The Clinical and Economic Effectiveness of MyDiaCare, Digital Tools combined with Diabetes Nurse Educator Support, for managing Diabetes in South Africa (Preprint)

2021 ◽  
Author(s):  
Hemant Makan ◽  
Lindie Strauss ◽  
Jacqueline Lubbe ◽  
Sarah Alami ◽  
Guila Lancman ◽  
...  
Keyword(s):  
South Africa ◽  
South African ◽  
Diabetes Management ◽  
Density Lipoprotein ◽  
Standard Of Care ◽  
Healthcare Sector ◽  
The South ◽  
Private Healthcare ◽  
Hba1c Levels

BACKGROUND In South Africa, diabetes prevalence is expected to reach 5.4 million by 2030. Moreover, a large proportion of adults remain undiagnosed. In South Africa, diabetes-related complications not only severely impact patient health and quality of life, but also the economy. OBJECTIVE The Diabetes Nurse Educator (DNE) study assessed the benefit of adding the MyDiaCare program to standard of care for managing type 1 and 2 diabetes patients in South Africa. An economic study was also performed to assess the benefit of adding MyDiaCare to standard of care in type 2 diabetes patients, older than 19 years, treated in the South African private healthcare sector. METHODS The real-world DNE study was designed as an observational, retrospective, multicenter, single group study. Eligible patients were older than 18 years and with at least 6 months of participation in the MyDiaCare program. The MyDiaCare program combines patient mobile application and a healthcare professional platform with face-to face visits with a DNE. The benefit of MyDiaCare was assessed by the changes in HbA1c levels, the proportion of patient achieving clinical and biological targets, adherence to care plans, and satisfaction after 6 months of participating in the MyDiaCare program. A budget impact model was performed using data from the DNE study and another South African cohort to estimate the economic benefit of MyDiaCare. RESULTS Between 25 November 2019 and 30 June 2020, 117 patients (8 with type 1 diabetes and 109 with type 2) were enrolled in two centers. After 6 months of MyDiaCare, a clinically relevant decrease in mean glycated hemoglobin (HbA1c) levels by 0.6% from 7.8% to 7.2% was observed. Furthermore, 54% of patients reached or maintained their HbA1c targets at 6 months. Most patients achieved their targets for blood pressure (67% for systolic and 89% for diastolic blood pressure) and lipid parameters (69% for low-density lipoprotein (LDL) cholesterol, 58% for high-density lipoprotein (HDL) cholesterol, and 83% for total cholesterol, but fewer patients for triglycerides (46%), waist circumference (18%), and body weight (17%). The mean overall adherence to the MyDiaCare care plan was 93%. Most patients (74%) were satisfied with the MyDiaCare program. The economic study estimated that after 1 year of using the MyDiaCare program, the cost of type 2 diabetes management in the South African private healthcare sector would be reduced by 26 billion rands: from 117 billion rands with standard of care to 91 billion rands by adding MyDiaCare. CONCLUSIONS The MyDiaCare program, that combines digital tools for patients and healthcare professionals with DNE support, is a practical, clinically effective (lowering HbA1c levels and other cardiovascular risk factors), and cost-saving solution for diabetes management in the South African private healthcare sector. CLINICALTRIAL Not applicable.

scholarly journals Experiences of returning patients at a Homoeopathic community clinic

2018 ◽  
Author(s):  
◽  
Vimbulaka Nhlakanipho Brian Ngobese
Keyword(s):  
South Africa ◽  
Health Care ◽  
Primary Health Care ◽  
Complementary Medicine ◽  
Healthcare System ◽  
Healthcare Sector ◽  
The South ◽  
Community Clinic ◽  
Private Healthcare ◽  
Primary Health

Introduction Abstract South Africa has a dual healthcare system which comprises of a public and private healthcare sector. The public sector is state controlled and provides allopathic medicinal care only, whilst the private healthcare sector is flexible. This means that the population has the choice of the medicinal therapy such as allopathic medicine or complementary medicine. Homeopathy is one of the complementary medicine with major growth and it has been in existence for so long in South Africa. However, a large proportion of the South African public is unclear with regards to homoeopathic understanding. Aim of the study The aim of the study was to explore the experiences of returning patients at Ukuba Nesibindi Homoeopathic Community Clinic and the study was guided by the grand tour question that is: What are the experiences as a returning patient, at UNHCC with regard to the care they had received? Methodology A qualitative, explorative, descriptive and contextual design was employed. Holloway and Wheeler (2010) suggest that a qualitative research in the field of healthcare is used to establish how people think of the experiences and their suffering and further explore their perspective on the care and treatment they received within the healthcare system. Purposive sampling was used to recruit a minimum of 12 participants who had visited the clinic four times or more. The data was collected and analysed using Tesch’s eight-step procedure. Results The results showed that although majority of the participant had vague understanding of homoeopathy, participants acknowledged that the quality of help received at the homeopathic clinic were highly beneficial. Furthermore, thematic analysis showed that participant ware dissatisfied with other streams of healthcare and contented with homoeopathic treatment. However, participants highlighted that the infrastructure at UNHCC needs improvement in terms of space. Conclusion The salient themes of this study strongly suggest that homeopathic medicine and practices was widely accepted by the participant. It also emerged that participant had trust and expressed confidence in homoeopaths at UNHCC. Based on these findings, the researcher highly recommends the need for the integration of homoeopathic practice and medicine into the South Africa Primary health care. Importantly, the integration of homoeopathic medicine as a primary health care provider will help provide an alternati ve platform to ease the load on conventional allopathic medical clinics.

