsApp messenger was used to collect data. Data were analyzed using descriptive statistics with SPSS version 26. Results: The el-CDDO components affected in the study included the Context, Delivery, and Outcomes of virtual learning in a rural-based university. The Context demonstrated geographically disadvantaged learner nurses, which affects virtual learning delivery. Thus, the Outcomes included various barriers to virtual learning, such as weak networks for connecting to Blackboard, the lack of ICT facilities, such as laptops and tablets, by learner nurses, a lack of skills for using Blackboard, and ageing academics. Conclusion: The study findings provide a baseline reference for future digital health in the clinical area and the use of virtual learning in a rural-based university. Though we noted complex challenges such as the lack of gadgets, our findings provide a significant contribution to the planning for virtual learning in universities and the use of digital health in the clinical area. Addressing the virtual learning barriers discussed in this paper will be a significant step forward in equipping learner nurses as future healthcare professionals with digital knowledge and skills. There is a need to develop strategies to enhance virtual learning in rural-based universities to ensure future digital health.

South Africa has recorded the highest COVID-19 morbidity and mortality compared to other African regions. Several authors have linked the least amount of death in African countries with under-reporting due to poor health systems and patients’ health-seeking behaviors, making the use of clinical audits more relevant for establishing the root causes of health problems, and improving quality patient care outcomes. Clinical audits, such as mortality audits, have a significant role in improving quality health care services, but very little is documented about the outcomes of the audits. Therefore, the study sought to determine the health care system and patient-related factors associated with COVID-19 mortality by reviewing the COVID-19 inpatient mortality audit narration reports. This was a retrospective qualitative research approach of all hospitalized COVID-19 patients, resulting in death between the first and second COVID-19 pandemic waves. Thematic analysis employed inductive coding to identify themes from mortality audits from all 41 public hospitals in Limpopo Province, South Africa. Four themes with seventeen sub-themes emerged: sub-standard emergency medical care provided, referral system inefficiencies contributed to delays in access to health care services, the advanced age of patients with known and unknown comorbidities, and poor management of medical supplies and equipment, as a health system and patient-related factors that contributed to the high mortality of COVID-19 patients. There is a need to routinely conduct clinical audits to identify clinical challenges and make recommendations for health promotion, risk communication, and community engagement. We recommend reviewing and expanding the scope of practice for health-care providers during epidemics and pandemics that include aspects such as task-shifting.

The battle against the Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) epidemic are still raging in South Africa (SA) despite all the preventive strategies implemented via the five-year strategic plan (2011–2015). The intensity of the AIDS pandemic in SA creates additional challenges for the health workers as they have to deal with an increasing number of people who suffer from this disease. Professional nurses are a critical part of the workforce. The qualitative, explorative, descriptive, and contextual study design was conducted in five public hospitals from each district of Limpopo Province. The purpose of the study was to explore and describe experiences regarding support received by professional nurses while providing care to HIV and AIDS patients in the public hospitals of Limpopo Province. Purposive sampling was employed to select the participants who provided care to HIV and AIDS patients for 24 months or more. The recruitment of participants continued until data saturation was reached at participant number 20. Data were collected through face-to-face individual interviews using a semi-structured guide. Data were analyzed using Tech’s qualitative data analysis method. Trustworthiness was measured through credibility, dependability, confirmability, and transferability. Findings: Emotional and physical strain due to a shortage of staff, heavy workload, staff turnover, and high absenteeism were experienced by the nurses fulfilling these tasks. Exhaustion, fatigue, increased levels of stress, and lack of training, counselling, debriefing sessions, recognitions, and reward systems were also experienced. Recommendations: A program for support of all professional nurses providing care to HIV and AIDS patients should be conceptualized and implemented.

cultural nuances influenced co-design workshops and artefacts. Adjustments to the rhythms of the workshops and co-design activities enabled "transferability" between rural and urban settings, and across diverse cultures, regardless of whether these settings include members from the same cultures. CCS CONCEPTS• Human-centered computing → Participatory design; Contextual design; Field studies.

Background: The primary purpose of introducing the COVID-19 vaccine was to fight the pandemic. However, the vaccine was not well received worldwide. This challenge has threatened the effective implementation and roll-out of COVID-19 immunization campaigns. The challenge of vaccine hesitancy was reported to be more prevalent in rural areas due to various factors such as cultural beliefs, misinformation, poverty, lack of education, and distrust of vaccines. Yet there seems to be a scarcity of studies determining the prevalence of vaccine hesitancy in deep rural areas of Limpopo. Purpose: The study aimed to explore the prevalence of COVID-19 hesitancy among the rural black population in South Africa. Study Methods: A longitudinal quantitative study was conducted with data from the DIMAMO Health and Demographic Surveillance Site (HDSS) database for 2020 to 2022. A non-probability total sampling technique was used to select the respondents. Trained fieldworkers collected data using an electronic data capture questionnaire. A comparison of categorical variables was performed using Chi-Square in SPSS version 26 and the statistical significance was set at p < 0.05, with a 95% confidence interval to analyze the data. Results: The limited availability of vaccination sites in Limpopo Province, South Africa, was associated with a reduced certainty that the vaccine would be accepted, as reported in the current study. The prevalence of visiting traditional healers was significantly higher in non-vaccinated than vaccinated participants among the rural black population, indicating a different cultural belief among the rural black population that existed before and during the COVID-19 pandemic. Conclusion: The present study findings show diverse factors of concern associated with vaccination hesitancy for COVID-19 among rural black people. Lack of education, gender, not being diagnosed with COVID-19, not being a Christian, visiting traditional healers, vaccine mistrust, unknown side effects, and a lack of confidence in the vaccine itself. Conspiracy theories were factors that impacted vaccine acceptance among black people living in rural areas. The prevalence of visiting traditional healers was significantly higher in non-vaccinated than vaccinated participants. Therefore, the present study findings emphasize the need to collectively integrate and utilize the traditional healers in the South African healthcare system.