scholarly journals THE INVOLUNTARY DETENTION AND ISOLATION OF PATIENTS INFECTED WITH EXTREME RESISTANT TUBERCULOSIS (XDR-TB): IMPLICATIONS FOR PUBLIC HEALTH, HUMAN RIGHTS AND INFORMED CONSENT Minister of Health, Western Cape v Goliath 2009 2 SA 248 (C)

Obiter ◽  
2021 ◽  
Vol 30 (2) ◽  
Author(s):  
Pieter Carstens

Public health-care providers (public hospitals) and related health-care services in South Africa have in recent times been under severe strain due to the seemingly uncontrollable increase in dangerous infectious airborne diseases like Extreme Resistant Tuberculosis (hereinafter “XDR-TB”). Ultimately these health-care providers/services have been challenged, not only in the diagnosis and treatment of XDR-TB patients, but specifically to control and curtail the spread thereof by effectively managing sufferers by way of forced isolation and monitoring to ensure that they abide by the rules and strict treatment regime related to XDR-TB. The said challenge hasbecome exacerbated specifically in public health-care facilities where patients suffering from XDR-TB fail to abide by the treatment regime and regularly abscond from follow-up appointments, posing a real threat of infection to the community at large. Consequently public health-care providers and communities have increasingly questioned whether it is possible to invoke some mechanism legally whereby the involuntary isolation of patients with XDR-TB in State-funded health-care facilities could be effected. It goes without saying that such a mechanism (by way of a court order/court authorisation) would have a definite and marked influence on a patient’s right to bodily integrity and freedom (as contemplated in s 12 of the Constitution of the Republic of South Africa, 1996) and will pose significant challenges to any constitutional limitation (as contemplated in s 36) and related legislation (such as the National Health Act 61 of 2003). Ultimately the question under consideration is whether the public’s right to be protected from potentially dangerous infectious diseases constitutionally trumps the right of an individual sufferer to bodily integrity. It is in this regard that the present case under discussion offers far-reaching perspectives. 

1994 ◽  
Vol 24 (3) ◽  
pp. 535-548 ◽  
Author(s):  
Sally Guttmacher

The single known instance of transmission of HIV from a health care provider to a patient raised issues concerning the responsibility of clinicians to their patients, and sparked debate over policies to prevent the spread of HIV in health care facilities. The intensity and politicization of the debate were reflected in revision of the Centers for Disease Control guidelines to control the spread of infection at health care facilities, and in legislation proposed in Congress. The guidelines and proposed legislation provoked responses by public health and medical organizations, several of which considered the measures to be unnecessarily restrictive and too costly in terms of potential benefits. This article describes the events and responses that took place during 1991–1992 after the public was made aware of the case involving transmission from provider to patient. The author examines the situation in the context of public health efforts to control the spread of HIV.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Edward Kalyango ◽  
Rornald Muhumuza Kananura ◽  
Elizabeth Ekirapa Kiracho

Abstract Introduction Uganda is in discussions to introduce a national health insurance scheme. However, there is a paucity of information on household preferences and willingness to pay for health insurance attributes that may guide the design of an acceptable health insurance scheme. Our study sought to assess household preferences and willingness to pay for health insurance in Kampala city using a discrete choice experiment. Methods This study was conducted from 16th February 2020 to 10th April 2020 on 240 households in the Kawempe division of Kampala city stratified into slum and non-slum communities in order to get a representative sample of the area. We purposively selected the communities that represented slum and non-slum communities and thereafter applied systematic sampling in the selection of the households that participated in the study from each of the communities. Four household and policy-relevant attributes were used in the experimental design of the study. Each respondent attended to 9 binary choice sets of health insurance plans that included one fixed choice set. Data were analyzed using mixed logit models. Results Households in both the non-slum and slum communities had a high preference for health insurance plans that included both private and public health care providers as compared to plans that included public health care providers only (non-slum coefficient β = 0.81, P < 0.05; slum β = 0.87, p < 0.05) and; health insurance plans that covered extended family members as compared to plans that had limitations on the number of family members allowed (non-slum β = 0.44, P < 0.05; slum β = 0.36, p < 0.05). Households in non-slum communities, in particular, had a high preference for health insurance plans that covered chronic illnesses and major surgeries to other plans (0.97 β, P < 0.05). Our findings suggest that location of the household influences willingness to pay with households from non-slum communities willing to pay more for the preferred attributes. Conclusion Potential health insurance schemes should consider including both private and public health care providers and allow more household members to be enrolled in both slum and non-slum communities. However, the inclusion of more HH members should be weighed against the possible depletion of resources and other attributes. Potential health insurance schemes should also prioritize coverage for chronic illnesses and major surgeries in non-slum communities, in particular, to make the scheme attractive and acceptable for these communities.


2020 ◽  
Vol 66 (4) ◽  
pp. 387-399
Author(s):  
Anand Kumar ◽  
◽  
Dhiraj Kumar Sharma ◽  
Satya Prakash ◽  
Ram Sakal Yadava ◽  
...  

At this critical juncture of time when the whole world is facing a health care emergency due to the occurrence of (SARS-CoV-2) pandemic. It becomes necessary to critically evaluate public health care facilities and their availability to common people to tackle the ongoing crisis rationally. In this regard, this paper tries to study the spatial distribution of public health care facilities and their availability in rural areas of Nalanda district. Location quotient, Lorenz curve and Gini's coefficient have been worked out to find unequal concentration, availability and distribution of public health care facilities across the study area. To show the concentration and distribution of health care facilities over space maps have been drawn on ArcGIS. MS Excel and Word have been used for showing the availability of health care facilities through graphical representation and for tabulation purposes. This paper concludes that community development blocks surrounding district headquarter have a higher concentration and larger availability of rural public health care facilities in comparison to peripheral community development blocks of the study area.


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