You are browsing the archive for Articles.

Dismantling the Chain: The Link between Gender-based Violence and HIV in South African Women

May 29, 2013 in Articles, Communicable diseases

HIV behavioural research and prevention efforts targeted at South African women has focused on increasing gender equality and reducing gender-based violence. We examined whether alcohol use and mental health problems (depression and posttraumatic stress) explained the link between experiencing violence and HIV in South African women. It was shown that alcohol use, but not depression or posttraumatic stress, explained the link between violence and unprotected sex. Women who have ever experienced physical or sexual abuse were more likely to report drinking more alcohol, and drinking more was predictive of more unprotected sex. Thus, it is important to not only address gender-based violence, it is necessary to also address subsequent alcohol use among women in South Africa.

Tags: , ,

Glimpses into the South African Health Review 2012/13

May 29, 2013 in Articles

The 16th edition of the South African Health Review (SAHR) broadly focuses on some of the key building blocks of the health system, namely, financing, governance and leadership, medical products and service delivery while issues pertaining to human resources and information run as a thread through most of the chapters. The Review also focuses on the social determinants of health, non-communicable diseases, climate change and occupational health and South Africa’s quest to address these. In this edition, we also introduce the newly launched Emerging Public Health Practitioner award that provides a voice to young and upcoming under-35 year old public professionals.

Tags: , ,

Hypertension: now is the time for action

May 29, 2013 in Articles

Hypertension is a major public health challenge worldwide, including South Africa. The availability of effective medication makes hypertension one of the most modifiable cardiovascular disease risk factors and optimal management, including lifestyle changes and medication, can significantly reduce the risk of complications, and decrease the associated social and medical costs. Nonetheless, this silent epidemic is not matched with comparable levels of awareness among policymakers or the general population. Lifestyle modification strategies need to be promoted through population-based approaches.

Tags: , ,

Human Resources for Health – Challenges and Solutions

February 28, 2013 in Articles

In South Africa the existing higher education sector is unable to meet the graduate output required by the health sector while foreign recruitment is constrained by current legislation on the registration and practice of foreign healthcare professionals. The Ministries of Health and Higher Education and Training in South Africa should give serious consideration to giving effect to the recommendation on private providers contained in the Green Paper for Post-School Education and Training, specifically, working with vetted private health sciences education providers to strengthen and expand provision in compliance with quality and accreditation requirements in priority and/or scarce skill areas.

Tags: ,

Addressing staff shortages in public hospitals: a role for clinical associates?

February 28, 2013 in Articles

Recent news headlines have highlighted the shortage of doctors in public hospitals, especially in disadvantaged areas. There is no doubt that more doctors need to be trained and recruited into the public sector. But are these strategies sufficient to solve the shortage of hospital staff with skills to diagnose patients’ problems and implement treatment? How long will it take to fill all the public sector’s vacant posts? And how much will it cost? Clinical associates have the potential to bring good quality hospital care closer to communities in a way that is affordable for the country. Along with other initiatives they could help to strengthen the public sector, and extend its coverage, as envisaged by the National Health Insurance policy.

Tags: , , ,

Where to work, what to do? Does the medical school experience influence career intentions?

February 28, 2013 in Articles

Medical graduates that are currently produced by the education system are ill-equipped to manage health challenges within their communities which can be addressed by the primary health care approach. Wits University Medical School introduced the Graduate Entry Medical Programme in 2003 to expose the students to public health and primary care disciplines as well as the traditional hospital based clinical training. A study conducted amongst the medical students in their final year of study and those in their first year
showed, however, that the medical school experience at the University as it is currently did not appear to have any influence with respect to working in primary care disciplines or remain in the public sector.

Tags: , ,

How golden policies lead to mud delivery – and how silver should become the new gold.

November 15, 2012 in Articles

Why does South Africa perform badly in health when compared to other African countries, despite good policies, adequate amounts of money and more skilled workers? One of the reasons is that there are many examples of policies and programmes that aim for an unrealistic gold standard (with its unnecessary and unhelpful complexity) and which, as a result, undermine the provision of good healthcare to as large a population as possible, e.g. the new Road to Health Booklet and the District Health Information System. Many people balk at the idea of not aiming for a “gold standard” at a policy level. In this article the author argues that it might be better to aim for a “silver standard”.

Tags: , ,

Capacity of the SA public health sector to deliver rehabilitation services: an institutional analysis

November 15, 2012 in Articles

There is emerging evidence that the public health sector is struggling to provide effective, efficient and equitable rehabilitation services, and this requires due attention to be paid to understanding what these capacity constraints are from a provider perspective. What is being witnessed is a conflict between strategic policies and operational structures, resulting in a widening gap between policy and practice. There are four key agencies that play a role in setting up rules guiding the delivery of rehabilitation services: Department of Health; Health Professions Council of South Africa; Department of Public Service Administration; and Tertiary training institutions. An analysis of the functioning of these four key institutions in the delivery of rehabilitation services is presented here to provide evidence of the constraining environment within which policies are required to be implemented.

Tags: , ,

Public health and the climate: addressing the challenges for Southern Africa

November 15, 2012 in Articles, Environmental and occupational health

The Lancet has declared that the changing climate and its impact on health is the most serious health threat of the 21st century. By placing health on the climate change agenda, we, as public health professionals, have the opportunity of focusing the climate challenge on human impacts as compared to the other broader environmental impacts that have dominated the agenda to date. According to the best available science, the impact of climate on the global population is likely to develop to catastrophic proportions over the next 4-5 decades. Addressing risks that our children and their children will face can no longer be left to the politicians or international agencies. If we are to address global population health, it must become the task of health professionals to provide the lead.

Tags: ,

Multidrug-resistant tuberculosis: patients in KwaZulu-Natal have better cure rates than patients in the Eastern Cape (PETTS Cohort).

August 29, 2012 in Articles, Communicable diseases

South Africa has the third highest tuberculosis (TB) and the fifth highest drug-resistant tuberculosis (DR-TB) burden in the world. The increase of DR-TB is largely due to the HIV epidemic and the challenges that are faced with the management of the disease. KwaZulu-Natal (KZN) and the Eastern Cape (EC) have the highest burden of DR-TB cases in South Africa. During 2005-2008 the “Preserving the Effective TB Treatment Study” (PETTS) was conducted in order to determine the rate of, risk factors for and consequences of acquired resistance to second-line drugs in MDR-TB patients in the EC and KZN. The study results are presented here.

Tags: , , ,