The Medical History of South Africa: An Overview

Digby, Anne

doi:10.1111/j.1478-0542.2008.00544.x

Cited by 8 publications

(4 citation statements)

References 56 publications

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“…Physicians of African descent faced myriad hurdles, from limited educational opportunities to curtailed professional trajectories in predominantly white institutions. 5 Yet, in the face of adversity, the resilience of the medical community was evident. Many, transcending racial lines, championed the cause of equitable healthcare, challenging the divisive policies of the apartheid administration.…”

Section: Apartheid's Shadowmentioning

confidence: 99%

Internal medicine in South Africa: A historical and contemporary overview

Pillay

2023

Journal of the Colleges of Medicine of South Africa

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Section: Apartheid's Shadowmentioning

confidence: 99%

Internal medicine in South Africa: A historical and contemporary overview

Pillay

2023

Journal of the Colleges of Medicine of South Africa

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“…Accreditation of undergraduate education is perhaps the most important regulatory function for medical councils. Middle‐income South Africa had some regulation of medical education in the early nineteenth century but insisted that doctors were trained and certified in Europe [86]. This limited the profession to those who could afford the training, which ultimately meant that the medicine practised was not at all inclusive [86].…”

Section: Medical Councilsmentioning

confidence: 99%

“…Middle‐income South Africa had some regulation of medical education in the early nineteenth century but insisted that doctors were trained and certified in Europe [86]. This limited the profession to those who could afford the training, which ultimately meant that the medicine practised was not at all inclusive [86]. Currently, there are large numbers of private medical schools in the SSA region without defined curricula, standards of assessment or external review, facts the international community has recognized [87].…”

Section: Medical Councilsmentioning

confidence: 99%

Adaptations in models of urological regulation and their application to sub‐Saharan Africa

et al. 2022

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Regulation of medical care is something that has grown from humble roots in professional craft groups to huge establishment in well-resourced, high-income countries. Self-regulation was the preferred method of determining appropriate behaviour initially, but a lack of public trust in this, and the desire of patients to contribute to the establishment of the standard of care that they receive, has meant that most Anglophone countries have adopted some form of independent regulation. Regulators are responsible for the registration of doctor's qualifications, licensing them to practise, accrediting institutions to provide undergraduate and postgraduate education and certifying the attainment of accepted standards of achievement by some form of assessment process. Regulators also have powers to sanction individuals whose practice falls outside expected levels of competence. Both centralized and devolved models of regulation have evolved. Much of the accreditation for postgraduate education and training has been handed down to collegiate bodies, or non-governmental organizations, who can also certify completion of training. Evidence-based medicine and clinical practice guidelines have enforced an informal tier of regulation in high-income countries; guideline-derived practice is now widely regarded as an accepted standard of care. In low-and middle-income countries in sub-Saharan Africa the governmental and legislative structures and finance available to provide the regulation espoused in more privileged environments is rarely available. The workforce is structured in a completely different way and some care groups are totally unregulated. Medical councils in sub-Saharan Africa fulfil a registration and licensing function but surgical collegiate bodies provide the structure for postgraduate training. The East and West African Colleges of Surgeons have developed into robust organizations, who have verifiable, quality-assured, accreditation systems that have helped improve standards of care for the large populations for which their member surgeons are responsible. Formal regulation of continuing practice and sanctions are challenges that are, at present, largely unaddressed.

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“…Very limited health services were concentrated in large cities where the minority of local populations resided, and mostly focused on interrupting transmission of infection. The treatment of disease among local indigenous populations was neglected, subsequently stigmatizing them by characterizing them as threats to public health and security ( 5 , 6 ). These historical factors led to healthcare deserts and social determinants that predisposed further disparities.…”

Section: Introductionmentioning

confidence: 99%

Addressing coloniality of power to improve HIV care in South Africa and other LMIC

Ordóñez

Marconi

Manderson

2023

Front. Reprod. Health

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We describe the appropriateness and potential for effectiveness of three strategic approaches for improving HIV care in South Africa: community-based primary healthcare, local/community-based stakeholder engagement, and community-engaged research. At their core, these approaches are related to overcoming health inequity and inequality resulting from coloniality of power's heterogenous structural processes impacting health care in many low- and middle-income countries (LMIC). We turn to South Africa, a middle-income country, as an example. There the HIV epidemic began in the 1980s and its ending is as elusive as achieving universal healthcare. Despite impressive achievements such as the antiretroviral treatment program (the largest in the world) and the country's outstanding cadre of HIV experts, healthcare workers and leaders, disadvantaged South Africans continue to experience disproportionate rates of HIV transmission. Innovation in global public health must prioritize overcoming the coloniality of power in LMIC, effected through the imposition of development and healthcare models conceived in high-income countries (HIC) and insufficient investment to address social determinants of health. We advocate for a paradigm shift in global health structures and financing to effectively respond to the HIV pandemic in LMIC. We propose ethically responsive, local/community-based stakeholder engagement as a key conceptual approach and strategy to improve HIV care in South Africa and elsewhere. We join in solidarity with local/community-based stakeholders' longstanding efforts and call upon others to change the current status quo characterized by global public health power concentrated in HIC.

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The Medical History of South Africa: An Overview

Cited by 8 publications

References 56 publications

Internal medicine in South Africa: A historical and contemporary overview

Internal medicine in South Africa: A historical and contemporary overview

Adaptations in models of urological regulation and their application to sub‐Saharan Africa

Addressing coloniality of power to improve HIV care in South Africa and other LMIC

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