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Jun 19
Healthy Men Build Healthy Communities: Prostate Cancer Awareness

By Siyabonga Gema – Communications Officer, Health Systems Trust 

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Men's Health Awareness Month, celebrated every June, aims to raise awareness of, and to educate men on preventable diseases, emphasising the importance of early detection, encouraging men to lead healthy lives. Generally, men are perceived as strong and resilient, attributes that men world-wide strive to exhibit and uphold. As impressive and inspiring as this can be, it may pose a barrier to men accessing health care and support due to the fear of being seen as weak or incapable of handling the pressures associated with being a man in this day and age.

It is precisely for this reason that June is earmarked as the month when men receive much-needed information about their health and how, through taking care of their health, men contribute to the well-being of society as a whole. A burning issue which is a serious threat to men, especially as they grow older, is cancer and, specifically, prostate cancer. Prostate cancer can develop when cells in the prostate start to grow in an uncontrolled way. Sometimes the cancer in the prostate develops too slowly to cause any problems or affect how long you live and because of this, many men with prostate cancer will never need any treatment. However, it sometimes progresses rapidly and tends to spread. This is more likely to cause problems and needs treatment to stop it from spreading.

Prostate cancer does not usually cause any symptoms until the cancer has grown large enough to put pressure on the tube that carries urine from the bladder out of the urethra.

Symptoms of prostate cancer can include:

  • needing to urinate more frequently, often during the night
  • needing to rush to the toilet
  • difficulty in starting to urinate (hesitancy)
  • straining or taking a long time while urinating
  • weak flow
  • the feeling that your bladder has not emptied fully
  • blood in urine or blood in semen.


These symptoms do not always mean you have prostate cancer. Many men's prostates get larger as they get older because of a non-cancerous condition called benign prostate enlargement.

According to the World Cancer Research Fund International, "prostate cancer is the second most commonly occurring cancer in men and the fourth most common cancer overall. There were more than 1.4 million new cases of prostate cancer in 2020". Further to this, CANSA indicates that "lifetime risk for prostate cancer in men in South Africa, is 1 in 15, according to the 2019 National Cancer Registry''. Prostate cancer accounts for about 13% of male deaths from cancer in South Africa. Prostate cancer in Black South African men is more likely to be hereditary than in other racial groups; hence, they are disproportionately affected. The statistics above shed light on the seriousness of the situation which calls on various stakeholders, especially the government, to devise an action plan to tackle the issue of prostate cancer prevalence in South Africa.

In 2012, as part of the National Development Plan 2030, the South African government set its sights on significantly reducing the prevalence of non-communicable diseases through strengthening monitoring and prevention in the public health services of common diseases such as breast and cervical cancers in women, and prostate and lung cancers, amongst other action items. While the treatment can work, the best way to tackle diseases, including prostate cancer, is through prevention. This is why efforts have been centred on strengthening health information sharing and public education programmes targeted at men who are most vulnerable to prostate cancer. Men are encouraged to undergo regular screening and testing because early detection is key. It is also crucial to know the risk factors that may lead to prostate cancer to ensure that you access screening and testing services. These risks include:

  • Age: Men over 50 years are more at risk. More than 80% of all prostate cancers are diagnosed in men over the age of 65 years.
  • Family history / Genetic factors: If a father or brother had prostate cancer, there is an increased risk of getting the disease.
  • Unhealthy Diet: There is a relationship between a diet high in animal fat and protein (especially red meat), and prostate cancer.


This Men's Health Awareness Month, the Health Systems Trust calls on all sectors of society to rally support for men through the provision of health, social and other essential services that empower men to continue playing their crucial role in our communities and their families. An array of resources are available for men to access, including support groups and engagement platforms where men engage on pressing issues with other men and empower each other with information.

For more information on prostate cancer and Men's Health Awareness Month visit;

https://www.gov.za/news/events/health-awareness-events/mens-health-month

https://www.kznhealth.gov.za/prostate-cancer.htm

https://cansa.org.za/prostate-cancer/

https://menshealthmonth.org/

 


Jun 14
Celebrating Youth Day: Empowering the Leaders of Tomorrow

By Mandisa Dlamini (Communications Assistant) and Phumula Mudau (Communications Intern)

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Youth Day is a world-wide event that honours youth's contribution to the advancement of society and promotes their involvement in forming the future. The 16 June 1976 protests in Soweto, where students marched against the Bantu Education Act and apartheid laws, is being celebrated for the 48th time this year. This day highlights the value of contributing to the development and wellbeing of the younger generation and serves as a reminder of their potential. This year's theme is "Actively advancing socioeconomic gains of our democracy". The commitment is to provide youth with the necessary tools, and resources to enable them to contribute significantly to society and to address critical problems such as unemployment, educational inequality, unfairness in society and insufficient medical care.

