A5060591178- HIV/AIDS Research and Interventions
- Health Systems, Economic Evaluations, Quality of Life
- Pharmaceutical Economics and Policy
- Adolescent Sexual and Reproductive Health
- HIV, Drug Use, Sexual Risk
- Pharmaceutical Quality and Counterfeiting
- Antibiotic Use and Resistance
- HIV/AIDS Impact and Responses
- Healthcare Policy and Management
- Primary Care and Health Outcomes
- Global Maternal and Child Health
- Healthcare Systems and Reforms
- Vaccine Coverage and Hesitancy
- Pneumonia and Respiratory Infections
- COVID-19 epidemiological studies
- Tuberculosis Research and Epidemiology
- Data-Driven Disease Surveillance
- Food Security and Health in Diverse Populations
- Biosimilars and Bioanalytical Methods
- Homelessness and Social Issues
- Health Policy Implementation Science
- Migration, Health and Trauma
- Fungal Infections and Studies
- Sex work and related issues
- Nosocomial Infections in ICU
University of the Witwatersrand
2014-2024
Africa Health Research Institute
2023
London School of Hygiene & Tropical Medicine
2023
Massachusetts General Hospital
2023
University College London
2023
New York University Press
2020
Cambridge University Press
2020
African Union
2020
Muhimbili University of Health and Allied Sciences
2020
Office Of Health Economics
2020
Sound regulatory systems are critical for protecting public health against use of medical products which do not meet international standards quality, safety and efficacy. This review provides a summary the current status National Medicines Regulatory Authorities (NMRAs) in Africa, various initiatives that have been established to improve their performance. All countries Africa (except Sahrawi Republic), NMRAs but organizational set-up functionality is variable. Some located within Ministries...
Abstract South Africa has a long history of community health workers (CHWs). It been journey that required balancing constrained resources and competing priorities. CHWs form bridge between communities healthcare service provision within facilities act as the cornerstone Africa’s Ward-Based Primary Healthcare Outreach Teams. This study aimed to document CHW policy implementation landscape across six provinces in explore reasons for local adaptation models identify potential barriers...
In response to the global pandemic of COVID-19, countries around world began imposing stay-at-home orders, restrictions on transport, and closures businesses in early 2020. South Africa implemented a strict lockdown March 2020 before its first COVID-19 wave started, gradually lifted between May September 2020, then re-imposed December second wave. There is concern that COVID-19-related morbidity mortality, fear transmission, government responses may have led reduction antiretroviral...
Abstract HIV treatment programs face challenges in identifying patients at risk for loss-to-follow-up and uncontrolled viremia. We applied predictive machine learning algorithms to anonymised, patient-level programmatic data from two districts South Africa, 2016–2018. developed patient scores outcomes: (1) visit attendance ≤ 28 days of the next scheduled clinic (2) suppression viral load (VL). Demographic, clinical, behavioral laboratory were investigated multiple models as predictor...
The African Medicines Regulatory Harmonization Initiative (AMRH) has contributed to reduce marketing authorization timelines in East Community and the Southern Development member states. Challenges still exist using outcome of regional joint dossier review processes for national decision making by medicines regulatory agencies. Progress domestication Union Model Law on Medical Products Regulation twelve countries provides basis improving systems. This is coupled designation eleven centers...
Abstract Background Limited capacity to regulate medical products is associated with circulation of which do not meet standards quality, safety and efficacy negative public health economic outcomes. This study focused on assessing the effect East African Community (EAC) medicines regulatory harmonization initiative national agencies, a focus registration inspection systems. Methods An exploratory mixed-method design using both qualitative quantitative data access from six authorities (NMRAs)...
Abstract Introduction South Africa has one of the highest rates internal migration on continent, largely comprised men seeking labour in urban centres. African who move within country (internal migrants) are at higher risk than non‐migrant acquiring HIV yet less likely to test or use pre‐exposure prophylaxis (PrEP). However, little is known about mechanisms that link and challenges engaging services. Methods We recruited 30 migrant (born outside Gauteng Province) during August 2022 for...
Systematic and transparent approaches to priority setting are needed, particularly in low-resource settings, produce decisions that sound acceptable stakeholders. The EVIDEM framework brings together Health Technology Assessment (HTA) multi-criteria decision analysis (MCDA) by proposing a comprehensive set of criteria with standardized processes support decisionmaking. objective the study was field test for decisionmaking on screening private health plan South Africa.Liquid-based cytology...
South Africa has embarked on major health policy reform to deliver universal coverage through the establishment of National Health Insurance (NHI). The aim is improve access, remove financial barriers care, and enhance care quality. technology assessment (HTA) explicitly identified in proposed NHI legislation will have a prominent role informing decisions about adoption access interventions technologies. specific arrangements approach HTA support this are yet be determined. Although there...
We developed a motivational interviewing (MI) counselling training and support program for lay counsellors in South Africa-branded "Thusa-Thuso-helping you help", commonly referred to as Thusa-Thuso. present the results of pilot study determine program's impact on MI technical skills qualitatively assess feasibility training-of-trainers (TOT) scale-up strategy among staff non-governmental (NGO) partners human immunodeficiency virus (HIV) treatment Africa. enrolled adult (≥ 18 years) from ten...
