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May 05
The case for midwives in South Africa. Is midwifery prioritised enough?

By: Joan Dippenaar (Technical Advisor: Health Systems Training Institute and Specialist Midwife)

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All South African midwives are trained as general nurses and midwives, and are seen as nurse- midwives, able to work in any healthcare setting. They form an integral part of South Africa's healthcare system, meaning that a woman will see a midwife at any stage of her pregnancy, right through to giving birth and to the post-natal period.

Skilled attendance (Defining skilled attendant: joint (WHO/UNFPA/UNICEF/World Bank statement 1999)  is the golden standard for maternal healthcare. And not all registered midwives in South Africa have developed the level of proficiency that meet this standard, with inequity in the context between the private and public sectors in service availability and quality.]

Midwives are the sole providers of maternal care in pregnancy and birth worldwide. As the International Confederation of Midwives celebrates International Day of the Midwife on 5 May, it is indeed time to reflect on the value of the midwife in a healthcare system by looking at the data and investing even more in midwifery as probed by the theme for 2021. 

To reduce the risk of problems when giving birth, women should be attended to by a skilled professional. A first study of its kind to be conducted in the country, the South Africa Demographic Health Survey (SADHS) of 1998 indicated that only 3 in 7 women in the public sector see a medical doctor once in pregnancy and birth. South Africa has an attendance skills level of 94% meeting the required international standard for maternal health but has not been able to reduce the maternal mortality to reach the set acceptable level for quality of care in birth and new-born care yet.

Although the 2012 Reproductive and Maternal Child Health Services (RMCH) programme and continued efforts made a difference since it was successful in many areas to improve maternal health outcomes, the Saving Mother's report 2016 still identified areas to be improved in clinical care with special reference to maternal deaths related to hypertensive disorders in pregnancy and still births. Overall the quality of maternal care is hampered by health system factors, equity issues and human resource challenges with reference to midwifery care and a supportive environment. In 2016 the skilled provider attendance was unchanged from 1998 (94% and 95%, respectively), but there have been changes in the types of antenatal care (ANC) providers. In 1998 about 33% of women were seen by a medical doctor, once in pregnancy and birth in. In 2016, 17% of women received ANC from a doctor and 77% from a nurse or midwife (SADHS 2016). 

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Visit the SACsoWAch website: https://www.sacsowach.org/index.php/who-we-are

The midwife is the key person to deliver qualitative, comprehensive, lifesaving care for the mother and baby in all the stages of pregnancy, birth and aftercare.  It is time to have a hard look at the data in South Africa and take stock of the global crisis of midwifery also reported by the president of the Society of Midwives of South Africa (SOMSA), Dr Elgonda Bekker. The questions asked are:

  • Does South Africa have enough midwives in the healthcare system? 
  • Are they sufficiently trained for their independent role?
  • Is the healthcare system supportive with an effective back-up system of skilled medical doctors? 

South Africa needs to follow the data on the provision of midwives for the future, but also investigate whether the healthcare system is midwife and mother friendly, and supportive. Without competent midwives in a competent healthcare system mothers and babies will suffer.

An important article by the Mail and Guardian highlighted how Midwives are the backbone of maternal health systems, and today, this is the State of the World's Midwifery 2021. Also see this information recently published by the Royal College of Obstetricians and Gynaecologists for healthcare professionals regarding Coronavirus (COVID-19) Infection in Pregnancy.  




Apr 29
Systems thinking: How an innovative idea boosted the CCMDD patient return rate at Reservoir Hills Clinic

​By: Presha Gopaul (Post-Basic Pharmacist Assistant), Nonhlanhla Sithole (Pharmacist), and Roma Ramphal – CCMDD Provincial Co-ordinator, KwaZulu-Natal

Since the Central Chronic Medicines Dispensing and Distribution (CCMDD) programme was launched in eThekwini in 2016, many challenges have been identified and resolved through system and process changes. However, a persistent challenge has been the return of CCMDD patients to facilities for clinical review.

That is, until now. 

Patients who do not attend a clinic in due time for their medical check after collecting their medicine parcels at an external pick-up point run the risk of being de-registered from the CCMDD programme, because missing a clinic appointment is likely to be a sign of treatment interruption.  A person's chronic illness has likely not been managed, and so their health becomes clinically unstable.