The Significance of Youth Day

Youth Day is very important because it honours the bravery and courage of young people who confronted injustice. It acts as a reminder of the influence youth activism has in transforming society and influencing the future. Youth Day highlights the value of funding young people's education, empowerment, and wellbeing by celebrating their contributions to social progress. It promotes a better and more inclusive tomorrow by motivating present and future generations to fight for justice, equality, and human rights. In addition to celebrating youth's vibrancy and potential, Youth Day offers a chance to consider the health and well-being of this generation.

Addressing Youth-Specific Health Challenges

The increase in human papillomavirus (HPV) infections among young women, in particular, in South Africa has drawn a lot of attention, as have initiatives to reduce the risk to health, such as cervical cancer prevention and treatment. If not properly treated, HPV, a common sexually transmitted infection, can cause cervical cancer. To reduce these dangers, South Africa has increased its health measures, especially for young girls. The inclusion of HPV vaccinations in the public health framework is one example of the proactive move taken by the South African government. The HPV vaccine campaign is intended to immunise children before become sexually active. Despite these initiatives, challenges still remain. The uptake of the HPV vaccine has been limited by socioeconomic inequality and restricted access to healthcare and there is still unequal coverage of cervical cancer screening, particularly in rural and disadvantaged areas. Partnerships with public health organisations and ongoing public health initiatives are essential to addressing these concerns. By raising knowledge of HPV and its risks and increasing vaccination rates, these efforts hope to increase participation in screening and vaccination campaigns. The Health Systems Trust also supports Cervical Cancer Prevention Action and Control.

Embracing Mental Health and Wellbeing

Youth present both potential and difficulties, but it's important to remember that mental health and wellbeing come first. Young brains can be negatively impacted by the demands of academic achievement, social expectations, and personal development. It is important to establish supportive environments that place a high priority on mental health awareness, and mental health treatment accessibility. Advancing the wellbeing of, and assisting young people on their path to emotional and psychological wellbeing on this Youth Day, is key.

On Youth Day let's show commitment to putting youth health and well-being first. We can guarantee that the upcoming generation not only survives but also leads healthier, happier lives by providing them with the information, tools, and assistance they require. While we acknowledge their potential and accomplishments, let us also acknowledge the critical role they play in creating a society that is stronger and more resilient.

 

Read More: Youth Health Africa

 

 

 


May 28
A Day in the life of the Health Systems Trust’s SyNCH Helpdesk Supervisor, Zinhle Mnguni

by Siyabonga Gema – HST Communications Officer

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Meet Zinhle Mnguni, the Health Systems Trust's (HST's) SyNCH Helpdesk Supervisor, who says she draws her inspiration from witnessing other people triumph over adversity. Zinhle, who is no stranger to HST, recently took up a new role and we caught up with her to learn more about what this new chapter means to her and what she has up her sleeve as she navigates her HST career.

Please share your professional and educational background

I hold a Diploma in Information Technology and joined HST under Columbus, HST's ICT service provider, as a SyNCH ICT Technician from 2017 to 2019. In February 2021, I was appointed as a SyNCH Helpdesk Consultant supporting KwaZulu-Natal under Columbus. In April this year, I was appointed as SyNCH Helpdesk Supervisor.

What influenced you to join the health sector?

Helping others, making a difference in people's lives and contributing to improving the health outcomes of all people was a strong motivator for me to join the health sector. The government's initiative and policies aimed at improving healthcare outcomes and increasing access to healthcare also created an attractive environment for me.

How are you finding your new role?

As a SyNCH Helpdesk Supervisor, I am enjoying taking responsibility and getting an opportunity to mentor and lead a team. Although it comes with new challenges compared to my previous role, and my day to day work routine has changed a lot, I am open to growing and developing new skills.

How do you think technological advances benefit the health sector?

Technological advances have revolutionised the health sector in numerous ways, and I'm excited to share some of the benefits:

  • Monitored/Governed access to the health systems to protect patient level data.
  • Remote monitoring of patients.
  • Promotion of rational medicine use principles
  • Improved and fast communication between health facilities and their service providers.
  • Easy access to the reports that are available electronically to improve patient care.


