Public awareness and knowledge of the National Health Insurance in South Africa

Introduction: Individuals residing in Limpopo, KwaZulu-Natal and the Eastern Cape provinces who had access to public health services were surveyed to determine public knowledge and awareness of the new National Health Insurance (NHI). Methods: A descriptive cross-sectional study was conducted and a total of 748 adult respondents were sampled using a two-stage systematic sampling design. Data were  collected using mobile phone assisted personal interviews. Results: The study found that 80.3% of the respondents were aware of the NHI and slightly less than half (49.8%) of the respondents did not have knowledge of how the NHI works and 71.8% lacked awareness  about the origin of the development of the NHI concept in South Africa. The knowledge of what the NHI would pay for was poor and 48.1% knew that the NHI Fund would pay for medical expenses if a person got sick and 45.7% knew that with health insurance, basic health requirement is ensured and that if one  becomes ill, medical treatment would be paid for by the NHI Fund, 50.9% of respondents did not  understand how the NHI Fund will pay for health care received, only 44.8% understood how the NHI will pay for health care services received. Conclusion: The public education campaigns to increase knowledge and understanding of the NHI  scheme might have been inadequate hence might not have penetrated many communities. It is  recommended that a comprehensive community consultation plan be established to increase awareness and knowledge of the NHI among community members targeting clinics, schools, pension pay points and other community sites.Key words: Awareness, knowledge, National health insurance, South Afric

Determinants of Pulmonary Tuberculosis among Inmates at Mangaung Maximum Correctional Facility in Bloemfontein, South Africa

Introduction. Correctional facilities house large number of inmates who are at high risk of developing tuberculosis (TB); however factors associated with TB among inmates at Mangaung Correctional Centre have not been studied. Study Population and Methods. We undertook a case control study and reviewed a total of 1140 medical records of inmates treated for TB between 2009 and 2010. Cases were selected randomly from the medical records of inmates who were treated. Data collected were analysed using STATA version 12.0 and determinants of TB were evaluated using multiple logistic regression analyses. Factors with P<0.05 were considered significant. Results. Prevalence of TB was 8.8% and 52% of inmates with TB were aged 31–40 years; 58% of the TB cases were HIV positive and 34% of them had CD4 cell count 350 cells/mm3. Factors associated with TB among inmates were HIV coinfection (OR: 4.2; 95% CI: 2.64–7.00); previous history of TB disease (OR: 3.58; 95% CI: 2.25–5.70); and smoking (OR: 2.1; 95% CI: 1.16–3.81). Conclusion. Interventions to improve TB detection such as regular screening of inmates with such factors need to be reinforced to control transmission of TB among inmates and the community

Utilisation of the National Antiretroviral Therapy Guidelines among health care professionals working in Abuja treatment centres, Nigeria

Background: Access to and utilisations of the National Antiretroviral Treatment Guidelines (NATG) are valuable factors for effective programme implementation. The objective of this study was to investigate the accessibility of the NATG and their utilisation by health care professionals from five treatment centres in Abuja, Nigeria. Method: A quantitative cross-sectional descriptive survey was conducted in 2007 using purposively sampled health care professionals. Questionnaires were self-administered to participants who consented in writing to participate in the survey. Results: 97 health care professionals participated in this study with about equal numbers of men and women: 48 (49.5%) women and 49 (50.5%) men. Of these, 21.6% were unaware of the existence of the NATG in their treatment centres. More than half (51.5%) reported that they did not have access to the NATG as opposed to those (48.5%) who had access to the guidelines. Furthermore, 16.5% of the participants confirmed that they had access to an institutional copy of the NATG while 14.4% indicated that they had individual copies and only 3.1% stated that they had individual copies and access to the hospital copy as well. Regarding utilisation of the NATG, 41.2% rarely used them, 32.9% never used them and only 25.7% often used them. The most frequent use of the NATG was among pharmacists (38.1%) compared to the least frequent use among nurses (20.0%). Conclusion: Poor accessibility of the NATG may have a negative impact on guidelines utilisation among health care professionals in Nigeria

A Qualitative Exploration of the Meaning and Understanding of Male Partner Involvement in Pregnancy-Related Care Among Men in Rural South Africa

Male partner involvement (MPI) during antenatal care has been promoted as an effective intervention to improve maternal and newborn health outcomes. Although MPI is commonly defined as men attending antenatal clinic visits with their female partner, few men attend antenatal clinic visits in rural communities in the province of Mpumalanga, South Africa. The study aimed to qualitatively explore the meaning and understanding of MPI as perceived by men visiting primary health care clinics in rural communities in Mpumalanga. Six focus groups discussions (n = 53) were conducted, digitally recorded, simultaneously transcribed, and translated verbatim into English. Data were analyzed using thematic content analysis. Perceptions of male roles during and after pregnancy differed among men. Male involvement was understood as giving instrumental support to female partners through financial help, helping out with physical tasks, and providing emotional support. Accompanying female partners to the clinic was also viewed as partner support, including behaviors such as holding a spot for her in the clinic queues. Community attitudes, traditional beliefs, and negative experiences in health facilities were barriers for MPI. This study provides support for concerted efforts to work with both men and women within the cultural context to explore the important roles of all members of the family in working together to provide the best possible health outcomes for mother and infant. In particular, future interventions should focus on making antenatal care services more responsive to male partners, and improving male partner accessibility in health care facilities

