Prerequisites for National Health Insurance in South Africa: Results of a national household survey

Background. National Health Insurance (NHI) is currently highon the health policy agenda. The intention of this financing system is to promote efficiency and the equitable distribution of financial and human resources, improving health outcomes for the majority. However, there are some key prerequisites that need to be in place before an NHI can achieve these goals.Objectives. To explore public perceptions on what changes inthe public health system are necessary to ensure acceptabilityand sustainability of an NHI, and whether South Africans areready for a change in the health system.Methods. A cross-sectional nationally representative surveyof 4 800 households was undertaken, using a structured questionnaire. Data were analysed in STATA IC10.Results and conclusions. There is dissatisfaction with bothpublic and private sectors, suggesting South Africans are ready for health system change. Concerns about the quality of public sector services relate primarily to patient-provider engagements (empathic staff attitudes, communication and confidentiality issues), cleanliness of facilities and drug availability. There are concerns about the affordability of medical schemes and how the profit motive affects private providers’ behaviour. South Africans do not appear to bewell acquainted or generally supportive of the notion of risk cross-subsidies. However, there is strong support for income cross-subsidies. Public engagement is essential to improve understanding of the core principles of universal pre-payment mechanisms and the rationale for the development of NHI. Importantly, public support for pre-payment is unlikely to be forthcoming unless there is confidence in the availability of quality health services

Surface temperature trends from homogenized time series in South Africa : 1931-2015

Previous assessments of historical trends of measured surface temperature in South Africa have all shown a general upward trend, in both mean and extreme values, over recent decades. In addition, some regional differences in trends have been identified. Most of these studies focused on the period from about 1961 up to the last year that could be included before publication, as only climate stations situated in the same position for the entire analysis period were analysed. A data homogenisation procedure enabled the combination of time series of stations from which trend analysis could be applied, extending the common analysis period for this study back to around 1931. The trend results, based on the WMO ETCCDI indices, continue to show the general warming trend shown in previous analyses, with a general increase in extreme warm events, and a general decrease in extreme cold events across South Africa. The analysis of seasonal trends show that, while there are noteworthy differences on a regional basis, austral summer shows on average the strongest warming, followed by autumn, winter and spring. The central interior, which exhibited significant cooling in previous analyses, now shows non-significant or similar trends when compared to the other parts of South Africa. There is no countrywide acceleration in the warming trends, but some regional consistencies in the temporal changes in trends could be determined, i.e. increases in trends in the central interior and decreases in trends along most of the coastal region.http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1097-00882018-04-30hb2017Geography, Geoinformatics and Meteorolog

Potential suppressive effects of Mexican poppy weed residues on germination and early growth of maize and pearl millet crops

Argemone ochroleuca allelochemical properties have been reported but not empirically tested on economically important staple cereal crops. Therefore, the objective of this study was to determine the potential Allelopathic effects of the alien weed’s residues on germination and early-growth of maize (Zea mays L.) and Pearl millet (Pennisertum glaucum). Allelopathic effects of A. ochroleuca on maize and millet seed germination were tested in a 2 (shoot and root) x 11 (0, 10, 20, 30, 40, 50, 60, 70, 80, 90 and 100g/L water) factorial treatment arrangement in CRD in an incubator placed in a laboratory. Whereas effects of the weed extracts on the same crops’ early-growth were tested in a 2 (shoot and roots) x 8 (0, 2, 4, 6, 8, 10, 12 and 14g ground-powdered extracts) factorial arrangement in RCBD under laboratory conditions. Maize and millet germination percentage, germination speed, mean germination time, mean daily germination, plumule and radicle length were measured for germination test, whereas, plant height, stem diameter, root and shoot mass were used as indicators of A. ochroleuca suppression of early plant growth. Relative to untreated control, concentration equal to and greater than 10g/L aqueous extracts of A. ochroleuca reduced millet and maize seed germination variables by 10–100% and 28–56%, respectively, while early-growth variables were reduced by 66–100% and 4–37%, respectively. Argemone ochroleuca shoot extracts were more suppressive than root extracts on germination and early growth of the two crops. In conclusion, A. ochroleuca Allelopathic effects were concentration and plant-part dependent, inhibitory effects increased with concentrations, with extracts from shoots being more Allelopathic on measured variables when compared to root extracts. As A. ochroleuca continues to spread yearly without any control strategies in place, a threat exist on maize and Pearl millet production especially in communal farming areas where improved management strategies are non- existent.&nbsp

Substance use patterns in an adolescent psychiatric unit in Johannesburg, South Africa

Background: Substance use among adolescents carries a significant public health and socioeconomic burden with potential long-term consequences for the adolescent substance user (SU). Adolescents with mental health challenges are vulnerable to substance use and substance use worsens outcomes in this population. Aim: This study aimed to describe the substance use patterns among inpatients admitted to a specialised tertiary adolescent inpatient unit in Johannesburg over a 4-year period. Setting: This study was conducted at the Tara H. Moross Centre (Tara Hospital), in Johannesburg in the Gauteng province of South Africa. Methods: This was a retrospective comparative record review of all patients admitted to the adolescent unit over the 4 years. Results: A lifetime history of substance use was documented in 44.1% (n = 52) of the 118 patient’s records included in the final analysis. Cannabis was the most frequently used substance (n = 36, 69.2%). There were significant differences between the SU and substance nonuser groups regarding family structure (p = 0.012), family history of substance abuse (p = 0.046) and conflict within the family (p 0.001). Conclusion: The high prevalence of substance use in this sample demonstrates the dual burden of mental health disorders and substance use in an adolescent treatment programme in Johannesburg. Primary caregiver burden and relational difficulties within the family unit should be observed for planned multidisciplinary interventions. Contribution: The findings of this review provide an update on the pattern and prevalence of substance use among this adolescent mental healthcare user group, highlighting potential therapeutic targets