What is most fulfilling about your job?

As a Helpdesk Supervisor, I have a unique opportunity to make a positive impact on people's lives by resolving their issues and concerns. When I help someone resolve their issues, I get a sense of satisfaction and accomplishment knowing that I made a positive difference in their day.

I am also developing strong relationships with my team members and stakeholders. I get to understand their challenges, empathise with their frustrations, and build trust with them.

This job requires you to think critically and creatively to resolve complex issues. You must stay up-to-date with new developments and solutions, which can be engaging and stimulating.

What does your typical day at work look like?

Every day is different in this role when supervising seven provinces that are implementing SyNCH and there are always new challenges and opportunities to learn and grow.

From 8:00, I do my morning routine: checking emails; responding to urgent messages and escalating when necessary. I then prepare and organise team meetings to discuss priorities, goals, and ongoing issues or concerns. Part of my role entails tickets management where I monitor ticket updates and resolutions, escalate tickets to relevant stakeholders and provide team support and guidance as needed. Another aspect involves consolidating reports and analysis on a monthly and quarterly basis, and fostering ongoing collaboration through meetings to discuss SyNCH project issues and best practices.

What inspires you?

The personal experience of overcoming a challenge, learning a new skill or achieving a goal is my very powerful source of inspiration. Hearing about other people's experiences, struggles and triumphs can be incredibly inspiring.

How do you do away from work?

I am a very family orientated person. I spend most of my time with my family and my three beautiful kids.

What does the future hold for Zinhle?

I am willing to further develop my skills to stay competitive in the market by pursuing additional education or training in areas like project management, public health and data analytics.

 


May 27
Employee wellness is company wellness

​By Willemien Jansen (HST Copy and Content Editor)

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Workers have been through a lot in recent years. The COVID-19 pandemic created a work-from- home trend that, while it worked for some, increased isolation and made it more difficult for parents, for example, to balance their work lives and parental responsibilities. A worldwide survey done in 2020 and 2021 found that people experienced higher levels of stress, insomnia, anxiety and depression. These issues did not necessarily dissipate with the end of the pandemic. It is no wonder that workers are trying to strike a better work-life balance after the pandemic, and employers should help them to do so.

What is employee wellness?

Healthy employees lead to happy employees. Improved health leads to higher productivity, less time spent on sick leave and higher levels of motivation. According to the Department of Health, there are four pillars of employee wellness:

  1. Physical wellness
  2. Psycho-social wellness
  3. Organisational wellness
  4. Work-life balance


How can employers help staff achieve high levels of wellness?

The Health Systems Trust recently launched a series of wellness days that was successfully rolled out at the Midrand office. Employees could attend health screenings and listen to a series of talks on finance, diet and mental health. Wellness days like these go a long way to provide employees with education on their physical, financial and mental wellbeing. The company is also rolling out a hotline and suggestion/complaints box so that employees can report on various issues like bullying and other irregularities happening in the company. This transparency leads to better organisational wellness.

For the younger generations like Gen Z, work-life balance has become much more important than a big paycheck. Candidates will reject higher paying roles in favour of roles where they can achieve a better work-life balance. This generation places a higher value on a good work-life balance than settling for unhealthy work situations. They seek personal development, cherish candid conversations about mental health, and understand the significance of holistic fulfillment outside of the workplace. As this new generation comes up in the workforce, companies will be forced to rethink their mental wellness approaches.

Employees are increasingly looking for hybrid work environments that don't chain them to their desks for 8 hours a day, but allows them some freedom and flexibility to balance life and work. A study showed that 38% of organisations that participated indicated that more home/hybrid working has increased the organisation's productivity/efficiency. Only 13% of organisations indicated a decrease in productivity/efficiency.

More than pool tables and free coffee

Employee wellness is more than free coffee, fruit and fun relaxation areas. Wellbeing is not a one size fits all and evolves with your organisation. Initiatives like training and development, flexible work hours, social initiatives, company-wide meetings to build transparency, the effective use of sick days and mental health resources can all bolster productivity and create a healthier and more relaxed work environment.

