Background: Community health worker programmes have the potential to contribute critically towards universal health coverage. However, CHWs globally have often continued to operate on the periphery of the health care system, viewed as a non-essential cadre. This results in a workforce that often remains disempowered and under-supported.
View Article and Find Full Text PDFBackground: In 2021, South Africa introduced a new 6-month internship in family medicine and primary care. This study aimed to assess the new rotation at district health facilities in the Western Cape.
Methods: A descriptive survey of interns and supervisors, as phase-two of an exploratory sequential mixed methods study.
The therapeutic benefit of expressive writing has been well researched in the Global North but there is no literature from the Global South. Potentially healing interventions need to be investigated in different contexts, particularly where there is a need to build social cohesion. South Africa has a violent past and is a highly stressed society.
View Article and Find Full Text PDFBackground: In 2021, South Africa introduced a 6-month internship rotation in family medicine, in the second year of a 2-year internship programme for newly qualified doctors. This was a major change from the previous 3-months training in family medicine, and expanded the training platform to smaller district hospitals and primary health care (PHC) facilities, many of which had never had interns. The medical disciplines in South Africa needed to know if this change in the internship programme was worthwhile and successful.
View Article and Find Full Text PDFArgininosuccinic aciduria (ASA) is a metabolic disorder caused by a deficiency in argininosuccinate lyase (ASL), which cleaves argininosuccinic acid to arginine and fumarate in the urea cycle. ASL deficiency (ASLD) leads to hepatocyte dysfunction, hyperammonemia, encephalopathy, and respiratory alkalosis. Here we describe a novel therapeutic approach for treating ASA, based on nucleoside-modified messenger RNA (modRNA) formulated in lipid nanoparticles (LNP).
View Article and Find Full Text PDF: In contrast to alarming reports of exhaustion and burnout amongst healthcare workers in the first wave of the COVID-19 pandemic, we noticed surprisingly positive staff experiences of working in a COVID-19 field hospital in South Africa. The 862-bed "Hospital of Hope" was established at the Cape Town International Convention Centre specifically to cope with the effects of the first wave of the COVID-19 pandemic in Cape Town. : We aimed to systematically describe and assess the effects on staff and the local health system.
View Article and Find Full Text PDFLipid nanoparticles (LNPs) are clinically proven to successfully deliver both small interfering RNA (siRNA) therapeutics and larger mRNA payloads for prophylactic vaccine applications. Non-human primates (NHPs) are generally considered to be the most predictive of human responses. However, for ethical and economic reasons, LNP compositions have historically been optimized in rodents.
View Article and Find Full Text PDFObjectives: The objective of this study is to present a retrospective analysis of patients presenting to a Major Trauma Centre (MTC) following deliberate self-harm (DSH) and identifying the precipitants of DSH and psychiatric morbidity that will serve to inform the provision of care for these patients.
Patients And Methods: This was a retrospective observational study from a London Major Trauma Centre that identified all injured patients that presented with deliberate self-harm. Data was analysed from our established trauma database.
The Sf9 cell line, originally isolated from the ovarian tissue of larvae, is widely used in academia and industry for the baculovirus-mediated production of recombinant proteins and virus-like particles. RNA interference (RNAi) is a conserved antiviral pathway present in eukaryotic organisms and is the primary antiviral defence mechanism in insects. Recent evidence has implicated RNAi as an antiviral response to baculovirus infection in Sf9 cells.
View Article and Find Full Text PDFBackground: Reporting on the effect of health humanities teaching in health professions education courses to facilitate sharing and mutual exchange internationally, and the generation of a more interconnected body of evidence surrounding health humanities curricula is needed. This study asked, what could an internationally informed curriculum and evaluation framework for the implementation of health humanities for health professions education look like?
Methods: The participatory action research approach applied was based on three iterative phases 1. Perspective sharing and collaboration building.
Background: Non-communicable diseases (NCDs), including type-2 diabetes and hypertension, have been associated with increased morbidity and mortality rates because of coronavirus disease 2019 (COVID-19). Maintaining quality care for these conditions is important but data on the impact of COVID-19 on NCD care in South Africa are sparse.
Aim: This study aimed to assess the impact of COVID-19 on facility and community-based NCD care and management during the first COVID-19 wave.
