scholarly journals The Economic Cost of Smoking in South Africa, 2016

2020 ◽  
Author(s):  
Micheal Kofi Boachie ◽  
Laura Rossouw ◽  
Hana Ross
Keyword(s):  
South Africa ◽  
Tobacco Control ◽  
South African ◽  
Healthcare Costs ◽  
Economic Cost ◽  
Economic Costs ◽  
Middle Income ◽  
Middle Income Countries ◽  
Productivity Losses ◽  
Premature Deaths

Abstract Introduction Chronic, noncommunicable diseases are on the rise globally, with tobacco consumption being an important contributing risk factor. These increases result in significant economic costs due to increased healthcare costs, productive lives lost, and productive days lost due to illness. Estimates of these economic costs are scarce in low- and middle-income countries. Methods Drawing on a diverse range of data sources, direct healthcare costs, and productivity losses due to illness and premature deaths were estimated using the cost-of-illness approach. The present value of lifetime earnings was used to estimate productivity losses from premature deaths. Results We estimate that 25 708 deaths among persons aged 35–74 in 2016 are smoking-attributable. The economic cost of smoking was R42 billion (US$2.88 billion), of which R14.48 billion was for healthcare costs (hospitalization and outpatient department visits). The economic cost of smoking amounted to 0.97% of the South African GDP in 2016, while the healthcare cost of smoking-related diseases was 4.1% of total South African health expenditure. The costs are lower for women because of their lower smoking prevalence. Conclusion The economic burden of smoking calls for a further scaling-up of tobacco-control interventions in South Africa. Implications This article addresses the paucity of research on the detailed economic costs of smoking in low-and middle-income countries, including South Africa. Our calculations, based on an extensive range of recent data, provide the most detailed estimate to date and include quantification of the direct and indirect costs of smoking in South Africa. We found that the magnitude of the costs related to smoking in South Africa is larger than in the previous estimates and that for every Rand received in the form of cigarette tax, society loses 3.43 Rands. This article provides an economic case for evidence-based tobacco control in South Africa.

The Oxford Handbook of the South African Economy

2021 ◽  
Keyword(s):  
South Africa ◽  
South African ◽  
Economic History ◽  
Economic Policies ◽  
The South ◽  
Economic Sectors ◽  
Middle Income ◽  
Strategic Issues ◽  
Middle Income Countries ◽  
Depth Analysis

While South Africa shares some characteristics with other middle-income countries, it has a unique economic history with distinctive characteristics. South Africa is an economic powerhouse with a significant role not only at the southern African regional and continental levels, but also as a member of BRICS. However, the country faces profound developmental challenges, including the ‘triple challenges’ of poverty, inequality and unemployment. There has been a lack of structural transformation and weak economic growth. Ongoing debates around economic policies to address these challenges need to be based on rigorous and robust empirical evidence and in-depth analysis of South African economic issues. This necessitates wide-ranging research, such as that brought together in this handbook. This volume intends to provide original, comprehensive, detailed, state-of-the-art analytical perspectives, that contribute to knowledge while also contributing to well-informed and productive discourse on the South African economy. While concentrating on the more recent economic challenges facing the country, the handbook also provides historical and political context, an in-depth examination of strategic issues in the various critical economic sectors, and assembles diverse analytical perspectives and arguments that have implications for policymaking.

scholarly journals The Participation of Children with Intellectual Disabilities: Including the Voices of Children and Their Caregivers in India and South Africa

2020 ◽  
Vol 17 (18) ◽  
pp. 6706
Author(s):  
Shakila Dada ◽  
Kirsty Bastable ◽  
Liezl Schlebusch ◽  
Santoshi Halder
Keyword(s):  
South Africa ◽  
Intellectual Disabilities ◽  
South African ◽  
Middle Income ◽  
African Languages ◽  
Middle Income Countries ◽  
Child Reports ◽  
Children’S Participation ◽  
Child Assessments ◽  
Children's Participation