During the last few months there was a significant spike in the number of patients who had missed their scheduled CCMDD review dates and this is of great concern. This could be because patients lose or forget to check their CCMDD Collection Cards, or are unable to get time away from work.

CCMDD patients receive a reminder SMS from the service provider, Pharmacy Direct, generated by SyNCH (the CCMDD electronic system) to remind them of their medicine parcel collection date – but no SMS reminders are issued about returning to the clinic for a check-up and prescription renewal.

Many patients rely on Pharmacy Direct's reminder message for collection of their medication, because it reassures them that their parcel is ready and waiting at the pick-up point. Why not apply the same concept for patient review and prescription renewal?

https://www.hst.org.za/PublishingImages/Presha%20Gopaul%2C%20an%20HST%20Post-Basic%20Pharmacists%E2%80%99%20Assistant%20at%20Reservoir%20Hills%20Clinic.jpgPresha Gopaul, an HST Post-Basic Pharmacists’ Assistant at Reservoir Hills Clinic, came up with anovel idea to introduce a system of bulk SMS reminders to patients alerting them to the dates of their clinical review appointments. 

Presha used SyNCH to extract the 'Expected Patients Return Report', which lists patients' appointment dates for prescription renewal. For three consecutive weeks (between 15 March and 2 April 2021), Presha used her personal cellphone with her own data bundles to send SMS reminders in isiZulu and English to the listed patients.  

Of the 101 patients who were sent SMS reminders, 82% visited the facility for review.

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Screenshot of a bulk SMS

Patient interviews were conducted in the third week of the trial period to determine whether the reminder was helpful. Of the 15 patients interviewed, 11 patients received the SMS and found it helpful and 13 patients confirmed that they would like to receive the reminder SMS routinely.

Patient Gina David said:

"I was excited to receive a reminder SMS. I would like to continue receiving the SMSs because sometimes I forget my clinic date or misplace my clinic card and do not remember my date. It also gives me a sense of feeling that the facility staff cares about my well-being. The SMS has also made it easier for me to request leave from my employer to attend the clinic."

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Patients received the SMS and returned on their scheduled date.

The initiative is successful because patient care is continued and maintained, and they also feel a sense of belonging. Patients are motivated to take charge of their own health and return to the facility timeously.

A special thanks to Reservoir Hills Clinic Nursing Services Manager, V A Francis, for allowing Presha and Nonhlanhla Sithole, the supporting Pharmacist, the opportunity to implement this strategy. 

With the assistance of the SA SURE Plus Programme, there is a plan to extend this strategy to all HST facilities in HST's supported districts in KZN. 








Apr 21
ABAQULUSI ARE DOING IT FOR THEMSELVES

By: Judith King  (Copy and Content Editor: SA SURE )

Sakhisizwe Community Development Organisation is a community-based organisation based (CBO) in KwaMnyathi (Vryheid) – formerly a mining area in Zululand District. Due to closure of the mines, 85% of residents are now unemployed, and with limited skills, people were left to fend for themselves.

There has been a noticeable rise in HIV infections in KwaMnyathi, where traditional culture has undermined disclosure due to the stigma associated with HIV which, in turn, makes continuity of treatment challenging. Sakhisizwe was contracted by the Health Systems Trust (HST) to set up adherence clubs for four facilities in the Abaqulusi Sub-district.

Sakhisizwe's first step was to adopt a strategy for recruiting patients newly initiated on antiretroviral therapy (ART) into treatment support groups. This intervention was implemented to create a good relationship between Sakhisizwe Facilitators, patients and community members. In this way, the CBO formed a pool of people who could be supported in their treatment journey towards qualifying for membership of adherence clubs.

The National Department of Health's Central Chronic Medicine Dispensing and Distribution (CCMDD) programme – also known as DablapMeds – enables patients who are stable on their medication to avoid costly and inconvenient clinic visits every month by collecting treatment at their chosen pick-up point outside the facility. HST runs an awareness-creation campaign focused on CCMDD in eThekwini called Get checked. Go collect in support of the NDoH and Dablapmeds.

Adherence clubs offer this collection option, along with a welcoming space in which patients can meet to receive advice on and discuss their adherence challenges and other issues related to health and wellbeing with their peers. This system also relieves the burden on health facilities, shortens the queues for those who have to attend the clinic, and supports prevention of COVID-19 infection.

