African Journal for Physical Activity and Health Sciences (AJPHES) - latest Issue

In continuation of the series of publications to mark the 25th anniversary of AJPHES, the September 2019 issue of the journal presents a compendium of research based articles which addresses contemporary issues in Sport, Physical Activity and Health. The lead article in this issue titled, “Society and gender equity in sport: Analysis from a South African perspective’ by Adom-Aboagye and Burnett draws attention to the clarion call to promote gender equity, not only in sports, but in all spheres of life. Based on data and narratives obtained from representatives of 18 non-governmental organisations responsible for the delivery of sport for development programmes and eight gender activists or leaders in the field, the study reports on “patriarchal and cultural issues, the lack of policy implementation, and hegemonic structures and practices where engendered spaces (private versus public) reflect unequal power relations and differential access to resources inclusive of leadership opportunities”.

Despite the global trend towards the empowerment of women, policies and practices regarding gender equity, South African women and girls still face multiple challenges in their quest for ideological and structural reform in various sport sectors. Different stakeholders associated with the sport for development (SfD) field, drive a social transformation agenda in which civic society organisations and actors play meaningful roles. This study aims to identify and discuss multiple barriers faced by women and girls within the SfD sector against complex socio-economic and political realities. African feminism underpins a human rights policy framework that finds expression in a social constructivist approach. Document analysis data of global and national policies and strategic plans, in addition to those of non-governmental organisations (NGOs) responsible for the delivery of sport for development programmes, triangulate with narrative data collected through interviews with 18 NGO representatives and eight gender activists or leaders in the field. The main findings report on patriarchal and cultural issues, the lack of policy implementation, and hegemonic structures and practices where engendered spaces (private versus public) reflect unequal power relations and differential access to resources inclusive of leadership opportunities. Such insights should feature as an agenda for social change, activism as well as contribute to reciprocal agency between donor and implementing partner in SfD initiatives.

The aim of this cross-sectional study was to examine the prevalence of overweight and obesity in 902 (429 girls and 473 boys) ‘Quintile Three’ primary school children in Mpumalanga province, South Africa.Anthropometric assessment of weight and height was conducted in accordance with the American College of Sports Medicine’s standardised procedures. The Centres for Disease Control and Prevention (CDCP) criteria were used to extrapolate BMI percentiles according to age and gender for each child. Means and standard deviations were reported for age and gender cohorts. Analysis of variance (ANOVA) was computed to determine significance of intergroup BMI percentile differences. Optimal weight was obtained in 79% of the children. Overweight prevalence was 11%, obesity rate was 7% and underweight occurred in 3% of the children. Statistically significant BMI differences were evident between age cohorts (p=0.047), but not across gender groups (p=0.678)

The aim of the study was to explore the preparation of Nurse Managers (NMs) for financial management roles. The South African Nursing Council (SANC) approved nursing management programmes which include the Diploma in Nursing Administration and the Diploma in Unit Management for registered nurses. A qualitative, exploratory design was used to explore the preparation of NMs for financial management roles in KwaZulu-Natal province, South Africa. The sample size for the semi-structured interviews conducted was guided by data saturation and comprised thirteen participants. Tesch’s open coding method was used to analyse the data. The results revealed that NMs are involved in financial management activities within the hospitals. However, they do not necessarily have the requisite management skills and competencies to function effectively in their financial management roles. It was concluded that NMs do indeed practice financial management, and therefore require the relevant knowledge, skills and competencies.

The sale of take-home HIV rapid test kits in retail pharmacies was authorised in May 2015 by the South African Pharmacy Council (SAPC) and pharmacists became front-runners in the sale of HIV rapid test kits. There is a risk of misuse and misinterpretation of the test results if pharmacists are not equipped with the necessary knowledge and skills regarding HIV rapid testing. The aim of this study was thus to assess the knowledge and perceptions of pharmacists regarding the HIV rapid test. The study adopted a quantitative approach and data were collected using self-administered questionnaires. Data were collected from all pharmacies (n=21) located in the Tshwane Central Business District and involved pharmacists (n=23). Quantitative data were analysed by descriptive statistics and responses from open-ended questionnaire items were captured and grouped according to similarity of aspects. About 60% of these pharmacists have not been trained on HIV diagnostic testing concepts. Only 44% understood the window period. The principle behind the test could not be explained by 52% of the pharmacists. Only 28% admitted that patients require counselling before and after testing and almost half of the pharmacists did not have time for counselling. The results of the research indicated that there are gaps in the knowledge of pharmacists regarding the HIV rapid test, the window period and counselling. For effective delivery of quality services regarding the use of the HIV rapid test, pharmacists need to be adequately equipped with relevant knowledge and skills through further training.

