scholarly journals The composition of old age homes in South Africa in relation to the residents and nursing personnel

Curationis ◽  
2000 ◽  
Vol 23 (1) ◽  
Author(s):  
A. Perold
Keyword(s):  
South Africa ◽  
Old Age ◽  
Nursing Care ◽  
Health Workers ◽  
Cost Effective ◽  
Nursing Personnel ◽  
Care Workers ◽  
The Cost ◽  
Descriptive Survey ◽  
Old Age Homes

This research project is the first phase of a larger study aimed at describing and exploring the cost-effective utilisation of nursing personnel in old age homes in South Africa. The aim in the first phase was to describe the composition of the residents and nursing personnel of old age homes in South Africa. An exploratory and descriptive survey was conducted and the data was collected by means of a questionnaire. The questionnaire also included data on the financial implications of utilising professional nursing personnel to manage the care of the frail residents/older persons in old age homes in South Africa. The questionnaires were mailed to 612 old age homes published in the Hospital and Nursing Yearbook of 1997 (100% sample). A total of 145 (23.69%) questionnaires were returned and included in the descriptive data analysis. The residents are mainly female (77%), older than 85 years of age, belong to the white race group (83,74%) and are highly dependent on nursing care and supervision (69,7%). Old age homes are mainly managed/ controlled by welfare organisations and lay health care workers are utilised to a large extent (42,22% of the nursing workforce) to render nursing care to the frail residents. The cost-effective utilisation of nursing personnel (registered and enrolled), as well as the utilisation of lay health workers in old age homes, needs to be critically examined.

scholarly journals Economic Analysis of the CLIP Trials in India, Pakistan and Mozambique

2020 ◽  
Author(s):  
Jeffrey N Bone ◽  
Asif Khowaja ◽  
Marianne Vidler ◽  
Beth A. Payne ◽  
Mrutyunjaya B Bellad ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Health Workers ◽  
Cost Effective ◽  
World Health ◽  
Years Of Life Lost ◽  
Tree Model ◽  
Pregnancy Hypertension ◽  
Contact Frequency ◽  
Health Organization ◽  
The Cost

Abstract Background: The Community-Level Interventions for Pre-eclampsia (CLIP) Trials (NCT01911494) in India, Pakistan, and Mozambique (February 2014-7) involved community engagement and task-sharing with community health workers for triage and initial treatment of pregnancy hypertension. Maternal and perinatal mortality was less frequent among women who received ≥8 CLIP contacts. The aim of this analysis was to assess the costs and cost-effectiveness of the CLIP intervention overall, and by POM visit frequency. Methods: Included were all women enrolled in the three CLIP trials who had delivered with known outcomes by trial end. According to the number of POM-guided home contacts received (0, 1-3, 4-7, ³8), costs were collected from annual budgets and spending receipts, with inclusion of family opportunity costs in Pakistan. A decision-tree model was built to determine the cost-effectiveness of the intervention (vs. usual care), based on the primary clinical endpoint of years-of-life-lost (YLL) for mothers and infants. A probabilistic sensitivity analysis was used to assess uncertainty in the cost and clinical outcomes.Results: The incremental per pregnancy cost of the intervention was USD$12.66 (India), USD$11.51 (Pakistan) and USD$13.26 (Mozambique). As implemented, the intervention was not cost-effective, due largely to minimal differences in years-of-life-lost between arms. However, among women who received ≥8 contacts (4 in Pakistan), the probability of health system and family (Pakistan) cost-effectiveness was ≥80% (all countries). Conclusion: The intervention was likely to be cost-effective for women receiving ≥8 contacts in Mozambique and India, and ≥4 in Pakistan, supporting World Health Organization guidance on antenatal contact frequency.Funding: The University of British Columbia, a grantee of the Bill & Melinda Gates Foundation (OPP1017337).Trial registration: clinicaltrials.gov. Registered 30 July 2013, https://clinicaltrials.gov/ct2/show/NCT01911494

scholarly journals Overview of predictive CSP spread prospects and its opportunities

2016 ◽  
Vol 27 (2) ◽  
pp. 50 ◽  
Author(s):  
Kai Timon Busse ◽  
Frank Dinter
Keyword(s):  
South Africa ◽  
Solar Power ◽  
Cost Effective ◽  
General Idea ◽  
Concentrating Solar Power ◽  
Storage Technology ◽  
The Cost

An investigation was carried out to illustrate the prospects and challenges associated with implementation of concentrating solar power (CSP) with storage technology in South Africa. Various factors were examined that have an effect on the cost of CSP plants and offer an overall review of the opportunities CSP has for the country. This paper appeals the general idea that CSP is not cost effective enough and attempts to illustrate the feasibility of this technology in South Africa.