There is a shortage of research on the participation of children with intellectual disabilities from middle-income countries. Also, most child assessments measure either the child’s or the caregiver’s perceptions of participation. Participation, however, is an amalgamation of both perspectives, as caregivers play a significant role in both accessing and facilitating opportunities for children’s participation. This paper reports on both perceptions—those of children with intellectual disabilities and those of their caregiver, in India and South Africa. A quantitative group comparison was conducted using the Children’s Assessment of Participation and Enjoyment (CAPE) that was translated into Bengali and four South African languages. One hundred child–caregiver dyads from India and 123 pairs from South Africa participated in the study. The results revealed interesting similarities and differences in participation patterns, both between countries and between children and their caregivers. Differences between countries were mostly related to the intensity of participation, with whom, and where participation occurred. Caregiver and child reports differed significantly regarding participation and the enjoyment of activities. This study emphasises the need for consideration of cultural differences when examining participation and suggests that a combined caregiver-and-child-reported approach may provide the broadest perspective on children’s participation.

scholarly journals The Role of Social Support in Participation Perspectives of Caregivers of Children with Intellectual Disabilities in India and South Africa

2020 ◽  
Vol 17 (18) ◽  
pp. 6644 ◽  
Author(s):  
Shakila Dada ◽  
Kirsty Bastable ◽  
Santoshi Halder
Keyword(s):  
Social Support ◽  
South Africa ◽  
Intellectual Disabilities ◽  
South African ◽  
Middle Income ◽  
Middle Income Countries ◽  
Lack Of Information ◽  
The Social ◽  
Children’S Participation ◽  
Children's Participation

Caregivers are an intrinsic component of the environment of children with intellectual disabilities. However, caregivers’ capacity to support children’s participation may be linked to the social support that they, as caregivers, receive. Social support may increase participation, educational, psychological, medical and financial opportunities. However, there is a lack of information on social support in middle-income countries. The current study described and compared the social support of caregivers of children with intellectual disabilities by using the Family Support Survey (FSS) in India and South Africa. The different types of social support were subsequently considered in relation to participation, using the Children’s Assessment of Participation and Enjoyment (CAPE). One hundred caregiver–child dyads from India and 123 from South Africa participated in this study. The data were analysed using non-parametric measures. Indian caregivers reported greater availability of more helpful support than did the South African caregivers. Social support was associated with children’s participation diversity (India) and intensity (South Africa). The child-/caregiver-reported participation data showed different associations with participation. Results from this study suggest that perceived social support of caregivers differs between countries and is associated with their child’s participation. These factors need to be considered when generalising results from different countries.

Systematic review of the evidence base for treatment of common mental disorders in South Africa

2017 ◽  
Vol 48 (1) ◽  
pp. 32-47 ◽  
Author(s):  
Debra Kaminer ◽  
Michael Owen ◽  
Byron Schwartz
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Mental Disorders ◽  
South African ◽  
Common Mental Disorders ◽  
Evidence Base ◽  
Middle Income ◽  
Middle Income Countries ◽  
Mental Health Interventions ◽  
Low And Middle Income

The scarcity of mental health resources in low- and middle-income countries requires the identification of effective interventions that can be taken to scale in a cost-efficient manner. Yet the evidence base for treatment of common mental disorders in low- and middle-income countries remains limited. As one of the better resourced countries on the African continent, South Africa could potentially play a leading role in developing an African evidence base for mental health care. This study sought to describe and evaluate the South African evidence base for treating common mental disorders. A systematic review of randomised controlled trials for depression, substance use, and anxiety in the adult South African population from 2000 to mid-2015 was conducted. Eligible studies were assessed for their consistency with recommendations for mental health interventions in low- and middle-income countries and for methodological and reporting rigour. A total of 16 RCTs satisfied the inclusion criteria, of which 8 targeted depression, 6 targeted substance use, and 2 targeted anxiety symptoms. There has been a strong trend towards alignment with prevailing recommendations for delivery of mental health interventions in resource-scarce regions. While there are some promising findings with regard to effectiveness of specific interventions, replication, costing, and dissemination studies are still required and there is still an urgent need for treatment studies for anxiety disorders, which are the most common class of common mental disorder in South Africa. The review also indicates that research design and reporting practices in South African mental health intervention research could be enhanced and recommendations towards this are suggested.