For a myriad of mental health tools and resources visit Masiviwe or the South African Depression and Anxiety Group

 


May 24
Celebrating Africa Month: A Continent of Diversity and Growth

By Mandisa Dlamini (HST Communications Assistant)

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The month of May is recognised as Africa month – a time when the continent of Africa commemorates the founding of the Organisation of African Unity (OAU). This year's celebration reflects on the progress made by the OAU in enhancing the lives of the African population. The theme of the 10th edition of Africa Month is Celebrating 30 Years of Freedom: Building a Better Africa and a Better World

Africa Month is celebrated to honour the rich cultural legacy, diversity, and historical accomplishments of the African continent and is an opportunity to reflect on the continent's progress, challenges, and goals. In 2024, the focus includes a number of important health projects that will improve public health and wellbeing across Africa.  

The World Health Organization Africa Region has introduced a comprehensive plan of action and targeted programmes aimed at addressing health challenges in Africa over the period 2023 to 2030. These efforts prioritise tackling health issues like TB, cervical cancer via HPV vaccination, and enhancing mental health services. They also emphasise the importance of resilient health systems capable of responding to both existing and new health risks.

A major effort is the African Health Initiative funded by the Doris Duke Charitable Foundation. Under this programme, sub-Saharan African healthcare systems are supported by the development of partnerships and the application of comprehensive models of integrated primary healthcare. It highlights local ownership of health solutions, continuous learning processes, and local ownership of health solutions. To ensure long-lasting improvements to health, this calls for co-operation between regional administrations, academic institutions, and international funders.

Leading the way in research, strategic assistance for the execution of key health programmes, and building health systems are the main areas of concentration for the Health Systems Trust (HST), an organisation supporting the South African public health sector. HST has been crucial to the development of the country's healthcare system as the following projects illustrate; the Cervical Cancer (CCPAC) Project is a three-year Cervical Cancer Prevention, Access, and Control project in the Zululand District funded by the U.S Centers for Disease Control and Prevention (CDC). It facilitates  access to early screening, diagnostic procedures, treatment, and palliative care services within the district. The DO ART Demonstration Project offers comprehensive screening services, initiates ART (Antiretroviral Therapy), and provides continuous community-based management for ART patients in the eThekwini South and Nongoma Sub-districts of KwaZulu-Natal. The organisation's goal is to make Africa healthier and more equitable in terms of health.

Africa Month also features activities designed to enhance the appreciation for arts and culture, indirectly benefiting mental health by fostering community unity and cultural pride. The celebration includes events that showcase the continent's rich cultural heritage.

The health related activities during Africa Month 2024 highlight a comprehensive approach to improving health outcomes, strengthening health systems and addressing specific diseases to promoting mental health and cultural well-being.

Read more on Africa Month.

 





May 21
World Malaria Day, 25 April 2024, “Accelerating the fight against malaria for a more equitable world”

​By Antoinette Stafford Cloete (Health Systems Trust Communications Manager)

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World Malaria Day was instituted at the World Health Assembly in 2007 and draws attention to the necessity of ongoing financial support as well as a genuine political commitment to the prevention and control of malaria.

Progress with regards to decreasing the incidence or prevalence of malaria with most cases (94%) found in the Africa region has been sub-optimal. The World Health Organization (WHO) estimates that there were approximately 608 000 deaths caused by malaria in 2022 and more than 249 million new cases. It is an astounding number for one geographical area. The WHO for the African Region argues that this threat to human life is fuelled by a brutal cycle of inequity and a long list of social determinants related to poverty. The most vulnerable in the region are impacted: newborns, children younger than five years of age, expectant mothers, internally displaced people, refugees and migrants all bear the brunt of the disease.

Rural areas are affected to a greater extent than urban settings due to a lack of ready access to health services, including mobile clinics. A lack of poor treatment and prevention roll out in the form of health promotion and health education efforts to assist people with better understanding the causes, effects and preventive measures is also a contributing factor. Many people are unable to obtain the necessary protective measures such as mosquito nets and repellent as a starting point. Non-governmental organisations like Goodbye Malaria, funded by the Global fund, attempts to close the gap that government cannot fill by running awareness programmes on malaria and making the preventive material mentioned more readily available for consumers under the banner "Save a life in your sleep". It is a community development effort to promote small business and job-creation efforts that aims to create employment around sorely needed life-saving products, saving lives and alleviating poverty in the process in South Africa, Eswatini and Mozambique.

Efforts to roll back malaria were already in place in 1998 when four of the biggest health orgnisations in the world, the United Nations Children's Fund (UNICEF), the United Nations Development Programme (UNDP), the World Bank and the World Health Organization (WHO), joined forces to launch a campaign to fight malaria. The programme, "Roll Back Malaria", sought to reduce the human suffering and economic losses due to one of the world's costliest diseases.

