Background: Child-rearing remains a concern within our communities, especially because families of today lack primary parents due to multifaceted challenges such as working mothers, diseases and violence. Health-promoting school initiatives are necessary because they allow a multifaceted approach to child-rearing. They further provide a conducive environment for continued schoolchild-rearing moving from home to school.Objectives: This study promotes an integrated approach to school care using the African concept of Ubuntu – solidarity and sense of community – as a point of departure. The socio-ecological model was used, which includes the work of the school healthcare nurse in contributing to holistic health services.Method: An integrative review was conducted in January 2013, which included methodology studies, a theory review and a variety of studies related to school health. The studies were categorised according to school health, Ubuntu and the socio-ecological model.Findings: The role of school healthcare nurses entails acting as a liaison officer between a variety of stakeholders who work together to shape the future of children.Conclusion: Ubuntu, together with the socio-ecological model, can assist us to involve an entire community to raise children. This knowledge serves as a background to the planning of a school health programme. The role of the nurse in school health can also assist in collaborative efforts to formulate the programme and develop the competencies that will inform school health nurse training curricula.

Background: An evidence-based practice suggests that the birth position adopted by women during labour has a significant impact on the maternal and neonatal birth outcomes. The birth positions are endorsed by guidelines of maternity care in South Africa, which documented that women in labour should be allowed to select the birth position of their choice, preferably alternative birth positions (including upright, kneeling, squatting and lateral positions) during labour. Thus, the lithotomy birth position should be avoided. However, despite available literature, midwives routinely position women in the lithotomy position during normal vertex births, which causes several adverse maternal outcomes (namely prolonged labour, postpartum haemorrhage) and adverse neonatal outcomes (such as foetal asphyxia and respiratory compromise).Aim: The aim was to explore and describe factors hindering midwives’ utilisation of alternative birth positions during labour in a selected public hospital.Setting: A public hospital in the Tshwane district, Pretoria were used in the study.Methods: This study used the qualitative, exploratory and descriptive research design. This design gathered quality information on factors hindering midwives’ utilisation of alternative birth positions during labour in a selected public hospital.Results: The study revealed the following themes: (1) midwives’ perceptions on alternative use of birth positions and (2) barriers to utilisation of alternative birth positions. The themes were discussed and validated through the use of a literature review.Conclusion: The lack of skills and training during the midwifery undergraduate and postgraduate programme contributes to the midwives being incompetent to utilise alternative birth positions during clinical practice.

Background: ‘Doing what the Romans do in Rome’ was an expression raised by one of the midwives following workplace culture and disregarding women’s birth choices. Midwifery practice in South Africa caters for a culturally diverse ethnic groups of childbearing women. Culturally appropriate care highlights the importance of including women in decision-making concerning their birth preferences including maternal positions during labour. Women’s right to choose their maternal position and cultural preferences during labour has been overlooked, leading to poor maternal healthcare provision and negative birth experiences.Aim: In this article, the researchers aimed to describe and explore midwives’ perspectives on culturally appropriate care to support maternal positions during the second stage of labour.Setting: Midwives working in the maternity ward in a public hospital in South Africa.Methods: A qualitative descriptive design using individual interviews was used to collect data. The participants were selected using the purposive sampling method. The study population comprised 20 midwives who volunteered to participate in the study. Data were transcribed manually and analysed using thematic analysis.Results: The four main themes are as follows: (1) Caring for women from various ethnic groups, (2) midwives disregard women’s beliefs and culture, (3) midwife personal cultural attributes and (4) midwifery unit workplace culture.Conclusion: The authors concluded that culturally appropriate care towards the women’s choices of birth position during the second stage of labour should form an integral part of the midwifery care rendered.

Background: Premature sexual activity has become a norm in South African society, often resulting in teenage pregnancy and sexually transmitted diseases (STD). Occurrence of premature sexual activity is related to insufficient education, gender inequal- ities, household poverty and place of residence. The Stepping Stones project uses a 10-session programme to educate learners about relationships, HIV-prevention and teenage pregnancy. The purpose was to measure and describe learners’ sexual knowl- edge and activities in a rural technical secondary school in North-west Province, South Africa. Methods: A cross-sectional survey. Questionnaires were distributed to learners in grade 8 to 12. Descriptive statistics was used in analysis. Results: Seventy-nine questionnaires were analysed. Despite a young sample, 26.6% were sexually active and 24.1% engaged in sexual activity. The mean age for first-time sexual intercourse was 15.2±2.3 years. The use of contraceptives was low (41.2%) and participants reported difficulty in talking to partners about condom use (54.8%). Almost half (45.5%) of the participants had never heard of STDs. Participants expressed a need to use social media as a sex education tool (12.3%). The primary source of information was from school-based programmes (58.0%). Conclusion: Findings point to unsafe sexual practice of learners at a school in rural South Africa, even from an early age. This concern is accompanied by the occurrence of low levels of sexually-related knowledge. The learners would benefit from contin- ued implementation of the Stepping Stones programme. Implementation could be improved by incorporating social media and emphasising gender equality and negotiation skills in sexually vulnerable situations. Keywords: Sexual knowledge; adolescent learners; South Africa.

Background: Irrespective of the provision of an integrated school health policy, the school health nurses continue to experience multiple challenges regarding the provisioning of school health service delivery.Aim: The aim of this paper was to explore and describe the experiences of school health nurses regarding school health service delivery in the Tshwane district.Setting: Schools in the Tshwane district in Pretoria were used in the study.Methods: A qualitative and descriptive phenomenological design was used to conduct the study. Purposive sampling techniques were used to select a sample from the population of school health nurses employed in the Tshwane district and conduct the enquiry because of their knowledge and experience of school health services. The researchers collected data by means of unstructured, one-on-one in-depth interviews. The Tesch data analysis method was used by the researcher and co-coder. The researcher identified categories, subcategories and themes and these were reduced into grouping topics that were related to one another.Results: Positive and negative experiences of school health nurses emerged. It was evident from the findings of the study that the factors affecting the quality of the integrated school health programme (ISHP) provided were interrelated. Most of these factors negatively affected service delivery.Conclusion: It was recommended that the partnership between the National Department of Health and National Department of Basic Education as the main role players should be sustained at all times to ensure the successful implementation of the ISHP.

Background: Perceptions of female teenagers in the Tshwane District contribute to the nonuseand or discontinued use of contraceptives as evidenced by increased levels of unplanned pregnancies.Objective: The objective of this study was to explore and describe the perceptions of female teenagers in the Tshwane District on the use of contraceptives.Methods: A qualitative, explorative, descriptive approach was followed in this study. The population comprised of pregnant female teenagers who were purposively selected. Data were collected using unstructured individual interviews on a face-to-face encounter in a natural setting. Data were analysed using the discourse method of data analysis.Results: The following perceptions on the use of contraceptives emerged: Perceptions on the use of contraceptives, emotions, contraceptive effects, social pressure and education on contraceptives. Teenagers’ perceptions were predominantly negative with unfounded fears. Though the teenagers were aware of the importance of the use of contraceptives, motivation to pursue contraception was lacking. Teenagers verbalised to be uncommitted as well.Conclusion: Various perceptions of female teenagers in the Tshwane District on the use of contraceptives were explored and described. It was noted that all the teenagers interviewed had great remorse and feelings of guilt regarding their behaviour of not using contraceptives.Their need for re-education was cited and seen as motivational enough to encourage the use of contraceptives at primary health care settings. Therefore, the study recommended that health education programmes should be restructured to effectively influence the female teenagers’perceptions positively and to promote the use of contraceptives.