This country profile examines the development of family medicine (FM) and primary health care (PHC) in Liberia, a low-income West African nation with significant health and socioeconomic challenges. Liberia's PHC system is structured across three tiers and relies heavily on community health workers to serve dispersed and underserved populations. Family medicine is an emerging specialty, crucial for strengthening PHC and advancing universal health coverage, especially in rural areas facing workforce shortages. The Family Medicine Specialty Training Program, launched in 2017, addresses the deficit of rural healthcare providers through comprehensive, context-specific education and rural rotations. Family physicians contribute at multiple levels of the health system, providing clinical care, mentorship, and leadership. The Society of Family Physicians of Liberia supports professional development and advocacy. Despite ongoing challenges, Liberia's integration of FM and PHC, supported by national and international partnerships, demonstrates significant progress and offers valuable lessons for building resilient health systems in low-resource settings.

BackgroundThis study employs a non-empirical review to examine how digital media platforms support public health education and awareness, with specific relevance to the South African context.AimTo explore the use of digital media in disseminating public health information and its implications for improving citizens’ awareness and health literacy. Drawing on global evidence, the review highlights relevance for South Africa’s digital communication landscape.MethodThe review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search was conducted across databases including Google Scholars, EBSCOhost, PubMed, ScienceDirect, Sabinet, ProQuest, Scopus and MEDLINE. Studies were selected using predefined inclusion and exclusion criteria, resulting in 15 peer-reviewed full text articles published between January 2019 and March 2023. Quality appraisal was conducted using the Joanna Briggs Institute Qualitative Assessment and Review Instrument, and findings were synthesised thematically.ResultsFindings indicate that digital media use reduces misinformation, strengthens social support networks, enhances the reach and efficiency of health information, and promotes positive health behaviours. Improvements in health knowledge and engagement were observed across diverse populations. However, challenges such as digital literacy gaps, unequal access to digital platforms, and algorithmic bias remain significant concerns.ConclusionDigital media represents a transformative tool for public health communication. When strategically implemented, it enhances awareness, supports behaviour change, and strengthens public engagement with health information.ContributionThe review highlights the importance of collaboration between health professionals and digital communication specialists to optimise digital strategies. It underscores policy imperatives such as improving digital literacy, ensuring equitable access, strengthening regulation of online health information, and fostering public-private partnership to improve health outcomes in South Africa.

Climate change has an adverse impact on health in Eastern Africa. Climate-sensitive diseases pose a threat to the health, growth and development of children. To determine the influence of climate change on children attending primary care in Isiolo County, Northern Kenya. The study was undertaken in Isiolo County Referral Hospital in Isiolo County, Northern Kenya. Convergent mixed methods research design. Quantitative data on climate variability and disease patterns were collected over the last 5 years and analysed using the Statistical Package for Social Sciences. Qualitative data from 12 interviews of parents with children under 5 years and six interviews of healthcare workers were analysed with Atlas-ti using the framework method. The county experienced climate fluctuation between 2019 and 2023, characterised by reduced rainfall, high temperatures, food insecurity, reduced access to water and flash floods. Families were vulnerable to the effects of these climate shocks because of limited finances. Primary care services were of low quality and lacked resilience. Healthcare workers reported limited medical resources, healthcare worker shortages and overcrowding in hospitals. Health effects reported by parents included malaria, pneumonia, diarrhoeal diseases and mental health illnesses. Social effects reported were displacement, child neglect and disruption to education. Climate change has had a substantial impact on children's health and social circumstances. Families that are dependent on public sector health services are vulnerable and lack the resilience needed to cope with climate stressors. The health facilities also lack the resilience needed to respond adequately to the challenges of climate change.Contribution:This study will strengthen climate and health data and improve policies to address regional community needs. It also demonstrates that improving healthcare financing will impact healthcare system resilience.