The then WHO Director-General, Dr Gro Harlem Brundtland, said that, "Malaria is the number one health priority of people and leaders in affected communities and countries, but their voices have not been heard … The human suffering is unacceptable and so is the economic burden and impediment to progress. Africa and other regions with malaria are responding and we must answer their call".

Almost three decades have passed since that statement and too many lives are still being lost to malaria because levels of political commitment, private sector engagement (the exception would be the Bill & Melinda Gates Foundation) and much-needed community involvement are still not optimal.

For more information:

The Malaria Consortium

Speak Up Africa

 

 

 

 

 



May 17
A day in the life of Thandeka Mzulwini, HST’s Pharmacist for uMgungundlovu District

​by Siyabonga Gema - HST Communications Officer

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As the country progresses towards universal health coverage as envisaged by the World Health Organization (WHO), the role of primary health care and, in particular, pharmacists as a first point of contact with people seeking medical advice, couldn't be more crucial.

At the Health Systems Trust (HST), our high calibre of pharmacy professionals places us centrally in providing the necessary support in human and technical resources to the Department of Health in pursuit of equitable health for all.

Thandeka Mzulwini, HST's Pharmacist based in uMgungundlovu District, had a brief chat with the Communications Unit and gave us a glimpse of her professional and personal life.

Why did you choose a career in Pharmacy?

I wanted to provide clients with an incomparable service in the healthcare field by ensuring the safe and effective use of medication, providing health advice and pharmacy-initiated therapy to the community without being consulted by a nurse or doctor, especially in this economic landscape. The pharmacy field offers diverse opportunities and is not limited to community or hospital work; it also opens doors to research and development, academia, regulatory affairs, and industrial and clinical pharmacy.

What qualities does one need to thrive in this field?

One has to be passionate about helping others with their health needs; you must have patience, be non-judgemental, impartial, compassionate, and eager to learn every day for continuous self-development.

Do you think people understand the important role that Pharmacists play in health care?

At the National Department of Health, it is not well represented, and within the institutions, we still observe health decisions taken without pharmacy input. Pharmacists should be heading the anti-microbial stewardship programmes combatting microbial resistance, heading Central Chronic Medicines Dispensing and Distribution (CCMDD) strategies, and should give inputs in the transportation of medicines from other countries to maintain the cold chain and medicine stability. So many gaps exist, and this should be addressed.

The general public is familiar with doctors and nurses, but they are not fully aware of what pharmacists do and some do not consider pharmacy as part of the healthcare sector. In some instances, people may use community pharmacies as a shortcut to get medication if they cannot afford consultations.

How do you stay up to date with new medical trends and information?

I attend health training sessions and do lots of reading on Department of Health guidelines, research articles, and package leaflets of generic drugs. In my field, doing research on new conditions or diseases and always reading public health websites is a crucial part of a Pharmacist's professional development. The benefit is that it creates self-confidence.

What's your biggest career highlight thus far?

After completing my Honours Degree in Pharmacy, I was unsure which field to choose within pharmacy. Working for a non-governmental organisation has assisted in directing me to aspire to further my studies. I have developed an interest in HIV/AIDS and TB management as the leading disease burden in our country. I am currently doing my Master's degree to gain more insight into public health challenges and how to overcome challenges in my current role as a Pharmacist working for HST. 

Take us through a typical day at work

My work involves data interpretation in the Dablapmeds programme / differentiated care model as a vehicle for medicine accessibility and adherence. I support the uMgungundlovu District's facilities and Dablapmeds external pick-up points in ensuring service delivery, capacitating prescribers in utilising the available systems, and following standard operating procedures guided by DoH guidelines. I also support HST's Mobile Pharmacy services and Pelebox innovations, and attend to patient queries at the district level.

What's your take on ethical behaviour in your field?

An individual decides to maintain professional responsibility in adhering to ethical standards of pharmacy and upholding the code of conduct and regulations. Prioritising patients' needs and interests should be top of mind, treating all patients fairly, with integrity, and reserving judgements and personal beliefs.

How do you spend time away from work?

As a family-orientated person, I believe in quality time with my family and church. But this year, I have a lot of studying which is taking up most of my time. However, when I do get the time, you will find me out and about with my family or in church.

What inspires you?

Waking up every day to fight for a better future.  Achieving set goals and overcoming obstacles. Doing good in people's lives and staying true to myself.

How would you advise someone who wants to pursue a career in pharmacy?