The use of tele-audiology in ototoxicity monitoring: A scoping review

2022 ◽  
pp. 1357633X2110682
Author(s):  
Nazeera Peerbhay ◽  
Danielle R Munsamy ◽  
Hombisa P Dlamini ◽  
Fisokuhle Langa ◽  
Jessica Paken
Keyword(s):  
South Africa ◽  
South African ◽  
Scoping Review ◽  
Network Connectivity ◽  
Cost Effective ◽  
Healthcare Facilities ◽  
Holistic Management ◽  
African Context ◽  
Meta Analyses ◽  
The Cost

Introduction Due to the growing burden of disease in South Africa, encompassing conditions such as tuberculosis, human immunodeficiency virus, and cancer, the holistic management of affected patients incorporating ototoxicity monitoring is a necessity. However, ototoxicity monitoring in developing countries may be limited due to a lack of resources and inadequate healthcare facilities. Subsequently, the use of tele-audiology may be a revolutionary technique with the potential to provide audiology services to under-served populations with limited access. Methods The study aimed to describe the use of tele-audiology services in ototoxicity monitoring through a scoping review of English peer-reviewed articles from June 2009 to June 2020. Seventeen articles were purposively selected from the following databases: PubMed, Science Direct, Taylor and Francis Online, WorldCat, and Google Scholar. Data was extracted as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses diagram and results were analyzed using deductive thematic analysis. Results and discussion While a minority of the studies indicated that the cost of implementation and network connectivity within a South African context pose as barriers, most researchers reported that tele-audiology provides a reliable, time-efficient, cost-effective, and easily accessible alternative for ototoxicity monitoring. Hardware including the WAHTS, KUDUwave, and OtoID, along with software such as the TabSINT, Otocalc, uHear, and the hearTest, have proven to be useful for ototoxicity monitoring. A need for further investigations regarding the feasibility of tele-audiology implementation in South Africa is evident. Despite this, it provides audiologists with an opportunity to offer contact-less services during COVID-19, thus, confirming its versatility as an augmentative method for ototoxicity monitoring.

scholarly journals Cost-effectiveness of a Pharmacogenomic Test for Stratified Isoniazid Dosing in Treatment of Active Tuberculosis

2020 ◽  
Author(s):  
Neil E Rens ◽  
Carin A Uyl-de Groot ◽  
Jeremy D Goldhaber-Fiebert ◽  
Julio Croda ◽  
Jason R Andrews
Keyword(s):  
South Africa ◽  
Cost Effectiveness ◽  
Cost Effective ◽  
Sensitivity Analyses ◽  
Tree Model ◽  
A Value ◽  
Life Years ◽  
Nat2 Gene ◽  
Potential Clinical Impact ◽  
The Cost

Abstract Background There is marked interindividual variability in metabolism and resulting toxicity and effectiveness of drugs used for tuberculosis treatment. For isoniazid, mutations in the N-acetyltransferase 2 (NAT2) gene explain >88% of pharmacokinetic variability. However, weight-based dosing remains the norm globally. The potential clinical impact and cost-effectiveness of pharmacogenomic-guided therapy (PGT) are unknown. Methods We constructed a decision tree model to project lifetime costs and benefits of isoniazid PGT for drug-susceptible tuberculosis in Brazil, South Africa, and India. PGT was modeled to reduce isoniazid toxicity among slow NAT2 acetylators and reduce treatment failure among rapid acetylators. The genotyping test was assumed to cost the same as the GeneXpert test. The main outcomes were costs (2018 US dollars), quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios. Results In Brazil, PGT gained 19 discounted life-years (23 QALYs) and cost $11 064 per 1000 patients, a value of $476 per QALY gained. In South Africa, PGT gained 15 life-years (19 QALYs) and cost $33 182 per 1000 patients, a value of $1780 per QALY gained. In India, PGT gained 20 life-years (24 QALYs) and cost $13 195 per 1000 patients, a value of $546 per QALY gained. One-way sensitivity analyses showed the cost-effectiveness to be robust to all input parameters. Probabilistic sensitivity analyses were below per capita gross domestic product in all 3 countries in 99% of simulations. Conclusions Isoniazid PGT improves health outcomes and would be cost-effective in the treatment of drug-susceptible tuberculosis in Brazil, South Africa, and India.