The CBO also markets the adherence clubs to stakeholders in Operation Sukuma Sakhe ('stand up and build') War Room gatherings and Traditional Council meetings. The aim of these presentations is to foster a clear understanding of the clubs' purpose and the important role that they play in helping people living with HIV to remain virally suppressed. 


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The Sakhisizwe CBO team

Working hand-in-hand with the facility staff (Operational Managers, CCMDD Champions and HST team members), Sakhisizwe has formed 23 adherence clubs as at March 2021.

One of Sakhisizwe's four allocated facilities is Vumani Clinic, situated approximately 38 kilometres from Vryheid. Despite it being a small facility, nine adherence clubs have been established. Recruiting was supported by Vumani Clinic staff, War Room delegates, the CCMDD Champion, and Traditional Council leaders. HST provided training and support for facilitation of these clubs.

Participation in the clubs has generated a positive change in the members' lifestyle, as the patients are now applying the guidance they receive to make healthy choices and find ways of adhering to treatment. Those whose treatment is interrupted are easy to trace and return to care. Also, more people are willing to be a part of adherence clubs, as word has spread that medication can be collected closer to their homes and health education assists patients in disclosing their HIV status.

Nozipho Khuzwayo, one of the Club Facilitators from Mason Street Clinic, shares that although the venue for Lakeside (an urban and semi-urban area) is Lakeside Hall and patients are positive about their adherence club membership, they prefer to collect their medication from the facility. "This has taught me to accommodate their wishes and to respect their choice of pick-up point," she says. "When they arrive at the clinic, they are directed to me for this service and I am happy to observe the grace period for collection."

Nozipho also applauds the Community Health Workers for their assistance in tracing patients who do not arrive to collect their medication. "Their knowledge of the households is invaluable for supporting patients' continuity of treatment." 

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Project Manager of the Sakhisizwe Community Development Programme, Mrs Phumzile Doris Zulu.

The lesson learnt in this process is that success is ensured through the integrated approach of working with key stakeholders – fieldworkers, community structures, government officials, businesses and civil society – who share a commitment to helping people live healthy lives.



Apr 16
HST's HIT team footprint across South Africa

​By: Magrieta Liebenberg (Project Manager: Health Systems Strengthening)

The Health System Trust's Health Information Technology (HIT) team, managed by Health Systems Strengthening (HSS) Programme Manager Rakshika Bhana and HSS Project Manager Marieta Liebenberg, celebrates its sixth year of service provision to the National Department of Health (NDoH).

Since June 2015, the HIT team has been supporting roll-out of health information systems in public health facilities with specific reference to the Health Patient Registration System (HPRS) across South Africa. Having been seconded to the National Health Insurance Information Systems (NHI-IS) Programme Office led by Milani Wolmarans and Pierre Fabe, these colleagues continue to fly the Health Systems Trust (HST) flag at great heights.

Starting with 13 members, the HIT team rendered support for implementation of RxSolutions in various provinces. RxSolutions is an electronic pharmacy management system designed to prevent drug stock-outs, minimise expired stock, and dispense medication to patients. HST's implementers not only installed and configured RxSolutions at public health facilities, they also built partnerships with District Pharmacists, District Information Officers and facility staff, and assisted with establishing databases for the different levels of care, checking data quality and ensuring accurate data entry.

The team now has a complement of 43 personnel, representing HST in eight provinces and 46 districts. These capable and committed technicians ensure quick turnaround on a range of sub-projects at all levels of the health system for continued assistance to the NDoH to implement, maintain and support health information systems. Focusing on implementation of the Health Patient Registration System (HPRS), they attend to facilities' service tickets and numerous ad hoc maintenance requirements, as well as train and mentor staff on health information processes and systems.

"Our staff have been resilient in responding to changes on demand and understanding clients' frustration when systems are failing, because we are committed to reaching our deadlines," observes Marieta. "I believe that the success of the group depends on the success of each individual member, so team support is vital."

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The HIT team took strength from a team-building moment during their meeting at the Hotel Midrand in September 2020 when they took on the Jerusalema Dance Challenge.

The onset of COVID-19 has necessitated the full development and implementation of tool-sets by Braam Steenkamp, who is the HIT team's Technical Manager and a full-time employee of HST and seconded to NDoH, to assist with COVID-19-related processes and reporting at hospitals and clinics. The team is providing second-level support and where required, supports the use of the Electronic Vaccine Distribution System (EVDS) at hospitals.

