A Brief Profile of the Status of Health and the Health System in South Africa

Belli, Paolo; Matsebula, Thulani; Ndhlalambi, Melusi; Ngarachu, Maria

doi:10.1596/30036

Cited by 2 publications

(2 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Extreme inequality linked to historic disparities impacts many upstream issues such as education, housing, and poverty. These inequalities must be addressed in order to truly improve national health outcomes [92,93]. However, women today are living in settings that put them at increased risk for sexual violence and HIV, and they need treatment at a faster pace than is possible on a policy level.…”

Section: Discussionmentioning

confidence: 99%

ImpACT+, a coping intervention to improve clinical outcomes for women living with HIV and sexual trauma in South Africa: study protocol for a randomized controlled trial

Sikkema

Rabie

King

et al. 2022

Trials

View full text Add to dashboard Cite

Background Addressing sexual trauma in the context of HIV care is essential to improve clinical outcomes and mental health among women in South Africa. Women living with HIV (WLH) report disproportionately high levels of sexual trauma and have higher rates of posttraumatic stress disorder. Adherence to antiretroviral therapy (ART) may be difficult for traumatized women, as sexual trauma compounds the stress associated with managing HIV and is often comorbid with other mental health disorders, further compromising care engagement and adherence. ART initiation represents a unique window of opportunity for intervention to enhance motivation, increase care engagement, and address the negative effects of trauma on avoidant coping behaviors. Mental health interventions delivered by non-specialists in low- and middle-income countries have potential to treat depression, trauma, and effects of intimate partner violence among WLH. This study will examine the effectiveness of Improving AIDS Care after Trauma (ImpACT +), a task-shared, trauma-focused coping intervention, to promote viral suppression among WLH initiating ART in a South African clinic setting. Methods This study will be conducted in Khayelitsha, a peri-urban settlement situated near Cape Town, South Africa. Using a hybrid type 1 effectiveness-implementation design, we will randomize 350 WLH initiating ART to the ImpACT + experimental condition or the control condition (three weekly sessions of adapted problem-solving therapy) to examine the effectiveness of ImpACT + on viral suppression, ART adherence, and the degree to which mental health outcomes mediate intervention effects. ImpACT + participants will receive six once-a-week coping intervention sessions and six monthly maintenance sessions over the follow-up period. We will conduct mental health and bio-behavioral assessments at baseline, 4, 8, and 12 months, with care engagement data extracted from medical records. We will explore scalability using the Consolidated Framework for Implementation Research (CFIR). Discussion This trial is expected to yield important new information on psychologically informed intervention models that benefit the mental health and clinical outcomes of WLH with histories of sexual trauma. The proposed ImpACT + intervention, with its focus on building coping skills to address traumatic stress and engagement in HIV care and treatment, could have widespread impact on the health and wellbeing of individuals and communities in sub-Saharan Africa. Trial registration Clinicaltrials.gov NCT04793217. Retrospectively registered on 11 March 2021.

show abstract

Section: Discussionmentioning

confidence: 99%

ImpACT+, a coping intervention to improve clinical outcomes for women living with HIV and sexual trauma in South Africa: study protocol for a randomized controlled trial

Sikkema

Rabie

King

et al. 2022

Trials

View full text Add to dashboard Cite

show abstract

“…Enhancing the health system, which would extend to economic prosperity, is the primary goal of the health reforms. Due to this, numerous policy frameworks and techniques to accomplish this goal have been discussed (Belli et al, 2018). These actions and policies implemented by the South African Government are meant to improve and expand access to healthcare and the capacity of health practitioners.…”

Section: Introductionmentioning

confidence: 99%

A Critical Review of the Sustainability of South Africa's Health System, User’s Satisfaction and Key Performance Scores

Gani

2023

IJESSS

View full text Add to dashboard Cite

The South African Government has made accessibility and equity the primary focus of its health policy objectives since 1994. However, the extent to which these policies achieve their aims of lessening inequality is not synthetically documented. This study critically reviews and synthesises the literature on the nature of the South African health system, user’s satisfaction and key performance scores. The study conducted a content analysis of several research papers and policy papers in the South African health sector. The review showed that the current health system is dualistic, indicating that the public health system is not living up to the National Core Scores and that this has impacted negatively on the level of satisfaction of households. The evidence demonstrated ongoing discrepancies in access to and use of health services, notwithstanding legislative initiatives. Moreover, the review showed that user’s perceptions of the quality of public healthcare services are deteriorating in South Africa. There is evidence of treatment delays, long waiting times, acute shortages of doctors, specialists and nurses, a lack of appropriate medication and poor health services delivery. The evidence provided about the South African health system can contribute to global policy discussions about health equity on the use of health services by households from different socioeconomic backgrounds and how policies can increase access to quality health care for low-income households.

show abstract

A Brief Profile of the Status of Health and the Health System in South Africa

Cited by 2 publications

References 0 publications

ImpACT+, a coping intervention to improve clinical outcomes for women living with HIV and sexual trauma in South Africa: study protocol for a randomized controlled trial

ImpACT+, a coping intervention to improve clinical outcomes for women living with HIV and sexual trauma in South Africa: study protocol for a randomized controlled trial

A Critical Review of the Sustainability of South Africa's Health System, User’s Satisfaction and Key Performance Scores

Contact Info

Product

Resources

About