scholarly journals Clearing invasive alien plants as a cost-effective strategy for water catchment management: The case of the Olifants river catchment, South Africa

2016 ◽  
Vol 19 (5) ◽  
pp. 774-787 ◽  
Author(s):  
Tshepo Morokong ◽  
James Blignaut ◽  
Nonophile Nkambule ◽  
Shepherd Mudhavanhu ◽  
Thulile Vundla
Keyword(s):  
South Africa ◽  
Negative Impact ◽  
Cost Effective ◽  
Alien Plants ◽  
Catchment Management ◽  
Invasive Alien Plants ◽  
River Catchment ◽  
Olifants River ◽  
The Cost ◽  
The Impact

Invasive alien plants have a negative impact on ecosystem goods and services derived from ecosystems. Consequently, the aggressive spread of invasive alien plants (IAPs) in the river catchments of South Africa is a major threat to, inter alia, water security. The Olifants River catchment is one such a catchment that is under pressure because of the high demand for water from mainly industrial sources and unsustainable land-use, which includes IAPs. This study considered the cost-effectiveness of clearing IAPs and compared these with the cost of a recently constructed dam. The methods used for data collection were semistructured interviews, site observation, desktop data analysis, and a literature review to assess the impact of IAPs on the catchment’s water supply. The outcomes of this study indicate that clearing invasive alien plants is a cost-effective intervention with a Unit Reference Value (URV) of R1.44/m3, which compares very favourably with that of the De Hoop dam, the URV for which is R2.93/m3. These results suggest that clearing invasive alien plants is a cost-effective way of catchment management, as the opportunity cost of not doing so (forfeiting water to the value of R2.93/m3) is higher than that of protecting the investment in the dam.

scholarly journals The Cost-effectiveness of a Point-of-Care Paper Transaminase Test for Monitoring Treatment of HIV/TB Co-Infected Persons

2017 ◽  
Vol 4 (4) ◽  
Author(s):  
Radha Rajasingham ◽  
Nira R Pollock ◽  
Benjamin P Linas
Keyword(s):  
South Africa ◽  
Cost Effectiveness ◽  
Point Of Care ◽  
Cost Effective ◽  
Clinical Monitoring ◽  
Automated Testing ◽  
Decision Analytic Model ◽  
Laboratory Monitoring ◽  
Life Years ◽  
The Cost

Abstract Background Persons with HIV and tuberculosis (TB) co-infection require transaminase monitoring while on hepatotoxic medications. A novel paper-based, point-of-care transaminase test is in development at an anticipated cost of $1 per test. Methods To project long-term clinical outcomes and estimate the cost-effectiveness of using a paper-based fingerstick test to monitor for drug-induced liver injury (DILI), as compared with automated testing and with no laboratory monitoring. The design was a decision analytic model, including deterministic and probabilistic sensitivity analyses. Data sources were observational cohorts and a validation study of the paper-based test. The target population was HIV/TB co-infected persons in South Africa on antiretroviral therapy who were initiating TB therapy. Interventions: (1) clinical (no laboratory) monitoring; (2) monitoring using the paper-based test with a ≥120 IU/mL threshold for positivity; (3) monitoring using the paper-based test with a ≥200 IU/mL threshold for positivity; (4) monitoring using the paper-based test using 1 of 3 categories: <120 IU/mL, 120 to 200 IU/mL, and >200 IU/mL (“bin placement”); (5) monitoring using automated ALT testing using the same 3 categories (“automated testing”). The outcome measures were discounted quality-adjusted life-years (QALYs), costs, and incremental cost-effectiveness ratios (ICERs). Results The ICER of automated testing was $5180/QALY. Use of the paper-based test with the bin placement strategy was cost-effective compared with clinical monitoring alone. Conclusion At its current performance, monthly DILI monitoring by bin placement using the paper-based test was cost-effective, compared with clinical monitoring, in HIV/TB co-infected persons in South Africa.

scholarly journals Knowledge, Attitude and Perception of the National Health Insurance Amongst Health Workers in Ugu District, Kwa-Zulu Natal, South Africa in 2017