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The HIT team successfully prepared this vaccination site at Charlotte Maxeke Hospital in Parktown, Gauteng.

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The first vaccination at Abraham Esau District Hospital in Calvinia, Northern Cape.

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Having set up systems for COVID-19 vaccination points and observing the jabs in action, team member Philani Shange noted that doctors are also scared of needles!

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EVDS self-registration at Inkosi Albert Luthuli Hospital in eThekwini, KwaZulu-Natal. 

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Vaccination room at the Nelson Mandela Academic Hospital in Mthatha, Eastern Cape. 

Although the work of the HIT team is highly technical, the essence of this project is the group of people implementing vital technology to serve a whole population. As Dr Neil Malan from the Phoenix Trial Centre in Gqeberha commented recently, the HIT technicians take professional pride in their work.

The HIT team's history of success in this regard constitutes an indispensable resource for the NDoH that is standing the test of time.

Apr 13
Community education in Pongola spotlights HIV transmission, care and treatment

By: Lunga Memela (Communication Officer) 

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Clinic Operational Manager, Sr Samaria Simelane, performs a song and dance to de-stigmatise HIV before her address.

Cultural nuances and a level of shyness and discomfort about discussing the realities of sex usually derail communication on this topic between parents or guardians and their young and adolescent children. However, if we want to see local communities striving for healthier, more prosperous futures, it is time for honest and open intergenerational discussions about HIV transmission, treatment and care, and the often overlooked implications of poor family planning. 

This reminder emanated from a recent Community Dialogue held with young and old residents of Pongola – a small town in northern KwaZulu-Natal Province, situated only 10 kilometres from the eSwatini border. Co-facilitated by staff from the Itshelejuba Gateway Clinic and Health Systems Trust (HST), this community education session took place at Inkosiyethu Crèche, near the Itshelejuba District Hospital, which is home to the clinic.

Through technical assistance (training, mentoring and coaching) and supplemental support, HST's SA SURE Plus project strengthens local capacity to provide sustainable HIV and tuberculosis (TB) care and treatment services in South Africa's public health system. Funded by the Centers for Disease Control and Prevention (CDC) through the U.S. President's Emergency Plan for AIDS Relief (PEPFAR), the project supports the provincial, district and facility Department of Health (DoH) staff and communities in four PEPFAR focus districts in KwaZulu-Natal (KZN) Province, namely eThekwini, uMgungundlovu, uThukela, and Zululand. 

Itshelejuba Gateway Clinic treats a host of patients from within the province and near the eSwatini border, which is often a challenge for healthcare workers conducting HIV contact tracing and promoting treatment adherence. Sir Busangani Nhlabathi explained that the range of health services rendered at the two Itshelejuba facilities encompasses counselling, testing and treatment for HIV and sexually transmitted infections; promoting HIV pre-exposure prophylaxis (PrEP) and medical male circumcision; nutritional monitoring and care for minor ailments; women's health and family planning; maternity and postnatal care; adolescent and youth services; emergency services; and screening for and management of multidrug-resistant TB.

Despite these offerings, there is low throughput of patients in the facilities, which causes major concerns, not just about HIV care and treatment, but also the collection of and adherence to various treatment regimens. For example, women who have discovered that they are pregnant do not visit the clinic to receive the necessary services for maternal and child health, particularly to curb mother-to-child transmission of HIV. 

To understand this problem, HST's Community Co-ordinator, Mzikazi Masuku, led a conversation to probe the perceptions and misconceptions that lead people to delay visiting the clinic or hospital, even when protection of their health requires medical attention. The facilitators raised issues such as HIV transmission and unplanned pregnancies in an entertaining, interactive manner, designed to engage the participants of all generations in open and constructive discussion.

It surfaced from these community members that there was low awareness of and misinformation about the services available at the health facilities – notably the Family Planning options and HIV programming available. They shared that family dynamics tend to cause fear, shame, judgement and embarrassment when it emerges that young family members are sexually active. 

