The economic impact of operational inefficiencies in SA ports and the role of the ports regulator

Papers presented virtually at the 41st International Southern African Transport Conference on 10-13 July 2069Port performance is a critical factor that can shape the Southern African Development Community’s (SADC) trade competitiveness. The South African port system has been facing operational inefficiencies for several years, despite the implementation of regulation, Port Performance monitoring, performance standards by the Port Authority, and the Ports Regulator’s Weighted Efficiency Gains from Operations (WEGO). Poor port performance increases business costs and reduces ports' competitiveness in the region. The longer-term implication is a loss of both competitive and comparative advantage which impacts Foreign Direct Investments (FDI). This leads to port users, most predominantly end customers paying more for imported goods and commodities, whilst shippers pay a lot more on port and terminal costs for exports to reach overseas markets. The reality is that efficient integrated logistics and supply chains are crucial as instruments of economic growth. Successful execution of infrastructure investment determines how different transport modes will stimulate economic activity which benefits the region. The Ports Regulator of South Africa (PRSA), an independent regulatory authority responsible for the pricing and tariff regulation of port services in South Africa was established to promote competition and efficiency in the ports sector, protect port users from abuse of monopoly power, and foster investment in the industry. Mandated by the Ports Act, PRSA has been instrumental in addressing operational inefficiencies and ensuring the smooth running of the South African port system. This is done through regular monitoring of port activities, equity of access, port performance, CAPEX, and OPEX. This paper aims to pinpoint inefficiencies within the port systems that are actively operating in the region, identify the causal effects of such inefficiencies and recommend ways to deal with these ineptitudes

Approaches to improving the contribution of the nursing and midwifery workforce to increasing universal access to primary health care for vulnerable populations: A systematic review

© 2015 Dawson et al. Background: Despite considerable evidence showing the importance of the nursing and midwifery workforce, there are no systematic reviews outlining how these cadres are best supported to provide universal access and reduce health care disparities at the primary health care (PHC) level. This review aims to identify nursing and midwifery policy, staffing, education and training interventions, collaborative efforts and strategies that have improved the quantity, quality and relevance of the nursing and midwifery workforce leading to health improvements for vulnerable populations. Methods: We undertook a structured search of bibliographic databases for peer-reviewed research literature using a focused review question and inclusion/exclusion criteria. The quality of retrieved papers was appraised using standard tools. The characteristics of screened papers were described, and a deductive qualitative content analysis methodology was applied to analyse the interventions and findings of included studies using a conceptual framework. Results: Thirty-six papers were included in the review, the majority (25) from high-income countries and nursing settings (32). Eleven papers defined leadership and governance approaches that had impacted upon the health outcomes of disadvantaged groups including policies at the national and state level that had led to an increased supply and coverage of nursing and midwifery staff and scope of practice. Twenty-seven papers outlined human resource management strategies to support the expansion of nurse's and midwives' roles that often involved task shifting and task sharing. These included approaches to managing staffing supply, distribution and skills mix; workloads; supervision; performance management; and remuneration, financial incentives and staffing costs. Education and training activities were described in 14 papers to assist nurses and midwives to perform new or expanded roles and prepare nurses for inclusive practice. This review identified collaboration between nurses and midwives and other health providers and organizations, across sectors, and with communities and individuals that resulted in improved health care and outcomes. Conclusions: The findings of this review confirm the importance of a conceptual framework for understanding and planning leadership and governance approaches, management strategies and collaboration and education and training efforts to scale up and support nurses and midwives in existing or expanded roles to improve access to PHC for vulnerable populations

Screening and brief interventions for hazardous and harmful use of alcohol and other psychoactive substances: How are nurses and midwives involved?

