Uptake of health services among truck drivers in South Africa: analysis of routine data from nine roadside wellness centres.

BACKGROUND: Long-distance truck drivers are occupationally susceptible to poor health outcomes. Their patterns of healthcare utilisation and the suitability of healthcare services available to them are not well documented. We report on truck driver healthcare utilisation across South Africa and characterise the client population of the clinics serving them for future service development. METHODS: We analysed anonymised data routinely collected over a two-year period at nine Roadside Wellness Centres. Associations between services accessed and socio-demographic characteristics were assessed using univariable and multivariable logistic regression models. RESULTS: We recorded 16,688 visits by 13,252 individual truck drivers (average of 1.26 visits/person) who accessed 17,885 services for an average of 1.07 services/visit and 1.35 services/person. The mean age of truck drivers was 39 years. Sixty-seven percent reported being in stable relationships. The most accessed services were primary healthcare (PHC)(62%) followed by HIV (32%). Low proportions (≤6%) accessed STI,TB and malaria services. Most visits were characterised by only one service being accessed (93%, n = 15,523/16,688). Of the remaining 7% of visits, up to five services were accessed per visit and the combination of TB /HIV services in one visit remained extremely low (<1%, n = 14/16,688). Besides PHC services at the beginning of the reporting period, all service categories displayed similar seasonal utilisation trends(i.e. service utilisation peaked in the immediate few months post clinics opening and substantially decreased before holidays). Across all service categories, younger truck drivers, those with a stable partner currently, and those of South African origin were the main clinic attendees. Older truck drivers (≥40 years) were more likely to access TB and PHC services, yet less likely to access HIV and STI services. Those with stable partners were less likely to access STI and TB services but more likely to access malaria and PHC services. South African attendees were more likely to access PHC, while attendees from other nationalities were more likely to access HIV and malaria services. CONCLUSIONS: This utilisation analysis shows that tailored services assist in alleviating healthcare access challenges faced by truck drivers, but it underscores the importance of ensuring that service packages and clinics speak to truck drivers' needs in terms of services offered and clinic location

Review of drought coping and adaptation strategies in dryland cropping systems, irrigation, livestock and mixed systems

This report is Deliverable 2 of the Water Research Commission Project 2602 entitled “Coping and adaptation strategies for agricultural water use during drought periods”. The report starts by defining vulnerability to drought. This is followed by a brief history of drought in South Africa, then an outline of the role of early warning systems. The report then gives examples of coping and adaptation strategies adopted by selected countries. A number of strategies in water use in agriculture that have been implemented by South Africa are then described in the report. Drought resistant and new crop varieties and improved agronomic practices were identified in rainfed systems. Many strategies were implemented in irrigation, including scheduling, drip irrigation, rainwater harvesting and infrastructure maintenance. Strategies in livestock included creating fodder banks and pasture management. South Africa drilled many boreholes to provide water for both agriculture and domestic use during the recent drought, showing the importance of the groundwater resource in agriculture