Most of those attending the dialogue were not aware that antiretroviral therapy (ART) is promoted and widely available to prevent sexual transmission of HIV. Young girls want to be on contraceptives but feel that they would be judged by the local nurses if they are seen to be sexually active. Most women are unable to negotiate condom use with their partners, and when individuals contract illnesses such as TB, the symptoms are often attributed to witchcraft instead of seeking expert medical opinions. The list of misconceptions is expansive. 

Findings from the Community Dialogue were presented by a range of men and women in all age groups, to stimulate fair and open discussions on matters presented. Clinic Operational Manager, Sr Samaria Simelane, spoke frankly, taking note of all patient concerns. She encouraged the participants not to fear or perpetuate stigma around HIV and sexual activity – which all agreed was born of a lack of accurate information and support – and urged them to come to the clinic or hospital for expert advice.

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A dialogue participant gives feedback after a group discussion on PreP and family planning.

The participants were encouraged to know their status (be it for pregnancy or HIV) and to receive help promptly. "Pregnant women must come to the clinic as soon as they are aware that they have conceived a baby," Simelane advised. "We can live long lives! We need to give girls and boys a chance to finish their schooling and pursue their desired careers. Eat healthily and take very good care of yourself." 

Attendees were left fully aware of the importance of maternal and child health, the need to prevent HIV transmission by every means necessary, and to always adhere to medication. They were reminded that stigma about HIV is grounded in old and false understandings of untreatable illness that must be dispelled. 

Further community engagement will continue through HST's partnership with the local Department of Health. With around 166 000 people in South Africa newly infected with HIV during 2020 (as estimated by the Thembisa Model), this clinic–community connection is urgently needed.


Apr 08
DREAMS Project launched by eThekwini Mayor at iNanda on World Health Day

By: Lunga Memela (Communications Officer) 

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The Mayor of eThekwini, Cllr Mxolisi Kaunda, was proud to launch the PEPFAR-funded DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe) initiative which targets young and adolescent girls aged between 10 and 25, today at Amaoti and the greater Inanda township of Durban this World Health Day, 7 April 2021.

The Inanda, Ntuzuma and KwaMashu (INK) areas of eThekwini record the highest HIV statistics in KwaZulu-Natal, which is the epicentre of the AIDS pandemic in South Africa. Of grave concern is that gender-based violence, sexual assault, unwanted pregnancies and HIV transmission is rife amongst the targeted young and adolescent girls, who continue to be abducted and engage in transactional sex with older men, and later spread the virus to young males of their age group. "The situation is dire and needs to be nipped in the bud," explained the mayor and other speakers, who said in unison that the time to act is NOW!

The Mayor urged the Department of Health to help improve the situation by reporting underage pregnancies to the police so that perpetrators can face the full might of the law. 

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Caption: "ENOUGH is ENOUGH," says the Mayor of eThekwini, Cllr Mxolisi Kaunda.

Kaunda stressed the need for community men's forums that can address all the gender-based and socio-economic ills that are knitting HIV transmission into the city's social fabric. He said, "We must fight against any stigma and continue to support those living with HIV and AIDS," adding that community structures and government will lend a useful hand in supporting initiatives such as the DREAMS programme.

Young girls from a variety of local schools attended the launch. As if it was not enough to be hosted by surprise programme director and popular Isibaya actress, Lerato Mvelase, in came Miss South Africa, Shudufhadzo Musida, who stayed for the duration of the programme and encouraged the girls to love themselves, to dream big, and to always protect their physical and mental wellness.

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Caption: Miss South Africa, Shudufhadzo Musida, motivates the learners to DREAM BIG, to always love and protect themselves!

Also in attendance was Durban's Miss HIV Ambassador, Londeka Ngcongo. A plethora of strong female role models addressed the auditorium – all in absolute favour of the DREAMS programme. The learners also heard from dignitaries from the Departments of Health and Education.

The learners were given a chance to tell the Mayor about the constant challenges they face. These include being asked out, harassed and raped by older men. All they really ask is for their youth not to be taken away from them. They want to go to school, dream big and make it to university AIDS-free and without having being raped or ending up with unwanted pregnancies. Soon after they were led by the Mayor in pledging for a brighter future and steering away from experimenting with drugs and older men.

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Caption: Isibaya actress, Lerato Mvelase, facilitates as the learners tell the Mayor about the constant challenges they face within the community.

