The Prevention of Fetal Alcohol Spectrum Disorders: an Ecological Approach

Fetal alcohol spectrum disorders (FASD) is caused by maternal drinking during pregnancy. Pre-natal drinking has a range of deleterious effects including physical, mental and behavioural consequences for the affected child. Although FASD is completely preventable, it is irreversible with consequences that last into adulthood. The range of effects of FASD forms a spectrum with fully developed FAS on the one end and no effects on the other end of the spectrum. The Western Cape has one of the highest recorded rates of FAS in the world. This seriously affects almost all systems in society and strains the already overburdened educational-, health-, socialand judicial systems. For this reason preventing FASD is of the utmost importance and requires a comprehensive approach on multiple levels. This study explores and describes FASD prevention services in the Bonnievale, Robertson, Ashton and Montagu-areas – a wine-producing area in the Western Cape. Available FASD prevention services on all levels of prevention, the focus-areas of the different prevention activities, collaboration and co-ordination between the role-players and obstacles in delivering prevention services, was examined. By adopting an ecological approach, FASD prevention services could be investigated on multiple levels. This study used a combination of quantitative and qualitative research. An exploratory design and a purposive sampling method were used. Participants were interviewed individually and with the help of a semi-structured questionnaire. The findings of the empirical investigation show that, although prevention efforts are applied on the universal, selective and indicated levels of prevention, a lack of formal prevention efforts that are actively pursued especially on the level of indicated prevention exists. This is aggravated by the absence of formal co-ordination of services and structured systems of referrals. NGO‟s and government departments are, as a result, Stellenbosch University http://scholar.sun.ac.za