David Harrison

An Overview of Health and Health care in South Africa 1994 2010: Priorities, Progress and Prospects for New Gains

Published by: 
Department of Health (South Africa)

EXECUTIVE SUMMARY
This paper describes progress and challenges in efforts to improve the health of South Africans since 1994. It reviews the state of health and the health care system, identifies major accomplishments and shortcomings, and outlines some opportunities for new gains in national health priorities. The purpose of the paper is to help inform discussion of macro health policy and planning by identifying key riorities and opportunities for consideration.

Although restructuring of the public health sector post-1994 achieved substantial improvements in terms of access, rationalisation of health management and more equitable health expenditure, fifteen years later these early gains have been eroded by a greatly increased burden of disease related to HIV/AIDS, generally weak health systems management and low staff morale. The result is poor health outcomes relative to total health expenditure.

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Teenage pregnancy figures cause alarm

JOHANNESBURG, 6 March 2007 (IRIN) - Alarming figures released by a South African provincial education department indicate that schoolgirl pregnancies have doubled in the past year, despite a decade of spending on sex education and AIDS awareness.

Are our teens still not getting the HIV message?

Pharmacies are doing a brisk trade in the morning-after pill, especially among teens. It seems that even though there is a high risk of contracting HIV/AIDS, young people are still having unprotected sex and are concerned simply with preventing unwanted pregnancies. A spot survey conducted by The Star of a number of pharmacies around Johannesburg, revealed that chemists are doing a roaring trade in the three available types of morning-after pill. E-GEN-C, NorLevo and Ovral 28 must be orally ingested by a woman within 72 hours of her having had unprotected sex. The pills can be obtained over the counter without prescription and it seems young women are taking advantage of this. Graham Naughtin, a pharmacist at the Cliffview Medicare Pharmacy at Cresta, says that about 70 boxes of the morning-after pill are sold every weekend. While they are 90% effective in preventing pregnancy, they do not protect the user against any sexually transmitted infections (STIs) or AIDS.A locum doctor at the Selgo Pharmacy in Braamfontein, Blessing Motgatlha, says she has noticed a 50% increase in the use of the morning-after pill in the past two years. Lipalesa Malebanye, a pharmacist at Bruma Pharmacy, says where condom usage has dropped, there is a notable increase in the use of the morning-after pill, especially by teenagers. A teenager, who does not want to be named, says she has taken the morning-after pill four times this year alone. She adds that contracting an STI was not something she was concerned about at the time. While these drugs might prevent unwanted pregnancies, they do have side effects. Professor Basil van Iddekinge, a gynaecologist at Wits Medical School, says the morning-after pill is not meant for continuous or repetitive use and he stressed that it is not a long-term contraceptive. A women should rather use a non-emergency, long-term type of contraceptive. Van Iddekinge says one of the main problems of the morning-after pill is that it may alter the user's menstrual cycle. He explains the emergency pill is meant to be just that, used in an emergency. An emergency would be when the condom broke during intercourse, or perhaps when a woman has sex even though she did not intend to do so. Another emergency would be in the case of rape. Meanwhile, loveLife CEO, David Harrison, says the awareness organisation has not picked up this trend. If this is the case, it is really worrying that young people are being more irresponsible in their sexual activities, he says. Harrison warns that youngsters should employ dual protection to prevent pregnancy and STIs. The chief director of maternal, child and women's health unit in the department of health, Dr Eddie Mhlangu, holds Harrison's point of view. It's worrying, on the one hand, that people are not using condoms despite the threat of AIDS, while on the other, it is encouraging that it is cutting down on the number of unwanted pregnancies, he says. (Source: The Star, 14 April, 2003).

