Universal Prevention is Associated with Lower Prevalence of Fetal Alcohol Spectrum Disorders in Northern Cape, South Africa: A Multicentre Before-After Study (original) (raw)
Related papers
2016
Prevalence of fetal alcohol spectrum disorders (FASDs) is remarkably high in several provinces of South Africa; yet population-level knowledge of the harms of maternal drinking remains low. In two heavily affected areas, we assessed effective-ness of interventions to heighten awareness of these harms and to alter social norms about drinking in pregnancy. Methods: FASD prevalence, maternal knowledge and drinking behaviours were investigated in two Northern Cape Province towns, before and after interventions which included highlighting FASD using local media and health promotion talks at health facilities. Independently, two dysmorphologists and a neuropsychometrist examined children at 9 and 18 months. Results: Pre-intervention maternal knowl-edge of alcohol harms was low and FASD prevalence 8.9 % (72/809). Interventions reached high coverage and knowledge levels increased substantially. FASD prevalence was 5.7 % post-intervention (43/751; P = 0.02); 0.73 lower odds, controlling for ...
Journal of The American Academy of Nurse Practitioners, 2005
PurposeThe incidence of fetal alcohol spectrum disorders (FASD) is increasing, even though it is 100% preventable. This study examined use of, knowledge about, and attitudes toward alcohol of women requesting emergency contraception (EC) and/or a pregnancy test, and evaluated whether a brief intervention would be effective in educating them about the risks of FASD.The incidence of fetal alcohol spectrum disorders (FASD) is increasing, even though it is 100% preventable. This study examined use of, knowledge about, and attitudes toward alcohol of women requesting emergency contraception (EC) and/or a pregnancy test, and evaluated whether a brief intervention would be effective in educating them about the risks of FASD.Data sourcesFifty women from two outpatient clinics participated. Information was collected on demographic and personal health habits, alcohol use, and knowledge of and attitudes toward alcohol. As a brief intervention to increase knowledge about FASD, participants read a short pamphlet about the risks of alcohol exposure in pregnancy and then completed a post-test questionnaire. Descriptive statistics, including means, standard deviations, and skewness, were calculated for all variables. Pearson correlations were computed to assess relationships between demographic/lifestyle variables and attitudes toward and knowledge about alcohol. Paired t-tests were used to analyze the relationship between pretest and post-test knowledge scores.Fifty women from two outpatient clinics participated. Information was collected on demographic and personal health habits, alcohol use, and knowledge of and attitudes toward alcohol. As a brief intervention to increase knowledge about FASD, participants read a short pamphlet about the risks of alcohol exposure in pregnancy and then completed a post-test questionnaire. Descriptive statistics, including means, standard deviations, and skewness, were calculated for all variables. Pearson correlations were computed to assess relationships between demographic/lifestyle variables and attitudes toward and knowledge about alcohol. Paired t-tests were used to analyze the relationship between pretest and post-test knowledge scores.ConclusionsThe majority of participants were single (76%), college educated (94%), and received EC at the clinic visit (60%). The average age was 24 years. Slightly over half (52%) reported drinking beer at least once a week, with one to six cans on occasion. Younger women expressed more tolerant attitudes toward alcohol use (p= .02) and drank significantly more beer on occasion (p= .015). Women who reported drinking alcohol when they last had sex were significantly (p= .017) less tolerant in their attitudes toward alcohol use. The intervention used in this study was effective in communicating knowledge about FASD to this population (p < .0001).The majority of participants were single (76%), college educated (94%), and received EC at the clinic visit (60%). The average age was 24 years. Slightly over half (52%) reported drinking beer at least once a week, with one to six cans on occasion. Younger women expressed more tolerant attitudes toward alcohol use (p= .02) and drank significantly more beer on occasion (p= .015). Women who reported drinking alcohol when they last had sex were significantly (p= .017) less tolerant in their attitudes toward alcohol use. The intervention used in this study was effective in communicating knowledge about FASD to this population (p < .0001).Implications for practiceThese findings suggest that young women may be engaging in behaviors that could put potential offspring at risk for exposure to alcohol. Clinicians are advised to take a thorough history to determine alcohol use in all women of childbearing age and to provide information regarding FASD prevention.These findings suggest that young women may be engaging in behaviors that could put potential offspring at risk for exposure to alcohol. Clinicians are advised to take a thorough history to determine alcohol use in all women of childbearing age and to provide information regarding FASD prevention.
