Inequalities in morbidity in South Africa: A family perspective

Biney, Elizabeth; Amoateng, Acheampong Yaw; Ewemooje, Olusegun Sunday

doi:10.1016/j.ssmph.2020.100653

Cited by 9 publications

(7 citation statements)

References 16 publications

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“…Significant progress has been made in unifying the health system through the revitalisation of primary health care and progress made towards universal health coverage since 2011 [ 21 , 23 , 25 , 29 , 30 ]. However, the country is struggling to meet sustainable development targets due to the quadruple burden of disease, namely, HIV/AIDS and TB, high maternal and child mortality, non-communicable diseases and injuries [ 31 ], that is exacerbated by human resource shortages and maldistribution [ 30 , 32 ]. The country has nearly 503 health workers for every 100,000 population [ 21 ].…”

Section: Resultsmentioning

confidence: 99%

Lessons Learnt during the Implementation of WISN for Comprehensive Primary Health Care in India, South Africa and Peru

Mabunda

Gupta

Chitha

et al. 2021

IJERPH

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Introduction: The World Health Organization introduced the workload indicators of staffing needs (WISN) in 1998 to improve country-level health workforce planning. This study presents the primary care health workforce planning experiences of India, South Africa and Peru. Methods: A case study approach was used to explore the lessons learnt in the implementation of WISN in India and South Africa. It also describes the methods developed and implemented to estimate health workforce in Peru. We identify the barriers and facilitators faced by countries during the implementation phase through the triangulation of literature, government reports and accounts of involved health planners in the three countries. Results: India implemented WISN in a referral pathway of three district health facilities, including a primary health centre, community health centre and district hospital. Implementation was impeded by limited technical support, poor stakeholder consultation and information systems challenges. South Africa implemented WISN for health workforce planning in primary care and found the skills mix and staff determinations to be unaffordable. The Peruvian Ministry of Health considered using WISN but decided to develop a context-specific tool to estimate the health workforce needed using its available resources such as the National Register of Health Personnel. The main challenge in using WISN was the insufficient information on its inputs. Conclusion: While India and South Africa had unique experiences with the integration of WISN in their health system, none of the countries has yet benefited from the implementation of WISN due to financial, infrastructure and technical challenges. Since the methodology developed by the Peruvian Ministry of Health is context-specific, its implementation has been promising for health workforce planning. The learnings from these countries’ experiences will prove useful in bringing future changes for the health workforce.

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Section: Resultsmentioning

confidence: 99%

Lessons Learnt during the Implementation of WISN for Comprehensive Primary Health Care in India, South Africa and Peru

Mabunda

Gupta

Chitha

et al. 2021

IJERPH

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“…South Africa, as do many other countries globally, uses mortality and morbidity as standard indicators of population health. Morbidity and multimorbidity levels are high in South Africa due to the quadruple burden of disease [ 38 ]. Our participants reported that policy makers and health planners do not consider rehabilitation at a strategic level, possibly because they do not understand how rehabilitation contributes to population health.…”

Section: Discussionmentioning

confidence: 99%

“…The authors suggested that since their finding can be applied across cultures, it should be considered globally by health policy planners to advance health strategies such as rehabilitation, which is aimed at improving function. Considering that one-fifth of South Africans older than 15 years self-report poor health [ 38 ], this should be of concern to the government. Our participants suggested that evidence is needed to assist in explaining the role of rehabilitation to health policy makers.…”

Section: Discussionmentioning

confidence: 99%

Rehabilitation Capacity in South Africa—A Situational Analysis

Louw

Conradie

Xuma-Soyizwapi

et al. 2023

IJERPH

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Rehabilitation in South Africa (SA) operates independently of major health services and reforms, despite the increasing rehabilitation need. With the introduction of National Health Insurance (NHI), SA is facing another major health reform. Evidence is needed on the current SA rehabilitation situation, regarding shortcomings, opportunities, and priority strategic strengthening actions. We aimed to describe the current rehabilitation capacity in the SA public health sector, which serves the majority and most vulnerable South Africans. A cross-sectional survey was conducted in five provinces, using the World Health Organisation’s Template for Rehabilitation Information Collection (TRIC). Participants were purposively selected for their insights and experiences of rehabilitation in specific government departments, health sectors, organisations, and/or services. TRIC responses were analysed descriptively. Participants explained how timely and effective rehabilitation produced long-term health, social, and economic benefits. Positive initiatives were reported for rehabilitation data collection, service design, and innovation. Challenges included inadequacies in human resources, the integration of rehabilitation at primary care, guidelines, and specialised long-term care facilities. The continuity of care across levels of care was sub-optimal due to inefficient referral systems. Promoting and improving rehabilitation nationally requires concerted, innovative, collaborative, and integrated efforts from multiple stakeholders within, and outside, the health system.

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“…These may include disrupted family activities and productivity, anxiety or depression, interruption of social networks of support, high out-of-pocket costs for healthcare, and reductions in family savings and investments [ 26 , 27 ]. These intertwined compounding economic effects can also be felt throughout communities, as within many African cultures, and particularly in Ethiopia, individuals with chronic illness usually receive support from family as well from the surrounding community [ 28 ]. Ethiopia made significant changes in maternal-child health and communicable diseases over the last two decades.…”

Section: Discussionmentioning

confidence: 99%

Breast cancer morbidity and mortality in rural Ethiopia: data from 788 verbal autopsies

et al. 2022

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Introduction In Ethiopia, breast cancer is the leading cause of cancer among women. Little is known about the duration of disease and symptoms of patients who died from breast cancer in rural Ethiopia. The objective of this study was to assess breast cancer mortality with a particular focus on the self-reported duration of illness including suffering of symptoms, and need for medical care. Methods The cause of death was determined among randomly selected Ethiopian women residing in western Ethiopia. A modified standard verbal autopsy (VA) questionnaire was completed by women whose sisters had died. The questionnaires were reviewed by two independent local physicians to assign a cause of death. We analyzed pattern of cause of deaths, duration of suffering, symptoms, and treatment received. Result In our study, the age at death was very similar to other population-based data from Ethiopia. We found 32% of 788 deaths were caused by communicable diseases, 12.1% by neoplasms, and 9.4% by pregnancy/maternal mortality. Breast cancer was the second leading neoplasm, responsible for 21 (2.7%) of all deaths (95% CI 1.5–3.7%), and was among the top five causes of non-communicable deaths. The median age of breast cancer death was 37 years, younger than for other causes of death. The median duration of illness with breast cancer was around 1 year. This was substantially more compared to the duration of infectious diseases, but less than the duration of reproductive neoplasms, diabetes, and epilepsy. Discussion/conclusion Breast cancer deaths are common causes of death in women of rural Ethiopia. When assessing the total duration of illness according to specific causes of death, breast and other cancers accounted for a large share of the burden. This has practical implications and highlights the need for palliative care for cancer patients. Substantial efforts are necessary to improve early detection and treatment for breast cancer to reduce premature death in women.

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Inequalities in morbidity in South Africa: A family perspective

Cited by 9 publications

References 16 publications

Lessons Learnt during the Implementation of WISN for Comprehensive Primary Health Care in India, South Africa and Peru

Lessons Learnt during the Implementation of WISN for Comprehensive Primary Health Care in India, South Africa and Peru

Rehabilitation Capacity in South Africa—A Situational Analysis

Breast cancer morbidity and mortality in rural Ethiopia: data from 788 verbal autopsies

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