Chronic diseases of lifestyle
The PROTECT Africa Study: Pregnancy-Related Obesity Prevention Through Education and Communication Technology in AFRICA
Overview of the study
Educational levels in young African women remain at historical lows. This provides a particular challenge when attempting to optimise the health of mothers and babies through educational strategies. It is estimated that up to one in two pregnant women in urban communities like Soweto are either overweight or obese. In response, our group has pilot data showing the utility of an innovative information technology-based programme to provide readily accessible and understandable health education to this vulnerable sector of the population (HEDUAfrica – www.hedu-africa.org).
The PROTECT Africa Study is a multi-centre, appropriately powered, randomised control trial of an integrated information technology-based educational intervention programmeto minimise the risk of excessive weight gain in overweight (but not obese) pregnant African women, versusan enhanced form of usual care.
The study will involve 480 participants from two primary care clinics in Soweto. The study will conform to CONSORT guidelines for pragmatic trials (Zwarenstein, 2008). The primary endpoint will be the proportion of participants who gain more than 12kg from 16 weeks to delivery. Key secondary endpoints are change in BMI index, change in systolic and diastolic BP, number of caesarean births, treatment for infection post-delivery, and the occurrence of obstetric haemorrhages.
A number of sub-studies will also be performed, examining the change in health preference of pregnant women; the change in micronutrient levels and body-fat composition; the effect of health coaching via SMS technology (the SMS content will be based on content from videos on the HeduAfrica site); and flow murmur screening via a novel electronic stethoscope programme.
A prospective health-economics design analysis will examine the potential cost-benefits of the intervention to significantly reduce the proportion of pregnant women experiencing excessive weight gain (with associated adverse health outcomes) from a health service-payer perspective. Data will also be extrapolated to a whole-of-community and health system-wide perspective.
If proven successful and associated with cost-benefits, the PROTECT Africa intervention will provide an important opportunity to limit excessive weight gain in pregnant women in a low-income setting.
Chronic diseases of lifestyle awareness
A broader outreach programme to the general Soweto community: As seen with our very successful Chronic Disease Awareness Day to which 200 patients and their relatives who were at risk of chronic diseases are invited, there is a huge need for knowledge about healthy and affordable lifestyle choices.
Our programmes are supported by extensive research which has been published in highly respected international journals. We investigate the prevalence of cardiovascular disease in the broader Soweto community including aetiology and dominant risk factors.
This knowledge has allowed us to translate our findings into suitable programmes developed specifically for vulnerable communities in middle to lower income countries. We aim to do four annual Chronic Disease Days inviting people at risk for chronic diseases via local advertisements in radio, newspapers (e.g. the Sowetan, The Star, Daily Sun) and Drum magazine. All of these have previously reported on our activities.
Chronic diseases management project
Awareness days in Soweto (four per annum)
An awareness day was held on Monday, 18 April 2011 at the Michael Maponya primary health clinic in Soweto. The Socru team had set up a mobile clinic where residents came to be screened for risk factors of lifestyle diseases like heart disease, diabetes and high cholesterol. Patients’ weight, body mass index, as well as cholesterol and glucose levels were screened to assess their risk levels.
On Wednesday, 23 March 2011, a Chronic Diseases of Lifestyle Awareness Day was held at Mandela Sisulu Clinic, Soweto. The purpose of this day was to create awareness amongst the public, patients and health professionals about the causes, treatment and prevention of chronic diseases of lifestyle. People from the Soweto community came to be educated about the causes, treatment and prevention of chronic diseases of lifestyle, as well as be screened for risk factors such as, weight, height, BMI, cholesterol, glucose and blood pressure.
Lectures and cooking classes at PHC clinics
A Chronic Diseases of Lifestyle healthy eating cooking demonstration was held on Wednesday, 30 March 2011, 10h00 to 14h00, at Michael Maponya Clinic, Pimville, Soweto.
Outreach programmes for teenagers in schools
We have started to develop a suitable, simple and youth-appropriate education brochure, as well as a targeted DVD to create awareness about risk factors for chronic diseases of lifestyle.
Redesigning and updating the SOCRU website to make it user-friendly and accessible to the youth so they can access news, tips on a healthy lifestyle and recipes via YouTube, Facebook etc.
Awareness days targeted at adolescents at secondary schools in Soweto planned for July to November 2011.
Exercise during pregnancy
Try to fit in some mild exercise every day. This doesn't mean rushing off to the gym for an hour's strenuous workout.
Going for a walk is the best form of exercise when you're pregnant. It gets your blood flowing and increases oxygen levels throughout your body.
Don't do any sit ups, crunches or tummy exercises and avoid doing any heavy weightlifting.
Starting a gentle exercise regime now will help you stay in shape during pregnancy. Mild exercise also helps to lower your risk of miscarriage, and has been proven to help reduce he length of labor and labour complications.
Source: Circulation 1998. Hambrecht, R.
Free advice to your mobile: If you have questions about pregnancy and health, contact HEDUAfrica via their SMS portal.