They must work to obtain good results in Matric. Competition for university entry is very high, so it's in their best interest to work extra hard. They must do research about pharmacy before applying, and decide if they have a passion to become a Pharmacist and, mostly, they must fall in love with the career. The academic context is huge, but manageable if you put in the extra effort. It is also important to do research on approved institutions which offer pharmacy.

 


May 09
HIV ends with me – integrating U=U evidence into HIV service delivery

by Willemien Jansen and Judith King – Copy and Content Editors, and Siyabonga Gema – Communications Officer


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Being diagnosed as HIV-positive is no longer a death sentence.

In fact – with adherence to modern antiretroviral therapy (ART) – it is regarded as a chronic medical condition that can be well controlled, and it is possible for a person's viral load to be so low that HIV cannot be transmitted to someone else.

Based on several studies showing that there is no risk of HIV transmission from virally suppressed patients to HIV-negative partners, the global concept of sustained viral suppression is known as 'Undetectable = Untransmittable' or 'U=U'.

What is viral load?

Viral load is the amount of HIV found in a person's blood. This can be checked by doing a viral load test. Viral load is measured by testing the number of viral particles – or 'copies' ‒ in each millilitre (copies/ml) of a small sample of blood. Taking ART medication correctly every day lowers the viral load to the point where it cannot cause harm to the patient and it cannot be passed on to anyone else. This is known as viral load suppression.

What is undetectable?

When the results of two consecutive viral load tests taken over a period of six months show that a person has 50 copies/ml or less of HIV in their blood, their viral load is defined as undetectable. This can be achieved by taking one's treatment every day as prescribed, because the medication is so effective that the virus cannot reproduce to infect new cells in the body. It may take a little longer for some people to reach this level, but it is possible to achieve an undetectable viral load within six months.

It is important to remember that the virally suppressed person is still HIV-positive, as ART cannot cure HIV altogether. 'Resting' or latent HIV cells remain in the body, and the virus will begin to reproduce itself again if the person stops taking ART. This is why it is essential for a person living with HIV to remain on ART for life, so that sustained viral suppression keeps their immune system strong, and they can live as long as someone who is HIV-negative. 

What is 'untransmittable'?

'Untransmittable' means that virus cannot be passed on to another person or unborn baby through blood or sexual fluids. HIV is still present in a person's body, but there is too little of it for onward transmission.

Focusing on the proven option of treatment as prevention and the science of U=U can reduce HIV-related fear and stigma, make disclosure of one's HIV-positive status easier, and move us towards achieving HIV epidemic control.

HST's programming supports U=U as a public health campaign

Through the SA SURE PRO project and in partnership with the Department of Health, HST is supporting implementation of the U=U approach as a feature of all stages of HIV service provision and related technical assistance for case management.

Planning for this implementation began in mid-2021, and was built around the project's key objectives of ensuring optimal HIV case-finding and treatment enrolment, ART adherence, and continuity of care to achieve and maintain viral suppression.

At that point, data from the Ritshidze Project indicated that no more than 65% of patients understood the relevance of viral load suppression to HIV transmission, so the team also centred on ways to support patient and provider literacy, with healthcare workers using the U=U messaging as a powerful counselling tool to encourage treatment adherence and create demand for regular viral load monitoring among couples and individuals.

Based on diligent record-keeping and data analysis, and through collaboration with pharmacy staff and community caregivers, our teams working in facilities and communities are continuously tracking and tracing patients who have missed their clinical appointments and medication collection, which flags the risk of treatment interruption. Various return-to-care interventions ‒ such as the 'Welcome Back' strategy, enhanced adherence counselling, and intensified application of the Case Management Model II ‒ are deployed as needed.

Rigorous data reporting on sites needing urgent action for retention of patients on ART is undertaken to ensure that return-to-care targets are met in all four of the project's supported districts.

Our training and post-training mentorship programme, along with site support provided jointly by pharmacy, case management and clinic‒laboratory interface teams, incorporates multiple modules for every aspect of patient-centred HIV care.

SA SURE PRO project teams are partnering with civil society to actively disseminate accurate U=U information and contextually appropriate messaging. In so doing, they caution virally suppressed patients that although condomless sex will not result in HIV transmission, having an undetectable viral load does not provide protection from other sexually transmitted infections or pregnancy.

As a PEPFAR Implementing Partner, HST is committed to contributing to the rapid and widespread uptake of U=U, which has generated a new momentum for South Africa's HIV response and an improved quality of life for people living with HIV.