Several entities collaborated to make the event a success. There was plenty of on-stage entertainment, the learners received food and sanitary packs.  The Health Systems Trust felt privileged to support the eThekwini Mayor's Office and PEPFAR with the launch of DREAMS.

The DREAMS initiative is supported by the United States President's Emergency Plan for AIDS Relief (PEPFAR), the Bill & Melinda Gates Foundation and Girl Effect.







Mar 19
World Down Syndrome Day: Care, collaboration and a holistic approach to living with disability

​By: Lunga Memela (Communications Officer) 

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This Sunday, 21 March, the globe commemorates World Down Syndrome Day (WDSD) as dubbed by the United Nations and celebrated annually since 2012. Very few people know that this day (the 21st of the third month) was specifically chosen to signify the uniqueness of the 'triplication' (trisomy) of the 21st chromosome in the human body which causes the condition, Down syndrome, according to Down Syndrome International (DSI).

Chromosomes R Us is a short film by actors with Down syndrome explaining how Trisomy 21 occurs – made by Shabang Inclusive Learning in collaboration with Mediapreview, Huddersfield, UK – and funded by BBC Children in Need.

DSI explains that the condition is a naturally occurring chromosomal arrangement that has always been a part of the human condition, being universally present across racial, gender or socio-economic lines in approximately 1 in 800 live births, although there is considerable variation world-wide. "Down syndrome usually causes varying degrees of intellectual and physical disability and associated medical issues," the organisation explains.

Down syndrome is only one of many disabilities that exist. Increased awareness about young and old persons with disabilities should be created, and this does not exclude their parents and caregivers. "Persons with disabilities depend greatly on the willingness and ability of their families to adopt unexpected informal caregiving roles," according to a chapter authored by Noreth Muller-Kluitsi and Ilze Slabberti, published in the latest edition of the Health Systems Trust's flagship publication, the South African Health Review

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The authors highlight the need for a holistic approach to care, foregrounding the significant role that the social workers also play in addressing the caregiver burden in families of persons with disabilities. "Parents usually have high aspirations and dreams for their children, but when they discover some anomalies in their new-born child, other emotional experiences can arise, such as guilt based on the belief that they caused the child's disability through genetics, alcohol misuse, or stress. When a person acquires a disability later in life, the adjustment must be made by both the individual and the family. This adjustment is ongoing, with feelings of sorrow alternating with despair and acceptance. Persons with an acquired disability alternate between acknowledging their 'pre-disability' and 'new disability' identity."

The study explores factors such as policies guiding service delivery to persons with disabilities in South Africa, social work and disability, and families as caregivers of persons with disabilities in the country. The authors make noteworthy recommendations which, if implemented successfully, will not only benefit persons with disability but also their caregivers, public health policy, issues of access to healthcare and overall human wellness. 

Our country is privileged to have Down Syndrome South Africa (DSSA). The organisation is committed to finding ways to improve the quality of life of all persons with Down syndrome and other intellectual disabilities, promoting the idea of inclusivity and that they have the right to live with independence, dignity and security as valued adults and full citizens in our society. It endeavours to empower families through dissemination of information, and encourages research in the fields of early intervention, education, medical aspects and employment. Its ongoing mission is to bring South Africa in line with world trends in the field of Down Syndrome and to see to it that the UN Convention on the Rights of People with Disabilities (UNRPD) is recognised and honoured in all spheres.

Down Syndrome International have produced this Easy Read fundraising guide: https://workdrive.zohoexternal.com/external/8CkAlci0dp8-Jxfap

 



Mar 19
Happiness in a time of isolation

​By: Willemien Jansen (Copy and Content Editor)

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The International Day of Happiness was first celebrated by the United Nations on 20 March 2013 and was instituted to recognise the importance of happiness in our lives.

The General Assembly of the United Nations recognised the importance of happiness and well-being as something that all human beings aspire to. It is a day to be happy, but also one to acknowledge the world-wide need for a more "inclusive, equitable and balanced approach to economic growth that promotes sustainable development, poverty eradication, happiness and the well-being of all people."

There has always been a yearning for a sense of belonging, comfort and security that is universal and manifests in concepts such as Hygge or Gemütlichkeit.