AbstractGlobally, about two billion people use alcohol and between 172 and 250 million people used illicit drugs at least once in 2007. Harmful alcohol use accounts for 4.5% of the global burden of disease and is responsible for 3.8% of all deaths. Hazardous and harmful drinkers may constitute up to 20% of patients in primary health care in some countries. Given the extent of the problem and the risks of hazardous and harmful substance use to health, nurses and midwives are well placed to deliver appropriate interventions. Effective screening and brief interventions are central to the public health effort. This literature review focused on the role of nurses and midwives in both screening and delivering brief interventions and entailed review of  literature published in English in which nurses or midwives various databases.Findings from the review are important for developing strategies for maximizing the role nurses and midwives can play in brief interventions. Key words: nursing, midwifery, brief interventions, harmful alcohol use, psychoactive substance us

Integration of women in the maritime sector:the work-life balance paradox

Papers presented virtually at the 42nd International Southern African Transport Conference on 08 - 11 July 2024In May 2024 we celebrated International Day of Women in Maritime under the IMO Safe Horizons - Women Shaping the Future of Maritime Safety. Speaking at an international event to mark the occasion on Friday, 17 May 2024, the Secretary-General of the International Maritime Organization (IMO), Mr. Arsenio Dominguez stated:“We must – and will – do more. By investing in women's education and professional development, we empower women, drive innovation and foster sustainability within the maritime industry, to the benefit of all.”Working women across all modes of transport are faced with the challenge of how to have successful careers whilst raising children and maintaining healthy and happy family structures. Women development is in the forefront of organisations’ transformation programmes, however, in many instances organisations fall short in the execution of how women are enabled to successfully climb the ladder without having to choose a career or family.The question of whether women can have it all, is one that needs to be done away with as it implies that there must be something they need to sacrifice by virtue of being women.The question should rather be how we create working environments and policies that support a work-life balance. How do we use models like remote/hybrid work, flexible time and work-place policies to support women for career growth

A study of dental caries in rural and an urban primary school in Zambia

Urbanization contributes to the higher caries prevalence in the urban school children320 children 160 from a rural and 160 from an urban primary school were examined for dental caries.The urban children were found to have twice as much caries as their rural counterparts. Their D.M.F./df indices were also much higher. No significant sex difference was noted. The tribal distribution shows that the Tonga are the most susceptible tribe while the Lenje have the least caries. The relationship between caries and brushing habits, as well as consumption of confectionary was established. The commonest teeth affected and their relationship to age was also noted. It was concluded that urbanization has definitely contributed to the higher caries prevalence in the urban school children. Although the situation is not as bad as in the West, if it remains unchecked, 90% of the population may have caries in another 15 years.Office of Global AIDS/US Department of Stat

The role of nurses and midwives in polio eradication and measles control activities: a survey in Sudan and Zambia

<p>Abstract</p> <p>Background</p> <p>Nurses and midwives are the key providers of nursing and midwifery services; in many countries, they form the major category of frontline workers who provide both preventive and curative services in the community. When the skills and experience of nursing and midwifery personnel are maximized, they can contribute significantly to positive health outcomes. We conducted a survey among nurses and midwives working at district level in Sudan and Zambia to determine their roles and functions in polio eradication and measles elimination programmes.</p> <p>Methods</p> <p>Nurses and midwives practising in four selected districts in Sudan and in Zambia completed a self-administered questionnaire on their roles and responsibilities, their routine activities and their functions during supplementary immunization campaigns for polio and measles.</p> <p>Results</p> <p>Nurses and midwives were found to play significant roles in implementing immunization programme activities. The level of responsibilities of nurses and midwives in their routine work related more to existing opportunities than to their job descriptions.</p> <p>In Zambia, where nurses reported constraints in performing their tasks, the reasons cited were an increase in the burden of disease and the shortage of health personnel. Factors identified as key to improving work performance included written job descriptions, opportunities for staff and career development and opportunities to earn extra income through activities associated with their jobs.</p> <p>Other non-monetary incentives mentioned included reliable transport, resources and logistics to support routine work in the district. However, in both countries, during supplementary immunization activities or mass campaigns for polio eradication and measles control, nurses and midwives took on more management responsibilities.</p> <p>Conclusion</p> <p>This study shows that nurses and midwives play an important role in implementing immunization activities at the district level and that their roles can be maximized by creating opportunities that lead to their having more responsibilities in their work and in particular, their involvement in early phases of planning of priority health activities. This should be accompanied by written job descriptions, tasks and clear lines of authority as well as good supportive supervision. The lessons from supplementary immunization activities, where the roles of nurses and midwives are maximized, can be easily adopted to benefit the rest of the health services provided at district level.</p

Approaches to improving the contribution of the nursing and midwifery workforce to increasing universal access to primary health care for vulnerable populations: a systematic review

