Background Low birth weight continues to be a main cause of child morbidity and mortality. Low birth weight can cause complications in adult life, and is therefore a public health concern. In this study, we determined the maternal factors that contribute to low birth weight (LBW) deliveries in Tshwane District, South Africa. Methods We conducted a case control study of 1073 randomly selected mothers who delivered babies in four hospitals in the district. We reviewed antenatal and maternity registers to obtain information about the mothers and their offspring. We fitted a multiple logistic regression to examine relationships between possible factors associated with LBW. Results From the total sample of mothers (n = 1073), 77% (n = 824) were adult women, aged 20 to 35 years. Of the adult mothers, 38.54% (n = 412) delivered low birth weight (LBW) infants. The mean gestational age and weight of all infants at birth was 37.16 weeks (SD 2.92) and 2675.48 grams (SD 616.16) respectively. LBW was associated with prematurity, odds ratio (OR) 7.15, 95% confidence interval (CI) 5.18 to 9.89; premature rupture of membranes OR 7.33, 95% CI 2.43 to 22.12 and attending fewer than five antenatal care (ANC) visits OR 1.30, 95% CI 1.06 to 1.61. Male infants were less likely to be LBW, in this population. Conclusion Women who attended fewer than five ANC visits were predisposed to give birth to low birth weight babies. Mothers should be encouraged to attend ANC visits to detect adverse events like premature rupture of membranes and premature labour timeously.

Background. In Malawi, only 1 072 229 people out of a national target population of 13 546 324 had received at least one dose ofthe AstraZeneca COVID‑19 vaccine by 26 December 2021, and only 672 819 people were classified as fully vaccinated. PhalombeDistrict in Malawi had particularly low COVID‑19 vaccine uptake, with only 4% (n=8 538) of 225 219 people being fully vaccinated by26 December.Objectives. To explore reasons for vaccine hesitancy and refusal among people living in Phalombe District.Methods. This cross-sectional qualitative study employed six focus group discussions (FGDs) and 19 in-depth interviews (IDIs) to collect data. We purposefully selected two traditional authorities (TAs), Nazombe and Nkhumba, as study areas, and conducted FGDs and IDIs in 6 randomly selected villages in these two TAs. Participants were religious leaders, traditional leaders, youths, traditional healers and ordinary community members. We explored reasons for vaccine refusal and hesitancy, how contextual cultural beliefs influenced people’s decision to receive the COVID‑19 vaccine, and which sources of information were trusted in the community. Data were analysed using thematic content analysis.Results. We conducted 19 IDIs and six FGDs. Themes that emerged from the data were reasons for vaccine refusal and hesitancy, contextual cultural beliefs affecting the decision whether to be vaccinated, ways to improve COVID‑19 vaccine uptake, and means of communicating information about COVID‑19 vaccines. Participants mentioned that myths contributing to vaccine refusal and hesitancy circulated in the community through social media. With regard to contextual cultural beliefs, most participants believed that COVID‑19 was a disease of rich people, while others believed that it signalled the end of the world and that it could not be cured.Conclusion. Health systems should recognise and acknowledge the reasons leading to vaccine hesitancy and refusal and address these appropriately to improve vaccine uptake. Effective community sensitisation and engagement should be enhanced to clarify myths and address misinformation about the COVID‑19 vaccine.

Background Low uptake of family planning services by adolescent girls remains a public health concern. An estimated 120 out of every 1,000 girls aged 15 to 19 years are having unplanned pregnancies in the sub-Saharan region. Between January and June 2020, the Phalombe District of Malawi reported 3,030 adolescent pregnancies. At this stage, most Malawian schools were closed due to the COVID-19 pandemic. The high rate of adolescent pregnancies prompted the Ministry of Health to provide emergency contraceptives to reduce the number of unplanned pregnancies among adolescents. The provision of emergency contraceptives would be effective if girls were willing and able to access these family planning services. We thus explored the views of school-going adolescent girls regarding their preferences for modern family planning methods including emergency contraceptives in Phalombe, Malawi. Methods This was a cross-sectional, descriptive study, where quantitative data were collected using a structured questionnaire. Participants included randomly sampled school-going adolescent girls from eight purposively selected secondary schools and eight randomly selected primary schools. All the schools were sampled from three purposively selected Traditional Authorities namely Nkhulambe, Jenala and Nkhumba which had reported high numbers of adolescent pregnancies. We analyzed the GeoPoints for schools and health facilities using ArcGIS, while adolescent girls’ views were analyzed using STATA. Results Participants included 388 adolescent girls, ranging in age from 10 to 19 years (median age = 15.5 years, SD = 1.9 years). Participants were hesitant to use contraceptives because they were afraid of being stigmatized and embarrassed, had to travel long distances to reach the service center, knew little about modern family planning and were afraid of medical complications. Conclusion The uptake of family planning services by adolescent girls can be improved by bringing healthcare services closer to schools and homes. Family planning services should employ health workers who are non-judgmental and who are able to remove the stigma associated with family planning. Health workers should at any given opportunity, address the misconceptions and beliefs that adolescents have towards contraceptives. Community sensitization and health talks should be done to improve adolescent girls’ understanding of family planning services.

Background: The study was conducted to the background of a qualification in medical clinical practice offered at a Faculty of Health Sciences at a university in South Africa.Aim: The aim of the study was to determine how the theory of Whole Brain® thinking informed our professionalism and its relevance to transforming self and practice.Setting: The study was conducted in the context of a higher education institution, the University of Pretoria. The focus is specifically on the Bachelor of Clinical Medical Practice (BCMP). It has been offered since 2009.Methods: Participatory action research was the design of choice. The participatory part culminated in working as a collective in a scholarly community of practice. What is reported is the use of the Herrmann Brain Dominance Instrument® (HBDI®) as a research instrument. It was used to determine the thinking preferences of the lecturers. Each lecturer obtained their brain profile that served as baseline data for self-study in the future. The profiling revealed their strengths and areas that they needed to work on – as individuals and as a team.Results: The theory of Whole Brain® thinking was identified as an enabler towards transforming self and practice. This transformation involved both lecturers and prospective clinical associates.Conclusion: The value of the study mainly lies in the development of the professionalism of the lecturers. Linked to professionalism is the value of using the theory of Whole Brain® thinking that primarily informed the teaching practice of the lecturers. And secondary to this, the students’ authentic clinical practice, which included patients and simulated practice where peers act as patients. The study contributed to the scholarship of teaching and learning in a medical clinical context and to participatory action research – both interrogated from a Whole Brain® perspective for the first time in the context in question.

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