Cargando…

A guideline for the prevention and management of Fetal Alcohol Spectrum Disorder in South Africa

BACKGROUND: Fetal Alcohol Spectrum Disorder (FASD) is a public health problem globally, with South Africa having the highest recorded prevalence of all countries. Government programmes to prevent and manage FASD remain limited because of the lack of a specific policy. Herein, we developed a guidelin...

Descripción completa

Detalles Bibliográficos
Autores principales: Adebiyi, Babatope O., Mukumbang, Ferdinand C., Beytell, Anna-Marie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6836420/
https://www.ncbi.nlm.nih.gov/pubmed/31694624
http://dx.doi.org/10.1186/s12913-019-4677-x
_version_ 1783466902829400064
author Adebiyi, Babatope O.
Mukumbang, Ferdinand C.
Beytell, Anna-Marie
author_facet Adebiyi, Babatope O.
Mukumbang, Ferdinand C.
Beytell, Anna-Marie
author_sort Adebiyi, Babatope O.
collection PubMed
description BACKGROUND: Fetal Alcohol Spectrum Disorder (FASD) is a public health problem globally, with South Africa having the highest recorded prevalence of all countries. Government programmes to prevent and manage FASD remain limited because of the lack of a specific policy. Herein, we developed a guideline to inform policy on the prevention and management of FASD in South Africa. METHODS: We applied a modified version of the World Health Organization’s approach to guideline development in three phases. In the first phase, we designed the initial guideline prototype. To do this, we conducted an in-depth interview with policymakers and a focus group with relevant service providers on policy requirements for FASD, a document review of policies on FASD and a scoping review of various interventions for FASD. In phase 2, we refined the initially formulated guideline prototype through a discursive approach with seven local and international experts on FASD. Phase 3 involved refining the prototype using a modified Delphi approach. Forty-three and forty-one experts participated in rounds 1 and 2 of the Delphi approach, respectively. The acceptable consensus for each included policy statement was 85%. RESULTS: We identified three aspects of the proposed guideline, which are the approaches and guiding principles, the prevention measures and the management measures. The guideline proposes that a FASD policy should consider lifespan needs, be culturally diverse, collaborative, evidence-based, multi-sectoral and address social determinants of health contributing to FASD. The essential components of FASD prevention policy consist of awareness and education of the dangers of drinking alcohol, access to treatment for alcohol problems and training of service providers. The management components include capacity building related to diagnosis, educating parents regarding the needs and management, appropriate referral pathways, training of teachers regarding classroom management and support for parents and individuals with FASD. CONCLUSION: FASD in South Africa deserves urgent attention. Developing a specific policy to guide programmes could enhance and coordinate the efforts towards preventing and managing FASD. The guideline has the potential to assist policymakers in the development of a comprehensive and multi-sectoral policy for prevention and management of FASD, considering the consensus obtained from the experts.
format Online
Article
Text
id pubmed-6836420
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-68364202019-11-08 A guideline for the prevention and management of Fetal Alcohol Spectrum Disorder in South Africa Adebiyi, Babatope O. Mukumbang, Ferdinand C. Beytell, Anna-Marie BMC Health Serv Res Research Article BACKGROUND: Fetal Alcohol Spectrum Disorder (FASD) is a public health problem globally, with South Africa having the highest recorded prevalence of all countries. Government programmes to prevent and manage FASD remain limited because of the lack of a specific policy. Herein, we developed a guideline to inform policy on the prevention and management of FASD in South Africa. METHODS: We applied a modified version of the World Health Organization’s approach to guideline development in three phases. In the first phase, we designed the initial guideline prototype. To do this, we conducted an in-depth interview with policymakers and a focus group with relevant service providers on policy requirements for FASD, a document review of policies on FASD and a scoping review of various interventions for FASD. In phase 2, we refined the initially formulated guideline prototype through a discursive approach with seven local and international experts on FASD. Phase 3 involved refining the prototype using a modified Delphi approach. Forty-three and forty-one experts participated in rounds 1 and 2 of the Delphi approach, respectively. The acceptable consensus for each included policy statement was 85%. RESULTS: We identified three aspects of the proposed guideline, which are the approaches and guiding principles, the prevention measures and the management measures. The guideline proposes that a FASD policy should consider lifespan needs, be culturally diverse, collaborative, evidence-based, multi-sectoral and address social determinants of health contributing to FASD. The essential components of FASD prevention policy consist of awareness and education of the dangers of drinking alcohol, access to treatment for alcohol problems and training of service providers. The management components include capacity building related to diagnosis, educating parents regarding the needs and management, appropriate referral pathways, training of teachers regarding classroom management and support for parents and individuals with FASD. CONCLUSION: FASD in South Africa deserves urgent attention. Developing a specific policy to guide programmes could enhance and coordinate the efforts towards preventing and managing FASD. The guideline has the potential to assist policymakers in the development of a comprehensive and multi-sectoral policy for prevention and management of FASD, considering the consensus obtained from the experts. BioMed Central 2019-11-06 /pmc/articles/PMC6836420/ /pubmed/31694624 http://dx.doi.org/10.1186/s12913-019-4677-x Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Adebiyi, Babatope O.
Mukumbang, Ferdinand C.
Beytell, Anna-Marie
A guideline for the prevention and management of Fetal Alcohol Spectrum Disorder in South Africa
title A guideline for the prevention and management of Fetal Alcohol Spectrum Disorder in South Africa
title_full A guideline for the prevention and management of Fetal Alcohol Spectrum Disorder in South Africa
title_fullStr A guideline for the prevention and management of Fetal Alcohol Spectrum Disorder in South Africa
title_full_unstemmed A guideline for the prevention and management of Fetal Alcohol Spectrum Disorder in South Africa
title_short A guideline for the prevention and management of Fetal Alcohol Spectrum Disorder in South Africa
title_sort guideline for the prevention and management of fetal alcohol spectrum disorder in south africa
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6836420/
https://www.ncbi.nlm.nih.gov/pubmed/31694624
http://dx.doi.org/10.1186/s12913-019-4677-x
work_keys_str_mv AT adebiyibabatopeo aguidelineforthepreventionandmanagementoffetalalcoholspectrumdisorderinsouthafrica
AT mukumbangferdinandc aguidelineforthepreventionandmanagementoffetalalcoholspectrumdisorderinsouthafrica
AT beytellannamarie aguidelineforthepreventionandmanagementoffetalalcoholspectrumdisorderinsouthafrica
AT adebiyibabatopeo guidelineforthepreventionandmanagementoffetalalcoholspectrumdisorderinsouthafrica
AT mukumbangferdinandc guidelineforthepreventionandmanagementoffetalalcoholspectrumdisorderinsouthafrica
AT beytellannamarie guidelineforthepreventionandmanagementoffetalalcoholspectrumdisorderinsouthafrica