During the past year, due to the COVID-19 pandemic and the social distancing and isolation that it has caused, we may need to redefine "happiness" and how we achieve a sense of well-being. This, amidst job losses, mourning loved ones and dealing with the many COVID-19 restrictions that have been put in place, even governments have recognised that their people are struggling, not only financially and physically, but emotionally. The Japanese Government recently announced that it has appointed its first Minister of Loneliness. This minister, Tetsushi Sakamoto, is charged with dealing with the problems of isolation and loneliness in Japan, after this country saw a spike in suicide rates for the first time in 11 years. The rate of suicides in 2020 are more than three times higher than the number of COVID-19 deaths in Japan in the same year.

It is unclear how Japan's new minister will tackle the task, but hopefully a precedent can be set for the rest of the world to follow. The fact that a government has decided to address the mental health issues of its citizens in this manner, should at least remind us that we are not alone in our loneliness. The Centers for Disease Control and Prevention have laid out a few guidelines for how we can deal with stress and isolation during the pandemic:

1.       Take a break from the news, including that on social media:

It is good and important to be informed, but an overload of COVID-19 news and constantly exposing yourself to information about the pandemic, can be upsetting and depressing. It can cause stress and feelings of hopelessness. Consider limiting your news exposure and screen time to a couple of time a day.

2.       Take care of your body:

The worse you feel mentally, the easier it is to neglect your body, but there are many easy things you can do at home to give your body a boost. Try to stick to an exercise schedule and sleep routine. There are many free exercise routines available online that vary in difficulty and pace.  Try to eat healthy, well-balanced meals, and avoid excessive alcohol, tobacco and other substance use. Make meals fun by looking for new, easy and interesting recipes online and make the whole family join in meal prep process. Do breathing exercises, stretch, or meditate to calm your mind and help you relax.

3.       Make time to unwind:

Have fun! The internet is a wonderful resource and you can find many fun and relaxing activities that you can do in the comfort of your own home. Try spending time outside and in nature if possible. Read, play with your pets, journal, try something new. Once you've opened your mind and do some research, you will realise that the possibilities are endless!

4.       Connect with others:

Don't be shy or afraid to talk about your feelings. Chances are, most people in your circle are feeling the exact same way that you are. Reach out to the people you trust and talk about how you are really feeling.

5.       Connect with your community- or faith-based organisations:

Even though we miss giving out hugs, other physical contact and simply just being around other people, there are other ways that we can connect. Use the technology at your disposal to connect with people via social media, email, phone or even by mail. You will again realise that you are not as alone as you think, and there are wonderful support structures out there that will help you regain a sense of normalcy.

Happiness is so important to our well-being that the UN dedicated an entire day to it! Let's use this year's International Day of Happiness to remind ourselves that we CAN be happy and even thrive during an isolating pandemic. All it takes is some is a little effort and thinking outside the box.


Get in touch with the South African Depression and Anxiety Group if you happen to feel depressed:

For counselling queries e-mail: zane@sadag.org

To contact a counsellor between 8am-8pm Monday to Sunday, call: 011 234 4837 or fax: 011 234 8182

For a suicide emergency contact SADAG on 0800 567 567

24hr Helpline 0800 456 789

Facebook: The South African Depression and Anxiety Group

Twitter: @TheSADA


Mar 11
You ARE what you eat: Salt Awareness Week 2021

By: Lunga Memela (Communications Officer) 

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The theme of this year's World Salt Awareness Week is 'More Flavour, Less Salt', which probes the global community to really reconsider the repercussions of unhealthy diets. Unhealthy eating habits can give way to what could be preventable illnesses, such as high blood pressure, stroke, heart disease, osteoporosis, stomach cancer, kidney disease, renal stones and obesity, according to the international organisation World Action on Salt, Sugar and Health (WASSH). In the age of COVID-19, it goes without saying that comorbidities must be avoided at all cost.

Let's be honest, we all have that one friend who never fails to ask: 'Won't you please pass me salt', sometimes even before they've tasted their meal. Others will make subtle remarks about the food having been good 'but maybe too bland', and the really ardent will jump at the opportunity to add more salt and vinegar to their fries, or sprinkle more salt onto their restaurant steak or Shisanyama portions, not considering that the long-term overconsumption of salt poses high risk to their health. Caution!

