Landscaping teaching and training of urban health as a part of health professional education in India

Introduction India’s urban population will be doubled from 377 million in 2011 to 915 million in 2050. Such rapid urban growth may lead to several problems by affecting the economy, environment and the society at large. These problems further affect the health vulnerability in urban areas. Thus, there exists a need for health workforce equipped with the knowledge and skills to meet the urban health challenges. Objectives To undertake the landscaping of teaching and training of urban health as a part of health professional courses and to undertake mapping of specific training programmes related to urban health in India. Methodology A curriculum scan of various health professional courses in India ranging from medicine, dentistry, allied health, Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy (AYUSH), nursing to public health was undertaken related to teaching and training of urban health. An exclusive search was also carried out for identifying urban health-specific training programmes being offered in India. Results As per the curriculum scan, current health professional courses being offered in India have a very little focus on urban health. It was observed that various cross-cutting issues related to urban health are not adequately addressed in the current curricula. Also the curricula of these health professional courses have not clearly spelt out the desired urban health competencies. Few institutions in India offer short-term training programmes specific to urban health issues

Counting dermatologists in South Africa: number, distribution and requirement

RESEARCH LETTER - No abstract availabl

Enhancing normal labour by adopting antenatal physiotherapy: a prospective study

Background: In the recent past there had been a steady rise in caesarean section rate as against the vaginal delivery. Information is still scarce on the benefits of physiotherapy and birthing experience of women who exercises in antenatal duration. Benefits of exercise during pregnancy include; prevention of excessive gestational weight gain, gestational diabetes, pre-eclampsia, decrease need for caesarean section and reduced low back pain. The objective of this study was to evaluation of antenatal physiotherapy on maternal and perinatal outcome and subjective evaluation of degree of labour pain perception.Methods: In the study 150 primigravida subjects in second to third trimester without any associated high risk factor and were willing to exercise during pregnancy were chosen.Results: In the study group, the average duration of latent phase [7.56 (±2.02) hours] and active phase of first stage of labour [3.26 (±1.06) hours] was significantly lesser as compared to the control group, 89.3% (n=134) delivered vaginally and 10.7% (n=16) subjects had to be taken for caesarean section. In the study group no perineal tear or need for any instrumentation (outlet forceps/ventouse) to facilitate delivery was seen. Higher proportion of the study group subjects i.e. 70.9% experienced moderate to mild pain during labour. and majority i.e. 72% subjects delivered newborns with birth weight >2.5 kg,with higher one minute and five minutes APGAR scores.Conclusions: This highlights the very need for physiotherapy to be inculcated into the curriculum during antenatal period with conducive maternal and foetal outcome as it inflates the chances of normal deliveries and abate the rates of cesarean section and subsequent, which is the dire need of the day

Estimating the emergency care workforce in South Africa

Background: Emergency care is viewed as a fundamental human right in South Africa’s constitution. In the public sector, all emergency medical services (EMS) come under the Directorate: Emergency Medical Services and Disaster Medicine at the National Department of Health (NDoH), which provides regulation, policy and oversight guidance to provincial structures. Aim: The aim of the study is to understand the supply and status of human resources for EMS in South Africa. Setting: This research was undertaken for South Africa using the Health Professions Council of South Africa (HPCSA) database from 2002 to 2019. Methods: A retrospective record-based review of the HPCSA database was undertaken to estimate the current registered and future need for emergency care personnel forecasted up to 2030. Results: There are 76% Basic Ambulance Assistants registered with HPCSA. An additional 96 000 personnel will be required in 2030 to maintain the current ratio of 95.9 registered emergency care personnel per 100 000 population. The profile of an emergency care personnel employed in South Africa is likely to be a black male in the age group of 30–39-years, residing in one of the economically better-resourced provinces. Conclusion: It is time that the current educational framework is revised. Policy interventions must be undertaken to avoid future shortages of the trained emergency care personnel within South Africa

Estimating the specialist surgical workforce density in South Africa

Background: South Africa is an upper middle-income country with inequitable access to healthcare. There is a maldistribution of doctors between the private and public sectors, the latter which serves 86% of the population but has less than half of the human resources. Objective: The objective of this study was to estimate the specialist surgical workforce density in South Africa. Methods: This was a retrospective record-based review of the specialist surgical workforce in South Africa as defined by registration with the Health Professionals Council of South Africa for three cadres: 1) surgeons, and 2) anaesthesiologists, and 3) obstetrician/gynaecologists (OBGYN). Findings: The specialist surgical workforce in South Africa doubled from 2004 (N = 2956) to 2019 (N = 6144). As of December 2019, there were 3096 surgeons (50.4%), 1268 (20.6%) OBGYN, and 1780 (29.0%) anaesthesiologists. The specialist surgical workforce density in 2019 was 10.5 per 100,000 population which ranged from 1.8 in Limpopo and 22.8 per 100,000 in Western Cape province. The proportion of females and those classified other than white increased between 2004–2019. Conclusion: South Africa falls short of the minimum specialist workforce density of 20 per 100,000 to provide adequate essential and emergency surgical care. In order to address the current and future burden of disease treatable by surgical care, South Africa needs a robust surgical healthcare system with adequate human resources, to translate healthcare services into improved health outcomes