scholarly journals The Profession of Biokinetics in South Africa: The Need for Access to the Public Healthcare System

2021 ◽  
Author(s):  
Yvonne Paul ◽  
Terry J Ellapen ◽  
Takalani C. Muluvhu ◽  
Makwena B. Ntjana
Keyword(s):  
South African ◽  
Exercise Therapy ◽  
Communicable Disease ◽  
Empirical Studies ◽  
Healthcare Sector ◽  
Public Healthcare ◽  
The South ◽  
The Public ◽  
Private Healthcare ◽  
Public Healthcare Sector

This chapter reviews the efficacy of the only South African exercise therapy profession (Biokinetics) in the rehabilitation of non-communicable diseases (NCDs). Biokinetics is a South African exercise therapy profession established in 1983 and which operates in both the pathogenic and fortogenic healthcare paradigms. Unfortunately, the profession of Biokinetics is restricted to the South African private healthcare sector. This chapter describes the scope of the profession of Biokinetics, empirical studies illustrating the efficacy of the profession in addressing society’s non-communicable disease epidemic, and the challenges inhibiting the profession from gaining access to the South African public healthcare sector. It is hoped that the presentation and critical appraisal of the empirical evidence which illustrates the contribution of the profession of Biokinetics to the rehabilitation of NCDs justifies the authors’ claims for the inclusion of the aforementioned profession in the South African public healthcare sector.

Foreigners' Rights to Work and Fair Labour Practices in South Africa: A Review of the South African Labour Legislation and Jurisprudence

2020 ◽  
Vol 35 (1) ◽  
Author(s):  
Andre Mangu
Keyword(s):  
South Africa ◽  
Human Rights ◽  
South African ◽  
Bill Of Rights ◽  
The South ◽  
Legislation And Jurisprudence ◽  
Foreign Nationals ◽  
Lay Persons ◽  
Democratic State ◽  
Labour Legislation

After several decades of apartheid rule, which denied human rights to the majority of the population on the ground of race and came to be regarded as a crime against humanity, South Africa adopted its first democratic Constitution in the early 1990s. The 1996 Constitution, which succeeded the 1993 interim Constitution, is considered one of the most progressive in the world. In its founding provisions, it states that South Africa is a democratic state founded on human dignity, the achievement of equality, the advancement of human rights and freedoms. The Constitution enshrines fundamental human rights in a justiciable Bill of Rights as a cornerstone of democracy. Unfortunately, in the eyes of a number of politicians, officials and lay-persons, the rights in the Bill of Rights accrue to South African citizens only. Xenophobia, which has been rampant since the end of apartheid, seems to support the idea that foreigners should not enjoy these rights. Foreign nationals have often been accused of posing a threat to South African citizens with regard to employment opportunities. In light of the South African legislation and jurisprudence, this article affirms the position of the South African labour law that foreign nationals are indeed protected by the Constitution and entitled to rights in the Bill of Rights, including the rights to work and fair labour practices.

The Engagement of Beneficiaries in Farm Governance of Restituted Land through the Communal Property Association Model: The Ideal Versus the Reality of Beneficiary Farms in South Africa

2019 ◽  
Vol 16 (2) ◽  
Author(s):  
Mokoko Piet Sebola ◽  
Malemela Angelinah Mamabolo
Keyword(s):  
South Africa ◽  
South African ◽  
Land Reform ◽  
Farm Management ◽  
The South ◽  
African Government ◽  
Communal Property ◽  
Farm Ownership ◽  
Land Restitution ◽  
Communal Property Associations

The purpose of this article is to evaluate the engagement of farm beneficiaries in South Africa in the governance of restituted farms through communal property associations. The South African government has already spent millions of rands on land restitution to correct the imbalance of the past with regard to farm ownership by the African communities. Various methods of farm management to benefit the African society have been proposed, however, with little recorded success. This article argues that the South African post-apartheid government was so overwhelmed by political victory in 1994 that they introduced ambitious land reform policies that were based on ideal thinking rather than on a pragmatic approach to the South African situation. We used qualitative research methods to argue that the engagement of farm beneficiaries in farm management and governance through communal property associations is failing dismally. We conclude that a revisit of the communal property associations model is required in order to strengthen the position of beneficiaries and promote access to land by African communities for future benefit.

Exploring the South African Government Communication on Land Expropriation without Compensation

2020 ◽  
Vol 72 (1-3) ◽  
Author(s):  
Lungisani Moyo
Keyword(s):  
South Africa ◽  
Food Security ◽  
South African ◽  
Small Scale ◽  
South African Government ◽  
Eastern Cape ◽  
The South ◽  
Land Expropriation ◽  
African Government ◽  
Government Communication

ABSTRACT This paper used qualitative methodology to explore the South African government communication and land expropriation without compensation and its effects on food security using Alice town located in the Eastern Cape Province South Africa as its case study. This was done to allow the participants to give their perceptions on the role of government communication on land expropriation without compensation and its effects on South African food security. In this paper, a total population of 30 comprising of 26 small scale farmers in rural Alice and 4 employees from the Department of Agriculture (Alice), Eastern Cape, South Africa were interviewed to get their perception and views on government communications and land expropriation without compensation and its effects on South African food security. The findings of this paper revealed that the agricultural sector plays a vital role in the South African economy hence there is a great need to speed up transformation in the sector.

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