Clinical placements in mental health forms part of mental health programmes. Student support is crucial to facilitate learning in this context. Limited support creates negative experiences that influence mental health as a career choice. Shortages in the mental health delivery system can be addressed with retention and recruitment of students through student support. The aim of this structured review was to identify opportunities and challenges in the provision of student support by educators in the mental health context. Keywords used were student support, mental health placements, clinical accompaniments, preceptors and educators. Several databases were searched and a total of 71 potential articles identified. The researcher scrutinized the titles and abstracts and identified 15 articles for critical appraisal. Data were subsequently extracted from 12 articles for the structured review. A subject information specialist assisted with literature searches and a cocoder enhanced objectivity. Data were thematically analysed through Tesch’s open coding technique. Three main themes emerged: (i) Preparation for clinical placement (ii) Generating support during clinical placement and (iii) Process of transformation after clinical placement. The findings highlighted the importance of student support during clinical mental health placements to facilitate positive experiences that enhance mental health as career choice. Reflection can assist students during mental health clinical placements to develop self-awareness to identify knowledge gaps that need to be addressed.

Isoniazid preventive therapy is an effective strategy for preventing tuberculosis in people living with HIV/AIDS. However, its uptake among this group is very low. Knowledge, attitudes and practice related to isoniazid preventive therapy may play a role regarding this poor uptake. The aim of this study was to assess and describe knowledge, attitudes and practices related to isoniazid preventive therapy of adults living with HIV in Berea district, Lesotho. Guided by the theory of planned behaviour, a quantitative, descriptive design was used which included questionnaire administraton to a group of conveniently selected participants (n=350). Results are presented as percentage positive scores leading to enhanced isoniazid uptake. Specifically, knowledge predicting isoniazid uptake was determined as behavioural beliefs (88.9%), normative beliefs (82.9%), control beliefs (0.3%) and subjective norms (69.0%). The knowledge component favoured and attitudes (78.6%) enhanced isoniazid uptake. Practice was reflected as intention (99.4%), actual behavioural control (98.0%) and behaviour (82.9%). The practice component showed a strong tendency for isoniazid uptake. Recommendations are aligned to the theory of planned behaviour and include health promotion, training, and community involvement.

Referral and linkage to care scheme for people newly diagnosed with human immunodeficiency virus (HIV) ensures continuity of care and consequently, improved quality of life. In Ethiopia, the Federal Ministry of Health designed guidelines to facilitate the referral and linkage system and to improve the management, care and treatment of HIV in the country. This study describes the challenges experienced by healthcare professionals and providers in the referral and linkage of newly diagnosed HIV clients in Addis Ababa, Ethiopia. A qualitative, descriptive design was used. Participants included purposively selected healthcare professionals and service providers involved in HIV referral and linkage process. Three focus group discussions with twenty four participants (eight per group) were used to collect data. The discussions were audio recorded, transcribed and analysed manually following open and focused coding methods. Four main themes were derived from the data and classified as follows: challenges related to understanding of the concept of referral and linkage, HIV care protocol and communication, services and resources, and social stigma. Public health policy makers and managers need to strengthen the linkage and referral system for the newly diagnosed HIV clients in order to improve the continuity of care for people living with HIV.

The treatments, assessment and management strategies related to low back pain (LBP) developed for the western world may have limited relevance for traditional healing. This study explored the management of LBP symptoms by traditional healers at the Warwick Muthi Market in Durban. Using a qualitative method, semi-structured interviews were conducted with ten traditional healers. The gender of participants was equally distributed with the sample comprising 5 males and 5 females. The study found that traditional healers understand LBP in terms of the physical symptoms that a person may present. Traditional belief in LBP takes into account the cultural and biopsychosocial aspects of pain. Traditional healers reported various causes of LBP including ilumbo (a sexually transmitted disease, particularly affecting the youth, mainly males. It is characterised by penile sores, discharge, low sex drive and marked inguinal lymphadenopathy and is difficult to treat), umeqo (a form of witchcraft in which sickness is believed to be caused by walking or stepping over a traditional medicine), ancestors/culture, kidney disease and ageing. In addition, they tended to personalise the causes of LBP and the reason for becoming ill was often sought in the supernatural realm with the only remedy for such diseases being traditional treatment. The traditional healers described various treatments or management strategies for LBP, including plant remedies and certain animal extracts (animal fats). Other substances as well as specific rituals and traditional techniques and methods were also mentioned. These included making incisions in the painful areas (ukugcaba) and bowel cleansing (ukuchatha). Various plants and herbs commonly used for LBP symptoms were mentioned, such as roots and bark which may have certain healing properties and play a role in the treatment of LBP. The study concluded that traditional healers understand LBP in terms of its biopsychosocial nature, while their management and treatment of LBP focus holistically on this complex pain disorder.

