Moral hazard as a material fact in the assessment of the risk

From text: In the context of the law of insurance, moral hazard, also referred to as moral risk (see for example Peter Havenga ‘The Financial Position of an Insured and Serious Threats of Physical Attack on Insured Property as Material Facts’ (1995) 7 SA Merc LJ 110) generally refers to the financial position of the insured. In practice, however, hazard/risk refers to the ‘serious financial difficulties’ or ‘poor financial history’ of the insured, manifested in most cases by the insured’s actual but in other cases factual insolvency. Questions which arise are whether this hazard/risk is a  material fact which should be disclosed on conclusion of a contract of insurance (or on renewal, if the contract is renewable), and whether if this is not done the insurer can avoid liability on that basis

Trends in the utilization of medicines sold in the private sector post-registration in South Africa and the implications for similar countries

Background: Regulatory authorities register medicines for patients to access them within a reasonable period of time. There is a paucity of available data regarding the extent to which registered medicines reach the public after market authorisation is granted by the South African Health Products Regulatory Authority (SAHPRA). This is important since time spent by SAHPRA assessing medicines that are subsequently not launched onto the South African market means time wasted, which could be spent on assessing new medicines that address an unmet need in the country. Consequently, we initially analysed the time taken for registered medicines to reach patients and the relationship between medicines registered at SAHPRA and those subsequently dispensed in private pharmacies. The extent of registration of multiple sourced versus new patented medicines was also explored. Methods: A retrospective, descriptive and quantitative investigation was conducted for medicines registered between 2014 and 2019. Registered and dispensed medicines were compared to establish accessibility post registration. Data sources included SAHPRA and IQVIA datasets. Microsoft Excel and SAS were used for data storage, analysis, and computation of descriptive statistical analysis. Results: Of (N=2175) registered medicines, only 358 (16.5%; 95% CI 15.0% - 18.1%) were dispensed to patients, and out of 1735 medicines registered between 2015 and2019, only 57 (3.3%; 95% CI 2.5% - 4.2%) were dispensed during the study period. Medicines acting on the central nervous system were registered and dispensed the most at 21.0% and 18.0%, respectively, whereas antineoplastic and immunomodulation agents were registered and dispensed only 11% and 5%, respectively. A concern was that only 13.0% of registered medicines were originators, with most either as generics, including branded generics, or pseudo-generics. Conclusion: Regulatory measures should be implemented to ensure increased medicine access post-registration for new originators, especially for priority disease areas that benefit patients. Mental health diseases and improved access to oncology medicines require special attention and further investigation in South Africa

Investigating the drivers of trust perceptions of black young adult banking customers in South Africa

Abstract: Background: Black young adults form a substantial portion of South Africa’s young adult cohort and an important market segment for retail banks. Few studies have examined the precursors of perceived trust among black young adult banking customers in South Africa. Purpose of study: This study investigates the influence of shared values, reputation, satisfaction, and customisation on black young adult customers’ trust in the South African retail banking sector. Design/Methodology/Approach: A descriptive research design was followed and data were collected from black young adult retail banking customers using an electronic survey. A total of 320 responses were analysed using standard multiple regression analysis. Results/Findings: Shared values, reputation, satisfaction, and customisation were found to be predictors of perceived customer trust, and may be important for developing a business relationship strategy to strengthen the trust perceptions of black young adult customers in South Africa. The model tested validates the proposed hypothesised relationships between shared values, reputation, satisfaction, customisation, and perceived trust among South Africa’s black young adult banking customers

Medical waste disposal at a hospital in Mpumalanga Province, South Africa: Implications for training of healthcare professionals

Background. Healthcare professionals (HCPs) produce various types of waste in the course of rendering healthcare services. Each classification of waste must be disposed of according to the prescribed guidelines. Incorrect disposal of waste may pose a danger to employees, patients and the environment. HCPs must have adequate knowledge of the disposal of medical waste.Objectives. To determine the knowledge and practices of HCPs with regard to medical waste disposal at a hospital in Mpumalanga Province, South Africa.Methods. A quantitative cross-sectional research approach was used. The study respondents included nurses, medical doctors, dental health staff and allied health staff. Data were collected through self-administered questionnaires and analysed using IBM SPSS version 22.0.Results. A high proportion of HCPs did not have adequate knowledge regarding the disposal of medical waste, but nevertheless disposed of medical waste appropriately. While the knowledge and practices of HCPs with regard to medical waste disposal were not associated with age, gender or years of experience, there was an association between professional category and knowledge and practices.Conclusions. Disposal of medical waste is the responsibility of all HCPs. All categories of HCPs should receive regular training to improve their knowledge regarding disposal of medical waste and to minimise the risks associated with improper waste management. This will further increase compliance with the guidelines on disposal of medical waste

The 2011 Green Paper on Land Reform: Opportunities and Challenges - The National African Farmers Union (NAFU SA)

