The maternal death rate remains high in South Africa despite the availability of many existing strategies to improve the quality of service. A 30% increase in the maternal mortality rate was reported between 2020 and 2021, with Limpopo ranking fourth highest out of nine provinces. The Vhembe district maintained its position as the third-ranked area with a notably elevated maternal mortality rate. This study aimed to explore the strategies used to reduce the maternal death rate and improve the provision of quality maternal healthcare services based on participant experiences in selected hospitals of the Vhembe district, Limpopo Province. One hospital was purposively sampled from every four municipalities. A qualitative approach using a phenomenological design was employed. Twenty-eight participants were sampled using a convenience sampling method. The semi-structured interview guide was used to collect data, complemented by the use of an audio recorder, continuing until data saturation was reached. Data saturation was reached at the 20th participant; however, the researcher continued until 28 sampled participants were interviewed. An interpretative phenomenological analysis was used following the analytical stages of interpretative data analysis. The study proposal was ethically cleared by the University of Venda Ethics Committee (FHS/22/PH/08/3108). The results indicate that, despite implementing strategies to improve maternal healthcare services and reduce the maternal death rate, several factors, such as the lack of material resources, shortage of staff, incompetent staff and poor infection control, affect the quality of maternal health services in the Vhembe district. The Limpopo Department of Health and hospital management should ensure that hospitals have all the necessary resources and support healthcare professionals through in-service training to ensure the functionality of existing strategies.

INTRODUCTION: Despite the efforts of professional nurses, exclusive breastfeeding rate is very low in South Africa. Per statistic South Africa, exclusive breastfeeding (EFB) rate is 32% with Limpopo Province being rated 8% as one of the lowest in South Africa. Implementation of exclusive breastfeeding required professional nurses’ efforts, lactating mothers, families, and community need information and support from the health care system. The purpose of this study aimed at exploring professional nurses’ challenges regarding implementation of exclusive breastfeeding in Limpopo Province. METHODS: qualitative research involving phenomenological design was employed to explore professional nurses’ challenges using one on one, unstructured, in-depth interview with 30 professional nurses; 27 females and three males, working in the six birthing facilities of two selected districts; Vhembe and Waterberg, in Limpopo Province RESULTS: the three higher order themes emerged were: challenges experienced by nurses during promotion of exclusive breastfeeding; findings revealed challenges as cultural and religious beliefs, lack of family/community and health professional support, teen and HIV positive mothers, nurses found to have challenges to implement exclusive breastfeeding; healthcare system and services such as shortage of staff and lack of proper training on lactation management and perceived measures to promote exclusive breastfeeding suggested by health professionals, which include on-going health education, door to door campaigns, implementation of policy by health care professionals would promote exclusive breastfeeding strategies that are in place and encourage families and community to support lactating mothers to improve their confident on breastfeeding. CONCLUSION: professional nurses had challenges in promoting exclusive breastfeeding. An intervention is needed to promote exclusive breastfeeding.

Substance use continues to be a social problem globally. Around the world, approximately 275 million people use drugs, including 15% of South Africans, with over 36 million succumbing to drug disorders. In the Gauteng Province, about 55% of autopsies of deceased medicolegal cases (2003–2012) showed the presence of one or more illicit drugs in Pretoria. Most research shows that around one-third of people who have problems with alcohol and drugs are homeless. Evidence suggests that homeless people are often denied access to even the most essential assistance, including healthcare. This study assessed the healthcare-seeking behaviors of homeless substance users during the COVID-19 lockdowns in Gauteng, South Africa. A qualitative approach using an exploratory design assessed referrals based on those suffering from symptoms of COVID-19 during the lockdown period between 2020 and 2022. Data were collected from 25 homeless substance users in the City of Tshwane, Gauteng, through unstructured interviews. Three themes based on the study objectives included the types of healthcare services consulted, the determinants of health-seeking behaviors, and challenges experienced while seeking healthcare. Of the twenty-five participants, aged twenty-one to fifty, thirteen suffered from COVID-19 symptoms. Five used formal healthcare systems and eight used informal healthcare systems. Older participants access healthcare services, while less of the younger population use them. Barriers that are encountered while seeking medical services entail marginalization, stigmatization, and a lack of social support. Despite the formidable barriers posed by homelessness and substance use, homeless individuals demonstrated remarkable resilience in their efforts to access healthcare services during the COVID-19 lockdowns. This study highlights the importance and urgent need for harm reduction strategies and policy development for long-term service provision to this population, as well, as the literature on equity, diversity, and inclusion as a foundation for the rights of marginalized populations and groups. Future research directions should focus on harm reduction among this population group of homeless substance users.

