To what extent is Fetal Alcohol Spectrum Disorder considered in policy-related documents in South Africa? A document review

Abstract

Background South Africa is considered to have the highest prevalence of fetal alcohol spectrum disorder (FASD) globally. Nevertheless, the extent to which the South African government has responded to the high FASD prevalence at the policy level is unclear. Herein, we aimed to identify targeted and generic clauses that could be attributed to the prevention and management of FASD in relevant South African policy documents. Methods We conducted a search of two search engines (PubMed and Google) and the websites of South African national and provincial departments from January to April 2018. A total of 33 policy documents were included in this review. Using content analysis, we sought documents that mention the terms ‘fetal alcohol syndrome’ and ‘fetal alcohol spectrum disorder’. The Framework method was also used to thematically identify specific and generic clauses attributed to the prevention and management of FASD in South Africa. Results The content analysis indicated that 12 policy documents contained the searched terms. Findings from the thematic analysis showed that targeted and generic clauses for FASD exist in various policy documents. Some of the generic clauses focused on the regulation of liquor outlets, enforcement of liquor laws, and the general management of persons with mental and educational challenges. Specific clauses focused on creating platforms to improve the awareness, screening, identification and support for individuals with FASD. Conclusions There is a noticeable increase in the number of policy documents that considered elements of FASD enacted in the last decade. Although this study revealed the existence of targeted and generic clauses that could be attributed to the prevention and management of FASD, the sustained high prevalence of FASD in South Africa, as reported in the literature, calls for more holistic and comprehensive approaches to tackle the FASD problem in South Africa. Electronic supplementary material The online version of this article (10.1186/s12961-019-0447-9) contains supplementary material, which is available to authorized users.

Policy Requirements for the Prevention and Management of Fetal Alcohol Spectrum Disorder in South Africa: A Policy Brief

“…Findings from the two qualitative studies (21,22) and a document review (23), which formed part of our study, confirmed that there is no specific policy document addressing FASD in South Africa. However, clauses that could be attributed to the prevention and management of FASD exist in other related policy documents, although these do not holistically address FASD.…”

Integrated prevention and management of non-communicable diseases, including musculoskeletal health: a systematic policy analysis among OECD countries

“…Health policies of the 36 OCED Member States that reported on integrated NCD prevention/management and were submitted to WHO between 2015 and 2017 as part of a WHO NCD Country Capacity Survey were eligible for inclusion. We defined ‘policy document’ as any national or regional health policy, strategy or action plan submitted by a country in response a WHO NCD Country Capacity Survey, consistent with aligned research 28…”

A guideline for the prevention and management of Fetal Alcohol Spectrum Disorder in South Africa

“…In addition to the focus group discussions and in-depth interviews, we conducted a document review. We identified clauses of FASD policy in various South African-related policy documents [28]. We searched databases (PubMed and Google search engines) and the websites of South African national and provincial departments.…”

“…Despite the availability of context-relevant evidence-based interventions such as case management and universal prevention approaches to prevent FASD [26, 27], there is a lack of policy and resources to guide the expansion and implementation of these interventions to many parts of the country. There is evidence that current prevention and management interventions are informed by genetic-related and other generic policy documents [21, 28]. For instance, the Human Genetics Policy Guidelines for the Management and Prevention of Genetic Disorders, Birth Defects and Disabilities and the Mini Drug Master Plan covers FASD as a genetic disease.…”