The Economic Cost of Violence Against Women and Girls in Low- and Middle-Income Countries: A Systematic Review of the Evidence

2021 ◽  
pp. 152483802110160
Author(s):  
Seema Vyas ◽  
Melissa Meinhart ◽  
Katrina Troy ◽  
Hannah Brumbaum ◽  
Catherine Poulton ◽  
...  
Keyword(s):  
South Africa ◽  
Systematic Review ◽  
Violence Against Women ◽  
Economic Burden ◽  
Data Availability ◽  
Female Genital Cutting ◽  
Middle Income ◽  
Middle Income Countries ◽  
Women And Girls ◽  
Low And Middle Income

Evidence demonstrating the economic burden of violence against women and girls can support policy and advocacy efforts for investment in violence prevention and response programming. We undertook a systematic review of evidence on the costs of violence against women and girls in low- and middle-income countries published since 2005. In addition to understanding costs, we examined the consistency of methodological approaches applied and identified and assessed common methodological issues. Thirteen articles were identified, eight of which were from sub-Saharan Africa. Eight studies estimated costs associated with domestic or intimate partner violence, others estimated the costs of interpersonal violence, female genital cutting, and sexual assaults. Methodologies applied to estimate costs were typically based on accounting approaches. Our review found that out-of-pocket expenditures to individuals for seeking health care after an episode of violence ranged from US$29.72 (South Africa) to US$156.11 (Romania) and that lost productivity averaged from US$73.84 to US$2,151.48 (South Africa) per facility visit. Most studies that estimated provider costs of service delivery presented total programmatic costs, and there was variation in interventions, scale, and resource inputs measured which hampered comparability. Variations in methodological assumptions and data availability also made comparisons across countries and settings challenging. The limited scope of studies in measuring the multifaceted impacts of violence highlights the challenges in identifying cost metrics that extend beyond specific violence episodes. Despite the limited evidence base, our assessment leads us to conclude that the estimated costs of violence against women and girls are a fraction of its true economic burden.

scholarly journals Affordability and Availability of Child Restraints in an Under-Served Population in South Africa

2020 ◽  
Vol 17 (6) ◽  
pp. 1979 ◽  
Author(s):  
Prasanthi Puvanachandra ◽  
Aliasgher Janmohammed ◽  
Pumla Mtambeka ◽  
Megan Prinsloo ◽  
Sebastian Van As ◽  
...  
Keyword(s):  
South Africa ◽  
Road Traffic ◽  
Public Health Problem ◽  
Global Public Health ◽  
Injury Death ◽  
Middle Income ◽  
Suitable Alternative ◽  
Middle Income Countries ◽  
Restraint Use ◽  
Child Restraint

Background: Child road traffic injuries are a major global public health problem and the issue is particularly burdensome in middle-income countries such as South Africa where injury death rates are 41 per 100,000 for under 5′s and 24.5 per 100,000 for 5–14-year-old. Despite their known effectiveness in reducing injuries amongst children, the rates of use of child restraint systems (CRS) remains low in South Africa. Little is known about barriers to child restraint use especially in low- and middle-income countries. Methods: We carried out observation studies and parent/carer surveys in 7 suburbs of Cape Town over a three month period to assess usage rates and explore the knowledge and perceptions of parents towards child restraint legislation, ownership and cost; Results: Only 7.8% of child passengers were observed to be properly restrained in a CRS with driver seatbelt use and single child occupancy being associated with higher child restraint use. 92% of survey respondents claimed to have knowledge of current child restraint legislation, however, only 32% of those parents/carers were able to correctly identify the age requirements and penalty. Reasons given for not owning a child seat included high cost and the belief that seatbelts were a suitable alternative. Conclusions: These findings indicate the need for a tighter legislation with an increased fine paired with enhanced enforcement of both adult seatbelt and child restraint use. The provision of low-cost/subsidised CRS or borrowing schemes and targeted social marketing through online fora, well baby clinics, early learning centres would be beneficial in increasing ownership and use of CRS.

scholarly journals Tobacco intervention research in low- and middle-income countries: lessons learned and future directions

2016 ◽  
Vol 11 (2) ◽  
pp. 61-64 ◽  
Author(s):  
Kenneth D. Ward
Keyword(s):  
Tobacco Control ◽  
Tobacco Use ◽  
Tobacco Cessation ◽  
Tobacco Dependence ◽  
Lessons Learned ◽  
Future Directions ◽  
Middle Income ◽  
Middle Income Countries ◽  
Country Level ◽  
Tobacco Intervention