Childhood visual impairment is an important public health concern considering the social, emotional and economic consequences. Lack of access to eye care services contributes to this growing problem. Therefore, integrating primary eye care into existing primary healthcare would facilitate improved access to equitable, effective and affordable eye care services, particularly for children. The study assessed the provision of primary paediatric eye care services in health facilities in the Ashanti region of Ghana. The study was conducted at the primary health facilities in the Ashanti region of Ghana. Stratified random sampling was used to select 145 health facilities in this descriptive study. The eye care professionals in these facilities completed a questionnaire concerning primary eye care services for children. Data were analysed using descriptive and inferential statistics. Eye care services were available in 131 (90%) of the health facilities resourced with essential eye equipment. Refraction services were provided by 129 (98.5%) despite limited coverage by the national health insurance scheme. More than 80% of participants lacked continuing education and 59% had poor awareness of management guideline. Barriers identified included lack of specialised equipment and inadequate resources. The study highlights disparities in the provision of child eye care services among the health facilities in the Ashanti region of Ghana.Contribution:This study provides useful information to inform policy on targeted interventions for child eye care services to ensure accessible, equitable and comprehensive services.

Cervical cancer ranks fourth among cancers recorded globally and is the second most common cause of cancer-related morbidity and mortality in women. Although cervical cancer is fatal, the early discovery of precancerous cells by extensive and recurrent screening could lead to a significant decline in incidence. However, the acceptance of cervical cancer screening is low, even among healthcare workers. To explore the perceptions of primary care nurses about cervical cancer screening. The study was carried out in four primary health care centres (PHCCs) in the Leribe district. This is an exploratory qualitative study. The researcher purposively selected and interviewed 10 nurses at the selected PHCCs. The data were analysed thematically. Nurses' perceptions of cervical cancer screening influenced whether they routinely detect the disease. Certain perceptions, such as being susceptible to cancer, fear of cancer consequences, feeling relieved by negative results, high self-efficacy, training and witnessing deaths, all encouraged routine screening. Those that discouraged routine screening included fear of positive testing, lack of results, perceived lack of confidence and privacy in screeners and low self-efficacy. These findings show that nurses' decisions to undergo a regular screening are either encouraged or discouraged by their perceptions about cervical cancer screening. They also imply that the general public may be impacted by these perceptions as well.Contribution:These findings add significantly to the body of knowledge about how policies can be improved to improve nursing screening programmes, which can improve screening rates among the general population.

Cardiovascular diseases (CVDs), including hypertension (HTN), have emerged among people living with HIV (PLHIV) as the most important prevalent contributors of non-AIDS-related mortality. Moreover, HTN itself is a modifiable risk factor for other CVDs. Data are limited regarding the prevalence of HTN and associated factors among PLHIV in Lesotho. To determine the prevalence of HTN and associated factors among PLHIV attending Senkatana ART Clinic. The study was carried out at Senkatana ART Clinic in urban Maseru, Lesotho. A cross-sectional study was conducted from February to July 2022. Data were analysed using SAS statistical software (v9.4) and Microsoft Excel. To determine HTN prevalence, blood pressure (BP) was measured, and a questionnaire was administered to participants who were randomly selected using the lottery method from the clinic's daily attendance list. Multiple logistic regression was used to assess factors associated with HTN in PLHIV while controlling for potentially confounding factors. The prevalence of HTN was 57% (exact 95% CI: 51.2%, 62.7%). Of those with HTN, 33.3% were newly diagnosed during this study (exact 95% CI: 26.3%, 40.9%), while 69% of those previously diagnosed with HTN had uncontrolled HTN at enrollment (exact 95% CI: 60.0%, 77.6%). Age older than 50 years (p 0.0001) and a body mass index (BMI) of 25.0 kg/m2or higher (p 0.0002) were independently associated with HTN. Hypertension was highly prevalent and poorly controlled. Factors associated with HTN in PLHIV were older age and higher BMI. The study's findings support models of comprehensive healthcare delivery.