Africa Correspondence to:

ABSTRAcT Background: A group of experts attending a tripartite interregional meeting on best practices in HIV/AIDS workplace policies and programmes organised by the International Labour Organisation (ILO) in Geneva, Switzerland, identified 34 best practice workplace HIV programmes from across the world. Method: The ten criteria that were used for reviewing best practice workplace HIV/AIDS programmes in South Africa include acceptability, accessibility, ethical soundness, perceived impact, relevance, appropriateness, innovativeness, efficiency, sustainability and replicability. e-mail

Community engagement in the introduction and implementation of the National Health Insurance in South Africa

The South African government released a policy document for the introduction of a National Health Insurance (NHI) system planned to start in 2012. The consultation process for involving the public in the implementation of the NHI was also announced in August. When the consultation process on the NHI was announced, everyone assumed that the Government’s aim was to devolve power to communities and create a more patientfocused and community-oriented NHI. In this paper we look not only at how community engagement process on the NHI works, but we also review the democratic process to determine if it is a good means of holding decision makers to account to communities before and during the implementation of the NHI in South Africa. We review reasons for involving or engaging communities in health and related matters, the policy context of community engagement and review potential roles of nongovernmental organizations in assisting people to participate in debates for implementation of this new health policy initiative

National responses to HIV/AIDS and non-communicable diseases in developing countries: analysis of strategic parallels and differences

HIV/AIDS and non-communicable diseases (NCDs) epidemics may have many important similarities in their aetiology, pathogenesis and management. Evidence about the similarities and differences between the national responses HIV/AIDS and NCDs is essential for an integrated response. The objective of this study was to examine the parallels and differences between national responses to HIV/AIDS and NCDs in selected developing countries. This study applied a strategic level comparative case study approach as its study design. The main construct was national response to HIV/AIDS and NCDs. The 4 overarching themes were policy response, institutional mechanism, programmatic response and strategic information. Four countries were purposively selected as cases. Data were collected and triangulated from a multiple sources. The focus of analysis included identifying items for comparison, characteristics to be compared, degrees of similarity, and strategic importance of similarities. Analysis of data was qualitative content analysis with within-case, between-case, and across-case comparisons. While the nature of the disease and the contents of national HIV/AIDS and NCD policies are different, the policy processes involved are largely similar. Functional characteristics of programmatic response to HIV/AIDS and NCDs are similar. But the internal constituents are different. Though both HIV and NCDs require both a multi-sectorial response and a national coordination mechanism, the model and the complexity of the coordination are different. Strategic information frameworks for HIV/AIDS and NCDs use similar models. However, the indicators, targets and priorities are different. In conclusion, the national responses between HIV/AIDS and NCDs are largely similar in approaches and functions but different in content

Determinants of Pulmonary Tuberculosis among Inmates at Mangaung Maximum Correctional Facility in Bloemfontein, South Africa

Introduction. Correctional facilities house large number of inmates who are at high risk of developing tuberculosis (TB); however factors associated with TB among inmates at Mangaung Correctional Centre have not been studied. Study Population and Methods. We undertook a case control study and reviewed a total of 1140 medical records of inmates treated for TB between 2009 and 2010. Cases were selected randomly from the medical records of inmates who were treated. Data collected were analysed using STATA version 12.0 and determinants of TB were evaluated using multiple logistic regression analyses. Factors with P<0.05 were considered significant. Results. Prevalence of TB was 8.8% and 52% of inmates with TB were aged 31–40 years; 58% of the TB cases were HIV positive and 34% of them had CD4 cell count 350 cells/mm3. Factors associated with TB among inmates were HIV coinfection (OR: 4.2; 95% CI: 2.64–7.00); previous history of TB disease (OR: 3.58; 95% CI: 2.25–5.70); and smoking (OR: 2.1; 95% CI: 1.16–3.81). Conclusion. Interventions to improve TB detection such as regular screening of inmates with such factors need to be reinforced to control transmission of TB among inmates and the community

Magnitude of Diabetes Comorbidity among People Living with HIV: A Systematic Review

Abstract Although the clinical relationship between HIV/AIDS and Diabetes is well established, there is a little summarized evidence about the magnitude ofDiabetescomorbidity among people liv ing with HIV.The aim of this study was to summa rizeevidence on the incidence and prevalence of Diabetes comorbid ityamong people living with HIV.A systematic review of the incidence and prevalence of Diabetes comorbid ity among people living with HIV was conducted. Studies reporting incidence and/orprevalence of diabetes among people living with HIV were retrieved fro m Embase and Medline databases. Selection of the studieswas based on both relevance and quality.Study and outcome characteristics, were ext racted using a standardized checklist. Resulted were presented using narrative and graphic summaries. PRISMA checklist was used as a guide for reporting of the review results. A total of 12 studies met the inclusion and quality. In total of 43,296 people liv ing with HIV, 1,144 incident cases of diabetes were identified over 174,574 person-years. The incidence rates of diabetes comorbid ity as reported by these studies ranged from 5.72 to 23.8 per 1000 person-years. Similarly, a total of 1,724 prevalent cases of diabetes were identified among 41,068 people living with HIV. The reported prevalence rates ranged from 2.85% to 14.9%. High level of variab ility in the reported incidence and prevalence rates of diabetes comorb idity was observed. Generally, the findings are not in favour of a significantly increased magnitude of diabetes comorbidity in HIV