Perceived quality of care is a determinant of uptake of health services. This study aimed to assess the determinants of quality of care of enrollees in the National Health Insurance Scheme (NHIS) in Nigeria. The outcome was satisfaction with health care services, which was used as a proxy for quality.
View Article and Find Full Text PDFAfr J Prim Health Care Fam Med
December 2021
Background: The coronavirus pandemic has put extreme pressure on health care services in South Africa.
Aim: To describe the design, patients and outcomes of a field hospital during the first wave of the coronavirus disease 2019 (COVID-19) pandemic.
Setting: The Cape Town International Convention Centre was the first location in Cape Town to be commissioned as a field hospital that would serve as an intermediate care bed facility.
Background: The articulation of learning goals, processes and outcomes related to health humanities teaching currently lacks comparability of curricula and outcomes, and requires synthesis to provide a basis for developing a curriculum and evaluation framework for health humanities teaching and learning. This scoping review sought to answer how and why the health humanities are used in health professions education. It also sought to explore how health humanities curricula are evaluated and whether the programme evaluation aligns with the desired learning outcomes.
View Article and Find Full Text PDFThe National Health Insurance Scheme (NHIS) of Nigeria established in the year 2005 aims to minimize the inequity of access to quality healthcare services in Nigeria. As of the year 2017, enrollment in NHIS-accredited facilities in the southwest region of Nigeria was significantly clustered, with more than three-quarters of NHIS enrollees registered with only 10% of the available NHIS-accredited facilities in the six states of the region. This study explored the factors associated with the skewed distribution of enrollees across facilities and the influence of stakeholders.
View Article and Find Full Text PDFBackground: This study was carried out to enable an assessment of geospatial distribution and access to healthcare facilities under the National Health Insurance Scheme (NHIS) of Nigeria. The findings will be useful for efficient planning and equitable distribution of healthcare resources.
Methods: Data, including the distribution of selected health facilities, were collected in Ibadan, Nigeria.
Smoke impacts from large wildfires are mounting, and the projection is for more such events in the future as the one experienced October 2017 in Northern California, and subsequently in 2018 and 2020. Further, the evidence is growing about the health impacts from these events which are also difficult to simulate. Therefore, we simulated air quality conditions using a suite of remotely-sensed data, surface observational data, chemical transport modeling with WRF-CMAQ, one data fusion, and three machine learning methods to arrive at datasets useful to air quality and health impact analyses.
View Article and Find Full Text PDFAfr J Prim Health Care Fam Med
December 2020
In South Africa, the national policy on re-engineering primary health care (PHC) supports the implementation of ward-based outreach teams with community health workers. In the Western Cape, a community-orientated primary care (COPC) approach has been adopted in provincial goals for 2030 and the key strategies for the improvement of district health services. This approach is expected to improve health and also save costs.
View Article and Find Full Text PDFAfr J Prim Health Care Fam Med
October 2020
This short report captures the week-by-week reflections of a group of family physicians who joined the clinical and operational management teams tasked with providing the in-patient service of an 862-bed COVID-19 field hospital. The 'Hospital of Hope' at the Cape Town International Convention Centre (CTICC) was established as an intermediate care facility specifically to cope with the effects of the COVID-19 pandemic in Cape Town metropole. In an extraordinary feat of engineering, the conference centre floor was transformed within a matter of weeks into wards with piped oxygen at each bed.
View Article and Find Full Text PDFAs the coronavirus disease 2019 (Covid-19) pandemic evolves globally, we are realising its impact on communities from the disease itself and the measures being taken to limit infection spread. In South Africa (SA), 62 300 adults die annually from alcohol-attributable causes. Alcohol-related harm can be reduced by interventions, such as taxation, government monopolising retail sales, outlet density restriction, hours of sales and an advertising ban.
View Article and Find Full Text PDFResilience is a dynamic process of positive adaptation to significant adversity. While there has been substantial focus on risks and negative outcomes associated with youth migrancy, there is limited evidence of the relationship between the adversity of migration, and resilience, wellbeing, and positive mental health in adolescents. This international study aimed to explore the differences in resilience, wellbeing, and mental health behaviors in migrant and non-migrant adolescents tested across six countries (Australia, New Zealand, UK, China, South Africa, and Canada) with varying levels of trauma exposure.
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