Policy Requirements for the Prevention and Management of Fetal Alcohol Spectrum Disorder in South Africa: A Policy Brief
This policy brief is aimed to guide policymakers in developing a comprehensive and multi-sectoral policy for the prevention and management of fetal alcohol spectrum disorder (FASD). South Africa has been identified to have the highest reported prevalence of FASD in the world. Nevertheless, evidence shows that there is no specific policy for FASD, albeit there are clauses that could be attributed to its prevention and management in other existing policies. In this brief, the authors present a guideline to inform programs and interventions to tackle the FASD problem in South Africa and other relevant contexts through developing a policy.
The study adapted the WHO’s approach to guideline development. The study was conducted in three phases. In the first phase, two qualitative studies were conducted (in-depth interviews with policymakers and focus group discussions with service providers). Participants were asked about the policy requirements for the prevention and management of FASD. In addition to the qualitative studies, a document review of relevant South African policy documents was conducted. Furthermore, the researchers conducted a scoping review of the prevention and management interventions for FASD globally. The findings from these studies were aggregated to develop an initial guideline prototype. In Phase two, local and international experts were consulted to refine the initial prototype developed in phase one. Phase three involved engaging with experts on FASD through a two-round Delphi process to develop the final guideline prototype.
The identified policy requirements for the prevention of FASD comprised of awareness and education on the dangers of using alcohol during pregnancy, promotion of the use of contraceptives, skills development and social programs and assisting individuals with alcohol problems.
Routine screening of babies, training of professionals, skills development and support for individuals with FASD were some of the identified policy requirements for the management of FASD.
FASD is a lifelong disability that affects individuals, families and communities, preventing people from actualising their potentials, thus it is recognized as a public health problem. However, there is no specific policy to guide prevention and management efforts of FASD in South Africa, where there has been a persistent increase in FASD prevalence despite current prevention efforts. Consequently, there is a need for the decolonisation—without looking at how varying privilege, power and socialization of different genders and ethnic groups impacts on peoples—of the current FASD prevention and management approaches to improve their effectiveness. To achieve Vision 2030 [National Development Plan], strategies for the prevention and management of FASD should be streamlined within the current integrated services.