Grit is consistency of interest, perseverance and passion for long-term goal in a chosen activity, which normally translates into better acievements. Grittier athletes are assumed to be more safety conscious since they want to produce better performance in competitions. Therefore, this study explored the influence of university student-athletes’ perseverance and passion for long-term goal attainment and safety behaviour in sports performance. The Grit Scale and Safety Behaviour items were used to collect data from a sample of 644 university athletes who took part in the 2018 Ghana University Sports Association Games (2018 GUSA Games). Results indicate that 46% of these athletes had won at least a medal during the competition. However, about 10.4% either consumed alcohol, a mixture of alcohol and energy drink, smoked tobacco and/or took illicit drugs such as tramadol, marijuana, fentanyl, morphine, etc. at least once a day during the competition. Binomial logistic regression analysis indicates a significant prediction of sports performance (χ2 = 46.57, p = .001), with female athletes, those having higher grit scores and reporting health risk behaviours more likely being medal winners. However, female athletes with higher grit scores were less likely to engage in health risk behaviour, which could compromise the students’ sports performance and health status.

Football is the most popular female team sport in the world and specifically in South Africa. Yet, information pertaining to physical and health-related fitness parameters of female football players is sparse. Therefore, this study evaluated the profiles of first division female football players (n=133; age: 20.2 ± 5.7 years; body mass: 56.9 ± 9.6 kg; stature: 159.9 ± 6.4 cm) in Gauteng province, South Africa with specific reference to anthropometric and performance attributes. Various field tests were used to profile of the female football players’ physical (body fat percentage, body circumferences, flexibility, balance) and fitness (muscular strength and endurance, explosive power, acceleration and speed, agility and aerobic and anaerobic capacities) parameters. Participants were stratified according to playing positions (goalkeepers, defenders, midfielders and strikers) and data on their physical attributes and performances analysed using Kruskal Wallis tests. The tested sample yielded largely homogenous data, with only a few variables indicating disparities across playing positions. Specifically, greater body fat percentage (p = 0.023) and BMI (p = 0.014) were noted in goalkeepers than the other categories of players. Strikers were the worst performers in flexibility tests (p < 0.05) and defenders the slowest group in acceleration test (p = 0.008). The similar physical and performance characteristics among the various categories of players could be attributed to the teams’ lack of exposure to position-specific training programmes and suggest that positional distinction may not be apparent in first division female football. The results of this study could be useful to coaches and trainers to emphasise the physical and performance qualities that are essential for female football development.

Dear Editor​​​​,

In a report published in the African Journal for Physical Activity and Health Sciences on ‘Do biokineticists transgress on physiotherapists’ scope of profession? Evidence-based analysis of two physical rehabilitation disciplines in South Africa’ (Ellapen et al., 2018), the authors reported on a literature search and documentary analysis of peer-reviewed professional journal publications, statutory and professional bodies’ websites, communiqués, and proceedings from meetings. The authors’ objectives were to i) distinguish the scope of profession (SoP) of Physiotherapy and Biokinetics through the consideration of their gazetted SoP, ii) review the minimum training standards of both professions in relation to exercise and physical therapy, iii) identify potential areas of scope overlap between Physiotherapy and Biokinetics, and iv) identify remedial steps that could help to prevent any future infringement or overlap in SoP. The authors should be applauded for their magnanimous effort; however, we feel duty-bound to add comments and frame the situation from a different perspective. We are concerned that this commentary is poorly timed because the HPCSA is currently reviewing the SoP for biokinetics, physiotherapy and podiatry and it will soon be sent for public comment. Furthermore, we are concerned that the commentary has been presented as evidence to justify unhelpful and erroneous advice to biokineticists.