International journal of environmental research and public health, 2015
In the Western Cape Province of South Africa (ZA) a subculture of binge drinking produces the highest global documented prevalence of fetal alcohol spectrum disorders (FASD). FASD prevention research activities in ZA use the Comprehensive Prevention approach from the United States Institute of Medicine. Case management (CM) was delivered as a method of indicated prevention to empower heavy drinking pregnant women to achieve cessation or a reduction in drinking. CM activities incorporated life management, Motivational Interviewing (MI) techniques and the Community Reinforcement Approach (CRA). Data were collected at baseline, 6, 12 and 18 months. Mean drinking decreases 6 months into CM; but overall alcohol consumption rose significantly over time to levels higher than baseline at 12 and 18 months. Alcohol consumption drops significantly from before pregnancy to the second and third trimesters. AUDIT scores indicate that problematic drinking decreases significantly even after the vul...
Fetal Alcohol Spectrum Disorder: What does Public Awareness Tell Us about Prevention Programming
The prevalence of Fetal Alcohol Spectrum Disorder (FASD) does not appear to be diminishing over time. Indeed, recent data suggests that the disorder may be more prevalent than previously thought. A variety of public education programs developed over the last 20 years have promoted alcohol abstention during pregnancy, yet FASD remains a serious public health concern. This paper reports on a secondary data analysis of public awareness in one Canadian province looking at possible creative pathways to consider for future prevention efforts. The data indicates that the focus on women of childbearing age continues to make sense. The data also suggests that targeting formal (health care providers for examples) and informal support (partner, spouse, family, and friends) might also be valuable. They are seen as sources of encouragement, so ensuring they understand the risks, as well as effective ways to encourage abstinence or harm reduction, may be beneficial for both the woman and the pregnancy. Educating people who might support a woman in pregnancy may be as important as programs targeted towards women who may become or are pregnant. The data also suggests that there is already a significant level of awareness of FASD, thus highlighting the need to explore the effectiveness and value of current prevention approaches.
International Journal of Environmental Research and Public Health, 2019
The global prevalence of Fetal Alcohol Spectrum Disorder (FASD) remains high despite the various preventive and management interventions that have been designed and implemented to tackle the issue in various settings. The aim of the scoping review is to identify and classify prevention and management interventions of FASD reported globally across the life span and to map the concentration of these interventions across the globe. We searched some selected databases with predefined terms. Framework and narrative approaches were used to synthesize and report on the findings. Thirty-two prevention intervention studies and 41 management interventions studies were identified. All the interventions were reported to be effective or showed promising outcomes for the prevention and management of FASD, except four. Although Europe and Africa have a relatively higher prevalence of FASD, the lowest number of interventions to address FASD were identified in these regions. Most of the interventions for FASD were reported in North America with comparatively lower FASD prevalence. The uneven distribution of interventions designed for FASD vis-à-vis the burden of FASD in the different regions calls for a concerted effort for knowledge and intervention sharing to enhance the design of contextually sensitive preventive and management policy in the different regions.
International Journal of Population Data Science, 2022
Fetal Alcohol Spectrum Disorder (FASD) is a neurodevelopmental disorder caused by exposure to alcohol in utero. It has pervasive, lifelong impacts and is recognised as a major public health concern in many countries where alcohol is used. The FASD Research Australia Centre of Research Excellence (CRE) was funded by the National Health and Medical Research Council to generate and translate evidence to address prevention, diagnosis, and management of FASD in Australia. The current paper describes the approach to policy and practice impact taken by our CRE, including our stakeholder engagement processes and the key principles that underlie our approach. We provide examples of policy and practice influence in FASD prevention, diagnosis and management that have been achieved over the past five years and discuss challenges that are routinely faced in the translation of our work.