Malawi faces a heavy cancer burden because of high incidence and late-stage diagnoses, largely driven by low public awareness of cancer risk factors and early warning signs. This study aimed to explore the cancer knowledge of cancer risk factors and early warning signs, and sources of information among the public. This study was conducted in four districts within the Southern Region of Malawi. The study used a cross-sectional approach to elicit knowledge of cancer and sources of cancer information among a sample of 305 participants. Data were collected using a previously standardised Cancer Awareness Measure (CAM). Statistical data analyses were conducted using IBM®SPSS®statistics version 22. Awareness of cancer risk factors and early warning signs was found to be low, indicating a significant lack of public knowledge about cancer. The radio emerged as the most common medium of cancer information through which Malawians receive cancer information, followed by clinics and hospitals. Interestingly, many individuals perceived clinics - not the radio - as the primary source where they gained a clearer understanding of cancer information. The study concludes that public knowledge of cancer in Southern Malawi is low and although radio is the main information source, clinics are more effective because of expert guidance.Contribution:This study identifies critical gaps in cancer awareness and understanding in Malawi, highlighting the need for improved and targeted communication strategies, particularly among vulnerable populations.

Sexually transmitted infections (STIs) are a widespread public health concern, disproportionately impacting young adults. This group is at higher risk due to factors like limited knowledge, misconceptions about sexual health, inconsistent condom use, multiple sexual partners, and barriers to youth-friendly sexual and reproductive health services. Partner notification (PN) strategies are critical in STI control. Effective notification and communication with sexual partners can help break the infection chain and encourage early diagnosis and treatment. However, the dynamics of PN in young individuals remain unclear. To explore PN practices and experiences of STI-diagnosed patients with their sexual partners in the Ekurhuleni East sub-district, Gauteng, South Africa. The study was conducted in five healthcare facilities in Ekurhuleni East. Thirty participants were selected purposively, using an exploratory design. A semi-structured interview guide and in-depth face-to-face interviews were used. Data were analysed using thematic content analysis, following Braun and Clarke's six-phase approach: familiarisation, coding, theme identification, theme review, theme definition, and report production. The study identifies key areas for improving STI prevention and PN. Low understanding and cultural attitudes around STIs highlight the need for culturally relevant health education. PN presents emotional and relational issues, including intimate partner abuse and casual relationships, indicating the need for supportive and adaptable notification methods. The study highlights the importance of addressing knowledge gaps and cultural beliefs about STIs and promoting open communication in relationships.Contribution:This study contributes insights to healthcare policymakers and practitioners to improve STI management and safer sexual practices among young people.

BackgroundThe South African government signed the National Health Insurance (NHI) Bill into effect on 15th of May 2024 to ensure that all citizens have access to high-quality healthcare, regardless of their financial situation. While this initiative will impact all healthcare professionals, there is limited information on how speech-language therapists (SLTs) perceive its implementation in South Africa.AimThe study aimed to explore the knowledge, attitudes and perceptions of SLTs in the public and private healthcare sectors related to service provision regarding the implementation of the NHI.SettingThis study was conducted virtually via Zoom (Zoom Video Communication, San Jose, California, United States) and Teams (Microsoft Teams, 2017) with SLTs in their respective settings in South Africa.MethodsThe descriptive, qualitative research design involved virtual semi-structured interviews with 10 SLTs. NVivo software (QSR International, Victoria, Australia) was used to analyse the data, as guided by Tesch’s content analysis method.ResultsEleven sub-themes emerged related to the three themes of knowledge (4 sub-themes), attitudes (4 sub-themes) and perceived impact (3 sub-themes) of NHI implementation on SLT services.ConclusionThe study highlights SLTs’ knowledge, gaps and concerns about the impact of NHI implementation on their profession, emphasising the personal and professional areas that need to be addressed for its successful rollout.ContributionUnderstanding SLTs’ opinions will help address their concerns during the planning stages of integrating them into the NHI. This will lead to an equitable distribution of sufficient practitioners and ensure that many people benefit from its implementation.

Road Traffic Incidents (RTIs) are a major public health concern worldwide, particularly in low-income to middle-income regions such as sub-Saharan Africa. Data from sub-Saharan Africa suggests that the public transport industry accounts for the majority of fatal crashes that contribute to the high mortality and morbidity associated with RTIs. In this viewpoint, we advocate for integrated and comprehensive evidence-based health and safety interventions to address the challenge of RTIs in the public transport industry in sub-Saharan Africa. We provide evidence on the magnitude of the problem drawing on the state of mortality and morbidity and reported challenges associated with RTIs in the minibus taxi industry in South Africa as this is the most common mode of public transport in the region.