No Abstract

WINNING A CIVIL CASE WITHOUT GIVING ANY KIND OF EVIDENCE WHATSOEVER? Jordaan v Bloemfontein Transitional Local Authority [2004] 1 All SA 496 (SCA), 2004 3 SA 371 (SCA)

The standard of proof in a civil case is the well-known preponderance (balance) of probabilities. This requires of the party on whom the onus lies, in order to be successful, to satisfy the court that he is entitled to succeed on his claim or defence, as the case may be (Pillay v Krishna 1946 AD 946 952-953). The onus of establishing a case in accordance with this standard is on the party who makes the assertion since if a person claims something from another in a court of law, he has to satisfy the court that he is entitled to it (Pillay v Krishna supra 951; and Van Wyk v Lewis 1924 AD 438 444). According to Voet (22.3.10) the position is: “He who asserts, proves, and nothe who denies, since a denial of a fact cannot naturally be proved, provided that it is a fact that is denied and that the denial is absolute.” The person who makes the claim, and accordingly bears the onus of proof, is invariably the plaintiff. However, there are situations in which the defendant bears the onus. This ordinarily happens when the defendant is not content with a mere denial of the claim against him but sets up a special defence. In respect of the special defence the defendant becomes the claimant. For the specialdefence to succeed the defendant must satisfy the court that he is entitled to succeed on it (Pillay v Krishna supra 952; Corpus Juris (D.44.1.1); and Voet 22.3.9).The word “onus”, in this context, refers to the duty which is cast on the particular litigant, in order to be successful, of finally satisfying the court that he is entitled to succeed on his claim or defence, as the case may be. This is the meaning of the word in its true and original (primary) sense. In this sense the onus never shifts from the party upon which it originally rested (South Cape Corporation (Pty) Ltd v Engineering Management Services (Pty) Ltd 1977 3 SA 534 (A) 548A-B). In a secondary sense the word means the duty cast upon a litigant to adduce evidence in order to combat a prima facie case made by the opponent. In this sense the onus refers to the burden of adducing evidence in rebuttal. This may shift or be transferred in the course of the case, depending upon the measure of proof furnished by the one party or the other (South Cape Corporation (Pty) Ltd v Engineering Management Services (Pty) Ltd supra 548)

Medicine prescribing practices in renally-impaired patients admitted to the internal medicine wards at Dr George Mukhari Academic Hospital, Ga-Rankuwa, South Africa

The number of patients with renal impairment has increased dramatically over the past few years, and in general, advances in the treatment of the disease have permitted patients to live longer. Clinicians tend to prescribe multiple medications, which can reduce renal function or cause impairment. This practice increases patient exposure to medicine dosage errors. The most commonly-prescribed medications in patients with renal impairment were identified and investigated in this study.The study was quantitative, retrospective and cross-sectional. Seven hundred and sixty-five medicines were prescribed in 100 reviewed patient files. An average of 7.7 medicines was prescribed per prescription. The most commonly-prescribed group of medicines was for the cardiovascular system (260, 33.9%). The most frequently-prescribed nephrotoxic medicine was perindopril (20.2%). Of the nephrotoxic medicines, which required a dose adjustment, just over half (57%) were adjusted according to the recommended guidelines for adult renal impairment. Only a small percentage (2.7%) of the prescribed nephrotoxic medicines should not have been prescribed for renally-impaired patients. This study emphasizes the importance of calculating the CrCl and implementing the appropriate medicine dose adjustments in renally impaired patients. Availability of clinical pharmacist in the wards can assist prescribers in minimizing medicine overdose and improve adherence to medicine dosage guidelines.Keywords: Renal impairment, nephrotoxic medicines, dosage

Mental health care - a public health priority in South Africa

Mental health is an integral part of health and it includes an individual’s emotional, psychological and social well-being. Mental illness remains underreported and underdiagnosed, particularly in low- and middle-income countries, including South Africa. South Africa carries a huge burden of mental illnesses with the most prevalent being anxiety disorders, substance abuse disorders, mood disorders and depression. People with mental health conditions often face neglect in the health system as well as stigma and discrimination. This has resulted in poor health outcomes, isolation and high suicide rates, including amongst adolescents. The South African National Mental Health Policy Framework and Strategic Plan (2013–2020) aims to integrate mental health into the health system to provide quality mental health services that are accessible, equitable and comprehensive, particularly for community-based mental health. This article provides an overview of mental health care in South Africa, highlighting its public health importance

Governance and regulation of the tourism industry: An internet marketing perspective

The purpose of this qualitative study is to establish governance and regulation issues pertaining to Internet marketing approaches within the South African tourism sector. The study focuses on the norms and practices of Internet marketing among small-scale lodging establishments in Bushbuckridge – a small tourist town in northeast South Africa. In-depth interviews were collected from eight participating bed and breakfast (B&B) owners. Findings revealed that, while Internet awareness was quite high, only a few B&Bs utilised the Internet for marketing. Participants cited lack of clear industry guidelines on Internet marketing approaches as well as limited Internet experience, among others, as barriers to adoption. Implications and recommendations of the study are presented within the ambit of the existing literatur