Treating tobacco dependence is paramount for global tobacco control efforts, but is often overshadowed by other policy priorities. As stated by Jha (2009), “cessation by current smokers is the only practical way to avoid a substantial proportion of tobacco deaths worldwide before 2050.” Its importance is codified in Article 14 of the Framework Convention on Tobacco Control (FCTC), and in the WHO's MPOWER package of effective country-level policies. Unfortunately, only 15% of the world's population have access to appropriate cessation support (WHO, 2015). Moreover, parties to the FCTC have implemented only 51% of the indicators within Article 14, on average, which is far lower than many other articles (WHO, 2014). Further, commenting on the use of “O” measures (Offer help to quit tobacco use) in the MPOWER acronym, WHO recently concluded, “while there has been improvement in implementing comprehensive tobacco cessation services, this is nonetheless a most under-implemented MPOWER measure in terms of the number of countries that have fully implemented it” (WHO, 2015). To the detriment of global tobacco control efforts, only one in eight countries provides comprehensive cost-covered services, only one in four provide some cost coverage for nicotine replacement therapy, and fewer than one third provide a toll-free quit line (WHO, 2015).

scholarly journals The importance of context in early autism intervention: A qualitative South African study

Autism ◽  
2017 ◽  
Vol 22 (8) ◽  
pp. 1005-1017 ◽  
Author(s):  
Jessy Guler ◽  
Petrus J de Vries ◽  
Noleen Seris ◽  
Nokuthula Shabalala ◽  
Lauren Franz
Keyword(s):  
Autism Spectrum Disorder ◽  
South African ◽  
Health Workers ◽  
Contextual Factors ◽  
Autism Spectrum ◽  
Spectrum Disorder ◽  
Middle Income ◽  
Middle Income Countries ◽  
Treatment Type ◽  
Low And Middle Income

The majority of individuals with autism spectrum disorder live in low- and middle-income countries and receive little or no services from health or social care systems. The development and validation of autism spectrum disorder interventions has almost exclusively occurred in high-income countries, leaving many unanswered questions regarding what contextual factors would need to be considered to ensure the effectiveness of interventions in low- and middle-income countries. This study qualitatively explored contextual factors relevant to the adaptation of a caregiver-mediated early autism spectrum disorder intervention in a low-resource South African setting. We conducted four focus groups and four in-depth interviews with 28 caregivers of young children with autism spectrum disorder and used thematic analysis to identify key themes. Eight contextual factors including culture, language, location of treatment, cost of treatment, type of service provider, support, parenting practices, and stigma emerged as important. Caregivers reported a preference for an affordable, in-home, individualized early autism spectrum disorder intervention, where they have an active voice in shaping treatment goals. Distrust of community-based health workers and challenges associated with autism spectrum disorder-related stigma were identified. Recommendations that integrate caregiver preferences with the development of a low-cost and scalable caregiver-mediated early autism spectrum disorder intervention are included.

Factors in Toddlers With Late Language Emergence in a Middle-Income South African Sample

2021 ◽  
pp. 152574012110547
Author(s):  
Elmien Kraamwinkel ◽  
Alta Kritzinger
Keyword(s):  
South Africa ◽  
Environmental Factors ◽  
South African ◽  
Maternal Education ◽  
Receptive Language ◽  
Control Group ◽  
Play Skills ◽  
Middle Income ◽  
Language Emergence ◽  
Genetic And Environmental Factors

Late language emergence (LLE) may result from genetic and environmental factors. Little is known about environmental factors in LLE in South Africa. The study describes the nature of differences in language functioning between toddlers with LLE and without LLE, and which factors were associated with LLE in a middle-income area in South Africa. Toddlers, aged 24 to 36 months with LLE ( n = 20) were matched with a control group (CG, n = 21) for household income, age, gender, maternal education, and parental employment. The research group (RG) showed moderate delays in expressive and receptive language, and play skills, while the controls exhibited no delay. Significant differences in early feeding history and multilingual exposure were found between the groups. As far as known, it is the first study utilizing a South African middle-income sample indicating that multilingual exposure may play a role in LLE. The study focuses the attention on environmental factors which are potentially modifiable in LLE.

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