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Dr Thembisile Xulu – Chief Executive Officer of the South African National AIDS Council (SANAC) – reiterated at the national U=U launch that if an HIV-positive person adheres to treatment, they can achieve and maintain viral load suppression and not transmit the virus.

The National Minister of Health, Dr Joe Phaahla, led the official national U=U launch on Tuesday, 7 May 2024 in the uThukela District of KwaZulu-Natal. The launch saw representatives of national and provincial government, civil society organisations and the People Living with HIV sector come together to rally behind the science-based message that a person with HIV who adheres to treatment achieves an undetectable viral load and cannot transmit HIV sexually.

At the launch, the community of KwaDlamini in Ward 12 of Ntabamhlophe, Estcourt, interacted with health professionals from the Department of Health and non-governmental organisations who engaged them on the importance of knowing their HIV status, starting treatment if diagnosed as HIV-positive, and remaining on treatment.

In her address to the audience, Dr Xulu rebutted the popular notion that people who are HIV-positive are responsible for the spread of HIV. She explained that it is those who do not know their status, and are not aware that they need to be on HIV treatment, who run the risk of transmitting the virus through unprotected sex. Importantly, she pointed out that U=U is not only a tool to help lower the rate of HIV infections, but also to address the issue of stigma.

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A multisectoral response saw HST Outreach Teams joining other community-based providers offering HIV literacy, health education and HIV testing and counselling services at the launch.

Apart from encouraging community members to know their status, part of the launch engagement entailed educating the public that despite being on HIV treatment, people still need to use protection as a preventative measure for sexually transmitted infections (STIs).

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The U=U launch was preceded by the launch of 'Zikhala Kanjani' on 26 April 2024 in Richmond, uMgungundlovu District. This national communications campaign aims to increase the reach and quality of HIV prevention services for young people.



May 08
Mental illness stems from abuse in women

​By Willemien Jansen (HST Copy and Content Editor)

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Both men and women suffer from mental illness, but the reasons are very different.

Even though men are more likely to die by suicide due to unemployment, occupational issues, divorce and adverse childhood experiences, women are more likely to suffer from mental health issues due to abuse.

South Africa has the greatest number of reported incidences of violence against women worldwide; approximately one every six hours. One in four men have committed sexual offenses, while 40% have physically abused their partners. Violence against women is on the rise, with up to one in four women reporting that they have been beaten or subjected to abuse, even if only 2% of cases result in charges being brought. According to a study conducted by the Royal College of Psychiatrists, psychiatrists in the UK feel that, in large part because of their experience treating patients, violence and abuse are the main causes of mental illness in women and girls.

The majority of respondents (59%) say violence and abuse are contributing to mental illness in their female patients. This was closely followed by relationship issues (49%), often caused by coercive behaviour, and home and family pressures (48%), which also cause significant harm. Another issue that was mentioned as a frequent problem for female patients was isolation or loneliness (24%). Feelings of loneliness are a common problem for many persons with mental illnesses, but they are made much worse if they are being abused.

Women are not just abused physically, but also sexually and emotionally. "Not all abuse is physical – psychological abuse also causes extreme harm and casts a long shadow over victims. We need to identify and respond to trauma if we are to reduce the likelihood of women and girls developing mental illness," says the study. Dr Katherine Durkin, joint presidential lead for women and mental health at the Royal College of Psychiatrists, goes on to say that "sexual violence impacts on mental health in all genders. But these experiences are unfortunately much more common in girls and this plausibly contributes to higher rates of mental health difficulties in girls and women." Emotional abuse is harder to recognise than physical abuse because there are no physical scars, but the effects can be just as profound. Tactics of emotional abuse include gaslighting and shaming, which can leave the victim feeling helpless, hopeless and powerless.

Emotional abuse has serious effects on the victim's mental health. These include:

Short-term effects

  • isolation and loneliness
  • self-doubt
  • shame
  • confusion
  •  low self-esteem
  • fear when interacting with others
  • avoidance of activities related to the incident
  • feelings of powerlessness


Long-term effects

  • mental health conditions
  • neuroticism, or the tendency toward low mood and negative emotions like anger
  • chronic stress
  • physical health challenges like body aches and heart palpitations
  • attachment challenges
  • emotional disconnect or apathy.