The establishment and rapid spread of Sagittaria Platyphylla in South Africa:

Sagittaria platyphylla Engelm. (Alismataceae) is a freshwater aquatic macrophyte that has become an important invasive weed in freshwater systems in South Africa, New Zealand, Australia, and recently China. In South Africa, due to its rapid increase in distribution and ineffective control options, it is recognised as one of the country’s worst invasive aquatic alien plants. In this paper, we investigate the spread of the plant since its first detection in 2008, and the management strategies currently carried out against it. Despite early detection and rapid response programmes, which included chemical and mechanical control measures, the plant was able to spread both within and between sites, increasing from just one site in 2008 to 72 by 2019. Once introduced into a lotic system, the plant was able to spread rapidly, in some cases up to 120 km within 6 years, with an average of 10 km per year. The plant was successfully extirpated at some sites, however, due to the failure of chemical and mechanical control, biological control is currently being considered as a potential control option

Climate-smart harvesting and storing of water : the legacy of dhaka pits at Great Zimbabwe

Understanding past water management is crucial to address contemporary human-environmental challenges in sub-Saharan Africa, where urban growth is impacting upon water availability and supply. This study integrates soil profiles, high-resolution topographic data, historical sources, and socioecological memory to reconstruct how the ancient urban society at Great Zimbabwe negotiated water security. New evidence shows for the first time that closed depressions known as dhaka pits were used by the inhabitants of Great Zimbabwe for water storage and harvesting for a long time, possibly since the emergence of settlement in the mid-second millennium CE. These pits were part of a landscape-scale water management system that exploited catchment hydrology and groundwater by means of artificial dhaka reservoirs, wells, and springs to secure water for subsistence, farming, ritual and ceremony services. This study highlights the need for precise dating of the construction and functioning period of this water management system at Great Zimbabwe. Understanding past water management in such a water-scarce region is important for reconstructing how the ancient Great Zimbabwe urban society negotiated water security, but also for understanding contemporary human-environmental challenges.South African National Research Foundation (NRF) and by Danish National Research Foundation Centre of Excellence for Urban Network Evolutions (UrbNet).https://www.elsevier.com/locate/anceneam2023Anthropology and Archaeolog

Re-Generating Research Partnerships in Early Childhood Education: A Non-Idealized Vision

This chapter provides a challenge to positivist notions of partnership in early childhood education, and instead proposes a re-generative posthumanist perspective, based on relationality of partnerships. Specifically, the chapter addresses the troubles and struggles inherited in research partnerships through a non-idealized vision of research partnerships. It experiments with the notions of regenerating ‘change’ and regenerating ‘relationality’. It also addresses the multi-layered aspects of knowledge-in-the-making; non-innocent relations; difficulties of thinking change in research; and the potentialities of conflict and dissension. However, no certainties and closures about research partnerships are provided

Easy-To-Synthesize Spirocyclic Compounds Possess Remarkable in Vivo Activity against Mycobacterium tuberculosis

Society urgently needs new, effective medicines for the treatment of tuberculosis. To kick-start the required hit-to-lead campaigns, the libraries of pharmaceutical companies have recently been evaluated for starting points. The GlaxoSmithKline (GSK) library yielded many high-quality hits, and the associated data were placed in the public domain to stimulate engagement by the wider community. One such series, the spiro compounds, are described here. The compounds were explored by a combination of traditional in-house research and open source methods. The series benefits from a particularly simple structure and a short associated synthetic chemistry route. Many members of the series displayed striking potency and low toxicity, and highly promising in vivo activity in a mouse model was confirmed with one of the analogues. Ultimately the series was discontinued due to concerns over safety, but the associated data remain public domain, empowering others to resume the series if the perceived deficiencies can be overcome

Protective behaviours and secondary harms from non-pharmaceutical interventions during the COVID-19 epidemic in South Africa: a multisite prospective longitudinal study

BACKGROUND: In March 2020 South Africa implemented strict non-pharmaceutical interventions (NPIs) to contain Covid-19. Over the subsequent five months NPIs were eased in stages according to national strategy. Covid-19 spread throughout the country heterogeneously, reaching rural areas by July and peaking in July-August. Data on the impact of NPI policies on social and economic wellbeing and access to healthcare is limited. We therefore analysed how rural residents of three South African provinces changed their behaviour during the first epidemic wave. METHODS: The South African Population Research Infrastructure Network (SAPRIN) nodes in Mpumalanga (Agincourt), KwaZulu-Natal (AHRI) and Limpopo (DIMAMO) provinces conducted longitudinal telephone surveys among randomly sampled households from rural and peri-urban surveillance populations every 2-3 weeks. Interviews included questions on: Covid-19 knowledge and behaviours; health and economic impact of NPIs; and mental health. RESULTS: 2262 households completed 10,966 interviews between April and August 2020. By August, self-reported satisfaction with Covid-19 knowledge had risen from 48% to 85% and facemask use to over 95%. As selected NPIs were eased mobility increased, and economic losses and anxiety and depression symptoms fell. When Covid-19 cases spiked at one node in July, movement dropped rapidly, and missed daily medication rates doubled. Economic concerns and mental health symptoms were lower in households receiving a greater number of government-funded old-age pensions. CONCLUSIONS: South Africans reported complying with stringent Covid-19 NPIs despite the threat of substantial social, economic and health repercussions. Government-supported social welfare programmes appeared to buffer interruptions in income and healthcare access during local outbreaks. Epidemic control policies must be balanced against impacts on wellbeing in resource-limited settings and designed with parallel support systems where they threaten income and basic service access