Overall Goal -To develop a model for the prevention of Fetal Alcohol Syndrome and Alcohol Related Birth Defects that can be applied in different areas of South Africa. Stage I - Formative -The primary objective for Stage 1 is to fully understand the current patterns, norms, and consequences of alcohol consumption, of women of child bearing age, and the current alcohol related services. Stage II - Interventions -Develop and implement a detailed intervention program and monitoring plan based on the findings of Stage I, to include interventions that are specific to the individual, the group, and the general community level. Stage III - Evaluation- Evaluate each of the components of the intervention program, and assess the extent to which they could be sustained on a larger scale, in an integrated model. The study will use a participatory action research approach, with a community advisory board established in the two research sites. The sites: an urban area of Pretoria in the Tshwane Municipality, and a rural farming area of the Western Cape. A KAP survey (750 households), services audit, FAS family case studies, and mapping of liquor outlets will provide information on which to create a conceptual framework and to base a multi-level intervention program aiming to reduce risky drinking and promote family planning, especially by childbearing age women. The interventions will be executed in collaboration with existing services, using a health promotion approach. A randomized controlled trial will be used to assess the efficacy of augmented counseling over regular counseling. The support groups and community awareness campaign will assess to what extent the interventions have shifted the local awareness regarding the planning of pregnancy and the levels of risky drinking. Fetal Alcohol Syndrome and other alcohol related birth defects have been found to be at high levels in some rural and urban areas in South Africa, and there is a generally high level of risky drinking across all population groups of women in childbearing age. The health and social services are overwhelmed with the HIV/AIDS epidemic, and to date no prevention study has been done to investigate appropriate and sustainable strategies to prevent women of childbearing age from drinking in pregnancy, and to enable them to better plan their pregnancies. ? ? ?
