An old-style public health perspective of present-day health problems in a black peri-urban area of South Africa

Author(s):  
Samuel Kwasi Opoku ◽  
Walter Leal Filho ◽  
Fudjumdjum Hubert ◽  
Oluwabunmi Adejumo

Climate change is a global problem, which affects the various geographical regions at different levels. It is also associated with a wide range of human health problems, which pose a burden to health systems, especially in regions such as Africa. Indeed, across the African continent public health systems are under severe pressure, partly due to their fragile socioeconomic conditions. This paper reports on a cross-sectional study in six African countries (Ghana, Nigeria, South Africa, Namibia, Ethiopia, and Kenya) aimed at assessing their vulnerabilities to climate change, focusing on its impacts on human health. The study evaluated the levels of information, knowledge, and perceptions of public health professionals. It also examined the health systems’ preparedness to cope with these health hazards, the available resources, and those needed to build resilience to the country’s vulnerable population, as perceived by health professionals. The results revealed that 63.1% of the total respondents reported that climate change had been extensively experienced in the past years, while 32% claimed that the sampled countries had experienced them to some extent. Nigerian respondents recorded the highest levels (67.7%), followed by Kenya with 66.6%. South Africa had the lowest level of impact as perceived by the respondents (50.0%) when compared with the other sampled countries. All respondents from Ghana and Namibia reported that health problems caused by climate change are common in the two countries. As perceived by the health professionals, the inadequate resources reiterate the need for infrastructural resources, medical equipment, emergency response resources, and technical support. The study’s recommendations include the need to improve current policies at all levels (i.e., national, regional, and local) on climate change and public health and to strengthen health professionals’ skills. Improving the basic knowledge of health institutions to better respond to a changing climate is also recommended. The study provides valuable insights which may be helpful to other nations in Sub-Saharan Africa.


Author(s):  
Leticia Fernandez ◽  
Theresa Rossouw ◽  
Tessa Marcus ◽  
Angelika Reinbrech-Schutte ◽  
Nicoleen Smit ◽  
...  

Background: This research focused on patients’ views regarding healthcare services and identified factors associated with understanding of their management plan.Aim: To develop a baseline for patient–clinician collaboration and the extent to which patients felt included and understood their treatment plan.Setting: Tshwane district (South Africa) public health outpatient clinics.Method: Medical students interviewed 447 patients in 22 clinics in Tshwane district. Agreement was measured by the percentage of cases in which patients and clinicians were in accord about a particular aspect of the consultation.Results: About one-third of patients incorrectly answered questions on whether changes in lifestyle or diet were prescribed as part of their treatment. The likelihood that patients understood their plan was associated with seeing the same clinician three or more times;having a consultation in their same or a similar language; patient participation in the diagnosis;and feeling that the clinician had explained their health problems to them.Conclusions: There is need for greater emphasis on continuity of care, the clinicians’ ability to speak the patient’s language and involving patients in the consultation.


2019 ◽  
Vol 26 (15) ◽  
pp. 15105-15114 ◽  
Author(s):  
Daniel Pheeha Matlou ◽  
Marie Ebob AgborTabot Bissong ◽  
Christ-Donald Kaptchouang Tchatchouang ◽  
Mohomud Rashid Adem ◽  
Frank Eric Tatsing Foka ◽  
...  

2018 ◽  
Vol 8 (4) ◽  
pp. 668-678 ◽  
Author(s):  
James B. Tidwell ◽  
Jenala Chipungu ◽  
Roma Chilengi ◽  
Robert Aunger

Abstract Despite ongoing debates about what constitutes adequate sanitation, there is a lack of sanitation quality measures that are theoretically grounded in ways that allow empirical comparisons of quality across different types of sanitation. The Healthy Sanitation Framework (HSF) was developed to capture universal aspects of sanitation quality from a public health perspective. From this, the Peri-Urban Healthy Toilet Index (PUHTI) was created for measuring on-site, peri-urban sanitation quality. This PUHTI score was used to assess sanitation quality in a peri-urban area in Lusaka, Zambia. The HSF identified five categories for capturing sanitation quality: hygiene, use, sustainability, desirability, and accessibility. A composite index derived from these categories had high reliability and plausible validity, despite barriers to rigorously evaluating validity. Applying the PUHTI tool showed that while 87% of toilets were classified as ‘improved, but shared,’ there were frequent concerns about doors that could not be locked, dirty user interfaces, unhygienic containment, limited emptyability, and lack of handwashing facilities. The HSF allows granular measures of sanitation quality to be developed in any setting using a reproducible and theoretically grounded process. However, lack of a unified basis on which to compare different types of sanitation overall or evidence to compare within narrower categories currently limits comparisons across types of sanitation.


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