The American Journal of Drug and Alcohol Abuse, 2014
Background: South Africa has one of the highest rates of fetal alcohol spectrum disorder (FASD) in the world. However, little is known about what men and women who attend alcohol serving establishments believe about alcohol use during pregnancy and how these beliefs may be related to alcohol use. Objectives: To understand FASD beliefs and related behaviors among men and women attending alcohol-serving establishments. Methods: We surveyed 1047 men (n ¼ 565) and women (n ¼ 482) -including pregnant women and men with pregnant partners-attending alcohol serving establishments in a township located in Cape Town, South Africa. Results: Among both pregnant (n ¼ 53) and non-pregnant (n ¼ 429) women, 54% reported drinking alcohol at least 2-4 times per month, and 57% reported having at least 3-4 alcohol drinks during a typical drinking session. Pregnant women were less likely to believe that they should not drink alcohol and that alcohol can harm a fetus when compared to non-pregnant women. Similar findings were observed between men with pregnant partners compared to men without pregnant partners. Among women, beliefs about how much alcohol pregnant women can safely drink were associated with self-reported alcohol use. Conclusions: Efforts to address FASD need to focus on understanding how men and women perceive alcohol use during pregnancy and situational factors that contribute to alcohol consumption among pregnant women attending alcohol serving establishments. Structural and individual-level interventions targeting women at alcohol serving establishments should be prioritized to mitigate alcohol use during pregnancy.
Case management reduces drinking during pregnancy among high-risk women
The International Journal of Alcohol and Drug Research, 2013
May, P., Marais, A., Gossage, J., Barnard, R., Joubert, B., Cloete, M., Hendricks, N., Roux, S., Blom, A., Steenekamp, J., Alexander, T., Andreas, R., Human, S., Snell, C., Seedat, S., Parry, C., Kalberg, W., Buckley, D., & Blankenship, J. (2013). Case management reduces drinking during pregnancy among high-risk women. The International Journal Of Alcohol And Drug Research, 2(3), 61-70. doi:10.7895/ijadr.v2i3.79 (http://dx.doi.org/10.7895/ijadr.v2i3.79)Aim: To estimate the efficacy of Case Management (CM) for women at high risk for bearing a child with Fetal Alcohol Spectrum Disorders (FASD).Design: Women were recruited from antenatal clinics and engaged in 18 months of CM.Setting: A South African community with a subculture of heavy, regular, weekend, recreational drinking and with high documented rates of FASD. Participants: Forty-one women who were at high risk for bearing a child with FASD.Measures: Statistical analysis of trends in drinking and other risk factors.Findings: At i...
Fetal Alcohol Syndrome: A Menace to Maternal and Child Health
Continental J. Applied Sciences, 2024
Fetal Alcohol Syndrome (FAS) represents a significant public health concern, affecting both maternal and child health. It results from alcohol consumption during pregnancy and leads to a spectrum of physical, cognitive, and behavioral abnormalities in the affected children. Despite extensive research, FAS remains a prevalent issue due to a lack of awareness and understanding among women of reproductive age. This study uniquely focuses on assessing the knowledge of women of reproductive age regarding alcohol intake during pregnancy and its link to FAS. By identifying gaps in knowledge and understanding, the study aims to inform more effective educational and preventative strategies. The primary aim is to investigate the impact of FAS on maternal and child health, raise awareness about its consequences, and explore strategies for prevention and management. A comprehensive survey was designed and implemented across diverse demographic groups to evaluate the awareness and knowledge of women of reproductive age about the risks associated with alcohol consumption during pregnancy. The survey included questions on FAS, its causes, sources of information, perceptions, attitudes, and barriers to knowledge. Preliminary findings indicate that there is a significant gap in knowledge among women regarding the risks of alcohol consumption during pregnancy. Many women are unaware of the full extent of FAS and its long-term effects. Misconceptions and cultural beliefs further complicate understanding and behavior. Reliable sources of information are often inaccessible or underutilized. The study underscores the critical need for improved education and awareness programs targeting women of reproductive age. Accurate knowledge is essential for preventing FAS and mitigating its impact on maternal and child health. It is recommended that healthcare providers and public health campaigns focus on disseminating clear, accessible information about the dangers of alcohol consumption during pregnancy. Enhanced educational interventions and reliable sources of information are vital to address knowledge gaps and change behaviors to prevent FAS.