2020 ◽  
Vol 13 (1) ◽  
pp. 763-770
Author(s):  
Nagammal Govender ◽  
Ozayr Mahomed
Keyword(s):  
South Africa ◽  
Health Care ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
Health Care Workers ◽  
Health Workers ◽  
Successful Implementation ◽  
Detailed Knowledge ◽  
Care Workers

Background: South Africa aims to progress towards universal health coverage by implementing the National Health Insurance (NHI). The perception and actions of health care workers influence the successful implementation of any intervention. Aim: The aim of the study was to establish the knowledge, attitude and perception of National Health Insurance amongst health care workers in Ugu in 2017 Methods: A descriptive cross-sectional study using self -administered questionnaires were used to gather information from 380 conveniently selected respondents between October 2017 and December 2017 across all health facilities in Ugu Health District. To establish associations between demographic factors and knowledge, attitude and perception on NHI, Chi- Square (X2) test and multivariate logistic regression were analysed. Results: Most respondents were aware of National Health Insurance (96.84%). However, only 33% had detailed knowledge of the objectives of National Health Insurance. There was a significant relationship between age less than 45 years and more than 10 years of experience on knowledge of National Health Insurance. The overall perception of National Health Insurance was good (61.92%), despite 60% of respondents believing that there was no proper communication regarding National Health Insurance by the government. Healthcare workers who live in the urban residential area had a better perception of National Health Insurance. The attitude towards NHI was positive, as 77.84% of respondents were willing to comply with the requirements of National Health Insurance. Conclusion: A targeted approach for communicating information about the National Health Insurance and an increased investment could improve its credibility and effective application.

scholarly journals The cost of nephroblastoma treatment in South Africa: A very cost-effective investment with guidelines for the rest of Africa

2014 ◽  
Vol 8 (4) ◽  
pp. 128
Author(s):  
Daniela Cristina Stefan ◽  
D K Stones ◽  
A Van Zyl ◽  
R Uys
Keyword(s):  
South Africa ◽  
Cost Effective ◽  
The Cost

Prevalence, Prediction, and Clonality of Methicillin-ResistantStaphylococcus aureusCarriage at Admission to Medical Units in Hong Kong, China

2014 ◽  
Vol 35 (1) ◽  
pp. 42-48 ◽  
Author(s):  
Shik Luk ◽  
Alex Yat Man Ho ◽  
Tak Keung Ng ◽  
Iris Hoi Ling Tsang ◽  
Eliza Hoi Ying Chan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hong Kong ◽  
Old Age ◽  
Cost Effective ◽  
Screening Strategy ◽  
Control Measures ◽  
Carriage Rate ◽  
Screening Criteria ◽  
Infection Control Measures ◽  
Old Age Homes

Objective.To determine the prevalence, risk factors, and molecular epidemiology of methicillin-resistantStaphylococcus aureus(MRSA) colonization at the time of admission to acute medical units and to develop a cost-effective screening strategy.Methods.Nasal and groin screening cultures were performed for patients at admission to 15 acute medical units in all 7 catchment regions in Hong Kong. All MRSA isolates were subjected tospatyping.Results.The overall carriage rate of MRSA was 14.3% (95% confidence interval [CI], 13.5–15.1). MRSA history within the past 12 months (adjusted odds ratio [OR], 4.60 [95% CI, 3.28–6.44]), old age home residence (adjusted OR, 3.32 [95% CI, 2.78–3.98]), and bedbound state (adjusted OR, 2.19 [95% CI, 1.75–2.74]) were risk factors selected as MRSA screening criteria that provided reasonable sensitivity (67.4%) and specificity (81.8%), with an affordable burden (25.2%).spatyping showed that 89.5% (848/948) of the isolates were clustered into the 4spaclonal complexes (CCs):spaCC1081,spaCC032,spaCC002, andspaCC4677. Patients colonized with MRSAspatypes t1081 (OR, 1.77 [95% CI, 1.49–2.09]) and t4677 (OR, 3.09 [95% CI, 1.54–6.02]) were more likely to be old age home residents.Conclusions.MRSA carriage at admission to acute medical units was prevalent in Hong Kong. Our results suggest that targeted screening is a pragmatic approach to increase the detection of the MRSA reservoir. Molecular typing suggests that old age homes are epicenters in amplifying the MRSA burden in acute hospitals. Enhancement of infection control measures in old age homes is important for the control of MRSA in hospitals.

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