Introduction: A pregnant woman’s life and that of her child largely depend on the care they receive during the critical stage of pregnancy, labour, and the postpartum period. Some women question their decisions regarding future pregnancies as well as where and from whom they will receive their pregnancy care because of negative experiences that they have had. Aim: The aim of this study was to explore and describe the experiences of women regarding maternity care services in a selected hospital in Vhembe District, Limpopo Province. Methods: A qualitative approach using a phenomenological research design was adopted in this study. The study population included pregnant women who were admitted to the maternity ward of the selected hospital. A total of 18 participants and 1 hospital were purposively sampled. Pre-testing was conducted to check if the central question was clear and to test the researcher’s interviewing skills. Face-to-face interviews were conducted with all sampled participants in April and May 2024. Interpretive analysis was used to analyze the data collected from the participants. Results: Four themes emerged during data analysis: women’s experiences regrading the provision of maternal healthcare; environmental factors affecting maternal health services; lack of resources; and the attitude of nurses towards patients. Conclusions: This study concludes that the majority of the women stated that they were not happy about the maternity care services provided at the selected hospital. Issues such as trained nurses being verbally and physically abusive towards women in labour, as well as the infrastructure and lack of resources of the hospital contributed towards women not being happy about the provision of maternity care services being provided. This study recommends that in order for maternity care services to improve at the selected hospital, there should be workshops for staff on how to improve patient care principles and improvements in the standard of cleanliness in and around the selected hospital.

Background: Village health workers (VHWs), popularly known as community health workers (CHWs) in some contexts and settings, should effectively complement health care providers in primary health care (PHC) delivery in Zimbabwe. However, they continue to offer services that do not address current and emerging health issues. Aim: This study aims to review the literature and develop a conceptual framework to improve the effectiveness and efficiency of VHWs in service delivery. Method: Rodgers’ evolutionary framework was used to analyse the concept of ‘strategies for effective and efficient delivery of PHC by VHWs’. Articles and reports published in English from 2010 to 2022 in peer-reviewed journals from the PUBMED, EBSCO, ScienceDirect and Google Scholar databases were reviewed. Results: After screening and removal of duplicates a total of 52 articles and two reports were reviewed to identify antecedents, attributes and consequences of strategies to improve PHC services by village health workers. The antecedents included an enabling work environment, community participation, motivation, incentives, integration of community health into national health systems, and information and communication technology. The attributes consisted of ongoing training and skills development, mutual respect and trust, enhanced contact between VHWs and communities and supportive supervision. The consequences were equitable access to and improved quality of PHC service delivery. Conclusion: The concept of PHC service delivery by VHWs has evolved from health promotion to curative care through task shifting and is now an integral part of the health system. A supportive and enabling work environment, anchored in community participation, empowers VHWs to deliver equitable services effectively and efficiently. Contribution: The development of strategies for improving VHW service delivery and a conceptual framework informed by findings from the reviewed literature.

Background: Breastmilk only is enough for milestone of a child because it contains all necessary nutrients. Because of its benefits World Health Organization recommends that lactating mothers must give their infants only breastmilk for six months and continue up to two years with appropriate complementary food. Despite its benefits breastfeeding is not well practiced in developing countries, South Africa included. Objective: This study aimed to investigate enabling, reinforcing and predisposing factors influencing exclusive breastfeeding interruption among lactating mothers in Limpopo Province. Methods and materials: This study was cross sectional which employed quantitative measures. Data was collected from 399 lactating mothers during immunization in the selected birthing facilities of Limpopo Province and analysed using SPSS version 26. Results: The findings indicate that breastfeeding mothers were likely to stop breastfeeding completely when their babies were three months old. The findings were that the majority 72.9% of the mothers practised mixed feeding and the minority, only 27.1% practised EBF. It was also found that 38.5% mothers gave water to the infants, 30.2% were given soft porridge and 26.1% formula. Conclusion: The study revealed that the factors that affect exclusive breastfeeding include: influence from the Parents/in-laws Insufficient breastmilk, religious and cultural beliefs, illness of the mothers and young mothers and going back to work/school.