Forecasting for the need of dentists and specialists in South Africa until 2030

To manage the increasing burden of dental diseases, a robust health system is essential. In order to ensure the oral health system operates at an optimal level going into the future, a forecast of the national shortfall of dentists and dental specialists in South Africa (SA) was undertaken. There is currently a shortage of dentists and specialists in SA and given the huge burden of dental diseases, there is a dire need to increase the number of these health care workers. The aim was to determine the projected shortfall of dentists and specialists in each of the nine provinces in SA. The projected shortfall was calculated based on the SA Disability-Adjusted Life Years (DALYs) for each province. The estimate for the evaluation of the Global Burden of Disease (GBD) for SA was obtained from the Institute of Health Metrics and Evaluation (IHME) Global Burden of Disease website. For each province, age standardized DALYs were calculated with mid-year population estimates obtained from Statistics SA 2018. In order to reduce the existing human resources for health (HRH) inequity among the provinces of SA, three scenarios were created focussing on attaining horizontal equity. The best-case scenario estimates a shortfall of 430, 1252 and 1885 dentists and specialists in 2018, 2024 and 2030 respectively. In an optimistic scenario, the national shortfall was calculated at 733, 1540 and 2158 dentists and specialists for the years 2018, 2024 and 2030 respectively. In an aspirational scenario, shortfalls of 853 (2018), 1655 (2024) and 2267 (2030) dentists and specialists were forecasted. Access to oral health services should be ensured through the optimum supply of trained dentists and specialists and the delivery of appropriate oral health services. Thus, the roadmap provided for upscaling the oral health services recognizes the influence of both demand and supply factors on the pursuit of equity

Exploring national human resource profile and trends of Prosthetists/Orthotists in South Africa from 2002 to 2018

Background: The World Health Organization (WHO) in 2017 estimated that around35–40 million people require prosthetic or orthotic services. The Framework and Strategyfor Disability and Rehabilitation 2015–2030 for South Africa highlights a shortage of humanresources for disability and rehabilitation services to manage the various risks and types ofimpairments faced by the population.Objective: To describe the demographic trends of Prosthetists/Orthotists (P/O) registeredwith the Health Professions Council of South Africa (HPCSA) from 2002 to 2018.Methods: The study was a retrospective record-based review of the Health ProfessionsCouncil of South Africa (HPCSA) database from 2002 until 2018. The database of registeredProsthetists/Orthotists was obtained from the HPCSA.Results: Data were analysed using the Statistical Package for the Social Sciences (SPSSversion 22.0). In 2018, there were 544 P/Os registered with the HPCSA with a ratio of 0.09P/Os per 10,000 population. There has been an average annual increase of 6% from 2002 to2018. The majority (71.9%) of P/Os are located in the more densely populated and urbanizedprovinces, namely Gauteng, KwaZulu-Natal and Western Cape. The majority of registered P/Os identified as white (61%) followed by Black (22%), Indian (7%) and Coloured (2%). Most ofregistered P/Os are under the age of 40 years (54.2%) and males make up 73% of theregistered P/Os.Conclusion: This study highlights the unequal spatial distribution trends of P/Os which couldbe accounted for by South Africa’s apartheid history and the subsequent slow pace oftransformation. Addressing the existing shortages is necessary to expand access to P/Osservices and to ensure the motivation, planning and provision of adequate infrastructure toprovide these services. The study presents a compelling case for the prioritization andstrengthening of this workforce for the achievement of effective universal health coveragefor persons with disabilities. (PDF) Exploring national human resource profile and trends of Prosthetists/Orthotists in South Africa from 2002 to 2018. Available from: https://www.researchgate.net/publication/343281506_Exploring_national_human_resource_profile_and_trends_of_ProsthetistsOrthotists_in_South_Africa_from_2002_to_2018 [accessed Mar 03 2022]

Re-envisioning global health competencies for the African region aligned with local health needs and resources

Background: While many Global Health programs aim to address health inequalities within and between HICs and low- and middle-income countries (LMICs) there is a need to establish new Global Health academic programs within the growing trend towards ‘internationalization of higher education’. Objective: This study was undertaken to re-envision Global Health competencies for the African region context with respect to the local health needs and availability of resources. Methods: This study was undertaken over a period of four years from 2017 till 2020. A three-pronged strategy was undertaken to scan, scope, distil and develop a set of Global Health domains and competencies for the African region. Strategy 1 encompassed an environmental scan of Global Health competencies (2017–2019), and a literature review (2017–2020); strategy 2 comprised a scoping of education programs in Global Health (2018–2019); and strategy 3 involved an interest-group discussion in a face-to-face conference. Findings: Seven core and four cross-cutting global health competency statements were developed for the African region. The core competency statements included following domains: global health systems and international relations; global evidence ecosystem; role of international organizations; universal health issues; intellectual property rights; responses to issues affecting different at-risk groups; local, national, and international policy and economic context affecting global health. The four cross-cutting competency statements included following domains: digital and academic literacies; quantitative and qualitative research; policy and funding allocation resources; ethical conduct of global health practice and research global health. Conclusion: There is a need to enable higher education institutions (HEIs) from the Global South to offer global health qualifications with a set of competencies that better approximate solutions to contextualised problems – not only to students from the Global South but also from the Global North. The global health competencies developed in this research study will enable African HEIs to offer global health education in a more pragmatic manner