The honest truth

As families spend more time cooking at home than eating out due to COVID-19 lockdown regulations, perhaps discussions around the table should also include salt reduction, healthy diets and healthy lifestyle options. The World Health Organization (WHO) explains that noncommunicable diseases (NCDs) are chronic diseases, which tend to be of long duration and are the result of a combination of genetic, physiological, environmental and behavioural factors. Tobacco use, physical inactivity, the harmful use of alcohol and unhealthy diets all increase the risk of dying from an NCD, WHO cautions. For instance, 11 March is observed as World Kidney Day, so here's how to learn to live well with kidney disease. A slight alteration to salt intake should surely contribute positively to our livelihoods, at least as a behavioural modification?

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The New Daily recently published an article, Australians still failing to keep this silent killer out of their diets. It leaves no question as to whether a salt reduction revolution is needed. The South African government highlights that World Salt Awareness Week is to educate members of the public that salt can damage their health and it is linked to serious health conditions such as stroke and heart failure.

The time has come to #ActOnNCDs and perhaps a good start is to actively reduce salt intake within our daily diets. National Nutrition Advisor, Lily Henderson, shares the following steps to help reduce your daily salt intake:

  • Choose whole, unprocessed foods and eat plenty of vegetables and fruit.
  • Check food labels before you buy to help you choose less salty options.
  • Take salt and salty sauces off the table so younger family members won’t develop the habit of adding salt.
  • Use herbs, spices, garlic and citrus in place of salt to add flavour to your food during cooking and at the table.
  • Cut back on processed meats, smoked foods and salty takeaways.

It is important to note that the
United Nations (UN) General Assembly designated 2021 the International Year of Fruits and Vegetables (IYFV), which is a unique opportunity to raise awareness on the important role of fruits and vegetables in human nutrition, food security and health and as well in achieving UN Sustainable Development Goals.


Feb 23
HST Radio campaign highlights the benefits of adherence to chronic medication

By: Lunga Memela (Communications Officer) 

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There is increased dialogue, hope and a positive outlook on adherence to chronic medication amongst KwaZulu-Natal (KZN) residents, thanks to the successful launch of the Health Systems Trust's (HST) 2021 Get CheckedGo Collect radio campaign promoting the Department of Health's National Health Insurance initiative, CCMDD (Central Chronic Medication Dispensing and Distribution) / Dablapmeds.

A sequel to previous CCMDD radio campaigns, this year's 10-week campaign kick-started with a live radio interview on the popular Gagasi FM evening show, Indaba with Alex Mthiyane, who interviewed HST's Roving Pharmacist and Radio Champion, Charity Mchunu, recapping on 'what is CCMDD and who qualifies for this free service'?

Topics have included important information about Pelebox smart lockers and CCMDD pick-up-points which include local pharmacies, and shops like Dis-Chem, Clicks, Sparkport, and Pick 'n Pay. The best part is that the shows span across KZN's regional and community radio stations – Gagasi, Imbokodo, Inanda, Izwi LoMzansi and Vibe FM – enabling wide reach and proactive engagement about CCMDD, especially the time of COVID-19. 

HST explains that CCMDD is even more useful during the COVID-19 pandemic when it is important to avoid long queues and crowded places to reduce the spread of the coronavirus. By registering for this service, stable patients on chronic medication can avoid busy government clinics and collect medication at over 200 collection points in eThekwini

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Promoting adherence will remain an ongoing endeavour. Further radio topics are scheduled to cover CCMDD and COVID-19, debunking COVID-19 and vaccine myths, adherence and the benefits thereof, healthy living, as well as mental wellness as a chronic condition.

It is common knowledge that millions of South Africans have chronic conditions such as diabetes, high blood pressure or HIV. HST affirms that best way to manage a chronic condition is by staying on your prescribed medication and that patients who are stable on their medication can register for CCMDD. 

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HST's KZN CCMDD Provincial Co-ordinator, Roma Ramphal confirmed that the organisation's radio champions are not only knowledgeable and passionate about promoting adherence to chronic medication, but also that they strongly believe that CCMDD/Dablapmeds can effectively prolong life and livelihoods, ease the disease burden within the local communities and curb the spread of COVID-19. Kudos to our radio campaign champions: Charity Mcunu, Nolwazi Mpithi, Noni Sithole and Thulisile Bekwa together with HST health experts: Drs Nkosingiphile Gama, Tinyiko Khosa and Mbalenhle Nxele. 

Don't forget to visit and Like the Get Checked. Go Collect. Facebook page. ​




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