BACKGROUND: Despite considerable evidence showing the importance of the nursing and midwifery workforce, there are no systematic reviews outlining how these cadres are best supported to provide universal access and reduce health care disparities at the primary health care (PHC) level. This review aims to identify nursing and midwifery policy, staffing, education and training interventions, collaborative efforts and strategies that have improved the quantity, quality and relevance of the nursing and midwifery workforce leading to health improvements for vulnerable populations. METHODS: We undertook a structured search of bibliographic databases for peer-reviewed research literature using a focused review question and inclusion/exclusion criteria. The quality of retrieved papers was appraised using standard tools. The characteristics of screened papers were described, and a deductive qualitative content analysis methodology was applied to analyse the interventions and findings of included studies using a conceptual framework. RESULTS: Thirty-six papers were included in the review, the majority (25) from high-income countries and nursing settings (32). Eleven papers defined leadership and governance approaches that had impacted upon the health outcomes of disadvantaged groups including policies at the national and state level that had led to an increased supply and coverage of nursing and midwifery staff and scope of practice. Twenty-seven papers outlined human resource management strategies to support the expansion of nurse’s and midwives’ roles that often involved task shifting and task sharing. These included approaches to managing staffing supply, distribution and skills mix; workloads; supervision; performance management; and remuneration, financial incentives and staffing costs. Education and training activities were described in 14 papers to assist nurses and midwives to perform new or expanded roles and prepare nurses for inclusive practice. This review identified collaboration between nurses and midwives and other health providers and organizations, across sectors, and with communities and individuals that resulted in improved health care and outcomes. CONCLUSIONS: The findings of this review confirm the importance of a conceptual framework for understanding and planning leadership and governance approaches, management strategies and collaboration and education and training efforts to scale up and support nurses and midwives in existing or expanded roles to improve access to PHC for vulnerable populations

A mixed method outcome evaluation of a specialist Alcohol Hospital Liaison Team

Aims: To evaluate the effectiveness of an Alcohol Hospital Liaison Team at reducing alcohol-specific hospital attendances and admissions. Methods: In a mixed-method evaluation, 96 patients who accessed the team were monitored using data for alcohol-specific hospital attendances and Accident and Emergency (A&amp;E) admissions before, during, and after engaging with the team. A feedback survey was sent to patients and a focus group was held with staff from the team to identify barriers and facilitators to the successful delivery of this service. Results: No differences were observed when looking at alcohol admissions or A&amp;E attendances before patients engaged with the service to those after discharge. While hospital admissions decreased slightly and A&amp;E attendances increased slightly, these differences were not significant. Hospital admissions and A&amp;E attendances increased significantly during engagement with the service. The focus group identified confusion over who should be delivering brief interventions and that the team was holding onto patients for too long. Conclusion: The results of this evaluation demonstrated that this team was not effective at reducing alcohol attendances or admissions due to a number of factors. Policy makers should make note of the barriers to effectiveness highlighted in this article, before commissioning alcohol care teams in the future

From Emergence to Eradication: The Epidemiology of Poliomyelitis Deconstructed

Poliomyelitis has appeared in epidemic form, become endemic on a global scale, and been reduced to near-elimination, all within the span of documented medical history. Epidemics of the disease appeared in the late 19th century in many European countries and North America, following which polio became a global disease with annual epidemics. During the period of its epidemicity, 1900–1950, the age distribution of poliomyelitis cases increased gradually. Beginning in 1955, the creation of poliovirus vaccines led to a stepwise reduction in poliomyelitis, culminating in the unpredicted elimination of wild polioviruses in the United States by 1972. Global expansion of polio immunization resulted in a reduction of paralytic disease from an estimated annual prevaccine level of at least 600,000 cases to fewer than 1,000 cases in 2000. Indigenous wild type 2 poliovirus was eradicated in 1999, but unbroken localized circulation of poliovirus types 1 and 3 continues in 4 countries in Asia and Africa. Current challenges to the final eradication of paralytic poliomyelitis include the continued transmission of wild polioviruses in endemic reservoirs, reinfection of polio-free areas, outbreaks due to circulating vaccine-derived polioviruses, and persistent excretion of vaccine-derived poliovirus by a few vaccinees with B-cell immunodeficiencies. Beyond the current efforts to eradicate the last remaining wild polioviruses, global eradication efforts must safely navigate through an unprecedented series of endgame challenges to assure the permanent cessation of all human poliovirus infections