Abuse can cause a range of different mental illnesses, including anxiety, depression, substance use disorder, eating disorders and post-traumatic stress disorder (PTSD). Symptoms can be even more serious: "Tragically, it is not uncommon for female patients to experience long-term abuse that causes serious symptoms, including suicidal ideation or symptoms of psychosis," said Dr Durkin.

To reduce mental illness in women, we need to reduce the abuse that they suffer. According to the United Nations there are 10 things that everyone can do to help reduce abuse amongst women. These are:

  1. Listen and believe survivors
  2. Teach the next generation and learn from them
  3. Call for responses and services fit for purpose
  4. Understand consent
  5. Learn the signs of abuse and how you can help
  6. Start a conversation
  7. Stand against rape culture
  8. Fund women's organisations
  9. Hold each other accountable
  10. Know the data and demand more of it


If you or someone you know is being abused, call the Stop Gender Violence Hotline on 0800 150 150 or visit the Life Line website at https://lifelinesa.co.za/



May 08
OPINION: Women’s Health: The Right to Proper Health Care

By Antoinette Stafford Cloete (Health Systems Trust: Communications Manager) and Siyabonga Gema (Health Systems Trust: Communications Officer)

womens health by ASC.jpg

Photo credit: UN/Photo (Sylvain Lietchti)

Over the next few weeks we will examine a variety of health-related topics in a series on women's health, including menopause, puberty, pregnancy and childbirth, cancers that affect women, violence against women, and the potential applications of artificial intelligence in improving the health of women at a human rights interface.

As we close out Human Rights month in South Africa we reflect on how far we have come with regards to human rights in health.

The COVID-19 pandemic certainly confirmed what was long known, but never adequately addressed: women's health concerns are not as important as those of men. Caroline Criado Perez compiled a number of statistics in her book "Invisible Women: Exposing Data Bias in a World Designed for Men" that demonstrate the unequal treatment of women. She has argued that the data shows that "healthcare is systematically discriminating against women, leaving them chronically misunderstood and misdiagnosed".

In a paper presented at the International Conference on Reproductive Health in Mumbai, India, in 1998, jointly organised by the Indian Society for the Study of Reproduction and Fertility and the UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction, the author Dr Carmel Shadev outlines a departure from previous models of healthcare for women where they were merely tools without agency with regards to population development to a distinct emphasis on women's empowerment and individual needs, as well as the development of a growing body of knowledge regarding the relationship between health and human rights that connects novel ideas about health to the fight for social justice and respect for human dignity.

The United Nations Sustainable Development Goal 5: Achiev[ing] gender equality and empower[ing] all women and girls sets a number of targets towards creating gender equality by 2030 which they now admit may not be met, but hope to create inroads. These are to:

  • end all forms of discrimination against all women and girls everywhere;
  • eliminate all forms of violence against all women and girls in the public and private spheres, including trafficking and sexual and other types of exploitation;
  • eliminate all harmful practices, such as child, early and forced marriage and female genital mutilation;
  • recognise and value unpaid care and domestic work through the provision of public services, infrastructure and social protection policies and the promotion of shared responsibility within the household and the family as nationally appropriate;
  • ensure women's full and effective participation and equal opportunities for leadership at all levels of decision-making in political, economic and public life;
  • ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences;
  • undertake reforms to give women equal rights to economic resources, as well as access to ownership and control over land and other forms of property, financial services, inheritance and natural resources, in accordance with national laws;
  • enhance the use of enabling technology, in particular information and communications technology, to promote the empowerment of women; and
  • adopt and strengthen sound policies and enforceable legislation for the promotion of gender equality and the empowerment of all women and girls at all levels.


In South Africa, the right to quality healthcare is enshrined in our constitution and stipulates that it is a basic human right accorded to all citizens of this country with further emphasis placed on sexual and reproductive health rights in Section 27. The provision of health services, especially for women, is therefore a crucial enabler in recognising and upholding the South African Constitution.

We can thus see that the conversation around women's health and their right to access has been ongoing, at least since the first public health conference held in 1978 in Alma Ata (in Kazakhstan) which didn't explicitly state the rights of women vis-à-vis access to healthcare, but does mention in the Declaration that resulted from this gathering that "people have a right and duty to participate individually and collectively in the planning and implementation of their health care".

A quick Google search for [women's health] will surface the more current debates raging around women's access to health care and the disparities that exist between investments in men's health against that of women.

Over the next few weeks we will look more closely at these issues and will include information on the work we do as an organisation to be enablers of health equity through our various health programmes that support women, in particular.

For comments or questions do email us at: communications@hst.org.za




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