AFRICA: Turning on to safe sex

CLICK ON LINK BELOW FOR FULL REPORT Http://www.irinnews.org/AIDSReport.ASP?ReportID=1371 BARCELONA, 9 July (IRIN) - Preventing HIV/AIDS in theory seems simple enough. Provide sexually active young people with information on how the disease is spread, and they will naturally adopt safe sex behaviour. But the reality has proved much more complex. Twenty years after the disease was diagnosed, much ignorance surrounding HIV/AIDS still persists. According to the UN children's agency UNICEF, new studies have established that the vast majority of young people have no idea how HIV/AIDS is transmitted or how to protect themselves from the disease. In South Africa there have been two innovative approaches to that problem. Soul City, a telling it as it is television, radio and print initiative set in the community, and loveLife, a fresh and positive media-driven lifestyle brand. LoveLife's boss David Harrison believes that the lessons have been learned on not only how safe sex messages should be transmitted, but also what they should contain. It needs to be targeted, it needs to be focused, he told PlusNews. The need for a comprehensive approach to HIV/AIDS awareness is much more than the typical lone billboard in urban centres. It includes youth advisory services, drop-in centres and youth-friendly clinics. LoveLife, he explained, taps into youth culture and lifestyle to make safe sex sexy in a non-didactic manner. It combines a high-powered media campaign (for young people, by young people in a language they understand) with adolescent sexual health services, outreach and support programmes that have won the backing of the South African government and some major donors. While Love life's approach has stirred some controversy in South Africa, a national survey in 2001 found that 62 percent of young South Africans said they had heard of it and 76 percent of those said it had made them more aware of the risks of unprotected sex. But only 30 percent of sexually experienced youth reported using a condom every time they had a sexual experience in the past year.

On Stages and Screens, AIDS Educators Reach South Africa's Youths

If anything can stop the AIDS epidemic in South Africa, it will have to be the teenagers. But what South Africa calls the ABC message — Abstain/Be Faithful/Condomize — arrived long after the epidemic had taken hold, and is now likened to the safety lecture on airplanes: everyone has heard it so often, they hardly listen. New education initiatives, like the Love Life education outreach and the Soul City soap opera, are trying to find livelier ways to deliver the message. Younger teens are the crucial target audience. With little hope of getting proper drugs, H.I.V.-infected babies die quickly, leaving each generation virtually AIDS-free until puberty, when the numbers begin to climb. Girls are infected younger, experts say, by a ratio of 6 girls to 1 boy in their early teens. Some are the victims of rape or incest; many get into sugar daddy relationships for money or food. Open discussion of sex has had only a short history in South Africa. The religiously conservative pre- 1990 apartheid government did not talk openly about AIDS and condoms, and when President Nelson Mandela broached the topic of safe sex in a 1990 school speech, parents responded that he would give children bad ideas, so he stopped discussing AIDS for years, he said. Even now, uneasiness is widespread. A poll by Love Life, a private group supported by the Kaiser Family Foundation and the Bill and Melinda Gates Foundation, found that 70 percent of teenagers wished they had learned about sex from their parents, but only 22 percent did. The poll found that they learned more from their peers, their schools and the news media, in that order. Learning from peers has obvious hazards, and schools need to make big changes, said Dr. David Harrison, Love Life's chief executive officer. More troubling, he said, is the frequency of teacher-student relationships. There are other obstacles. In the rural areas where millions of students live, poverty and bad roads make it hard to get books and videotapes, while superstitions must also be overcome. The soap opera Soul City, broadcast from Johannesburg, reaches a large audience — 25 percent of the national population. Based in a black township's clinic, it is urban and sophisticated, but like the play it works to explode myths that may seem naïve to Americans. The show was created by Dr. Garth Japhet, a pediatrician who worked in the grim Alexandra township and wrote a health column for The Sowetan, a daily newspaper with a large black readership. Now, with backing from the European Union, and grants from Britain, Ireland, British Petroleum, the MTN phone company and the government, 13 new episodes a year are shown, plus reruns, and each new series starts with a million comic books inserted in daily newspapers with health-related stories. For rural audiences, Soul City is rewritten for radio in nine languages. The stars make appearances. (Source: New York Times, 3 February 2002)