Abstract Objectives Health technology assessment (HTA) is a cost-effective resource allocation tool in healthcare decision-making processes; however, its use limited low-income settings where countries fall short on both absorptive and technical capacity. This paper describes the journey of introduction HTA into processes through case study revising National Essential Medicines List (NEMLIT) Tanzania. It draws lessons establishing strengthening transparent priority-setting processes,...
Understanding the occurrence of antiretroviral (ARV)-related adverse events (AEs) among patients receiving second-line therapy (ART) is important in preventing switches to more limited and expensive third-line regimens. This study aimed estimate rates examine predictors AEs adult HIV-1-infected ART Right Care (RTC) clinical cohort South Africa. was a (≥ 18 years age) initiating standard Africa from 1 April 2004 10 January 2016. Our primary outcome development an AE within 24 months therapy....
Abstract Background The proposed National Health Insurance (NHI) system aims to re-engineer primary healthcare (PHC) in South Africa, envisioning both private sector providers and public clinics as independent contracting units the NHI Fund. In 2017, 16% of African population had medical insurance predominately utilised providers. However, it is estimated that up 28% access PHC services, with a meaningful segment low-income, uninsured paying for these services out-of-pocket. study objective...
Abstract Introduction Effective health communication is important for promoting adherence to antiretroviral therapy (ART). During counselling sessions with people living HIV (PLHIV) who are initiating or re-initiating ART, we assessed whether a simple visual aid using bead bottles explain the concept of viral suppression resulted in changes treatment literacy. Methods At three public sector clinics KwaZulu-Natal KZN) province, South Africa, enrolled adults tested HIV-positive and were newly...
In response to the global pandemic of COVID-19, South Africa implemented a strict lockdown in March 2020 before its first COVID-19 wave started, gradually lifted restrictions between May and September 2020, then re-imposed December second wave. There is concern that COVID-19-related morbidity mortality, deprioritization TB activities, fear transmission, societal led reduction tuberculosis (TB) treatment initiations. We analysed monthly public sector, facility-level data from Africa’s...
Introduction Adequate and sustainable funding of national medicine regulatory agencies (NMRAs) is key for assurance quality, safety efficacy medical products circulating in a market. The study aimed to determine factors affecting NMRAs five East African Community (EAC) countries namely: Burundi, Kenya, Rwanda, Tanzania (Mainland Zanzibar) Uganda. Methodology An exploratory, mixed method design using both qualitative quantitative data, was employed. Data from six collected through combination...
The proposed National Health Insurance (NHI) system aims to re-engineer primary healthcare (PHC) provision in South Africa, with strategic purchasing of services from both private and public sector providers by the NHI Fund. Currently, while access is primarily restricted high-income insured earners, an important proportion low-income segment choosing utilise PHC over clinics. In recent years, a number SA have established innovative models delivery that aim expand beyond population provide...
Abstract Background Cryptococcal meningitis in HIV-infected patients sub-Saharan Africa accounts for three-quarters of the global cases and 135,000 deaths per annum. Current treatment includes use fluconazole amphotericin B. Recent evidence has shown that synergistic flucytosine improves efficacy reduces toxicity, however affordability availability hampered access to many countries. This study investigated cost implications introducing as induction therapy cryptococcal adults South Africa....
Abstract Background While South Africa’s national HIV program is the largest in world, it has yet to reach UNAIDS 95–95-95 targets. To these targets, expansion of treatment may be accelerated through use private sector delivery models. This study identified three innovative non-governmental primary health care models (private sector) providing treatment, as well two government clinics (public that served similar populations. We estimated resources used, and costs outcomes across provide...
Abstract Introduction South Africa’s National Department of Health launched the Adherence Guidelines for Chronic Diseases in 2015. These guidelines include adherence clubs (AC) and decentralized medication delivery (DMD) as two differentiated models care stable HIV patients on antiretroviral therapy. While do not suggest that provider costs (costs to healthcare system medications, laboratory tests visits clinics or alternative locations) these will be lower than conventional, clinic‐based...
Antibiotics are miracles of science and critical for many surgical procedures. However, the emergence multidrug resistant pathogens resulting from inappropriate antibiotic use is a threat to modern medicine. This study aimed determine appropriateness use, cost, consumption impact an stewardship intervention round in ward setting.Baseline utilisation was determined with retrospective cross-sectional two wards tertiary academic hospital South Africa where medical records 264 patients who...
Introduction COVID-19 vaccination coverage in South Africa (RSA) remains low despite increased access to vaccines. On 1 November 2021, RSA introduced the Vooma Voucher programme which provided a small guaranteed financial incentive, redeemable at grocery stores, for among older adults, population most vulnerable serious illness, hospitalisation and death. However, association of incentives with unclear. Methods We evaluated conditional economic incentive first-dose rates adults (aged ≥60...
People who are homeless present for care with poor health status, influenced by their physical and social environment. Trinity Health Services is an interprofessional student-run clinic providing free to the inner city of Johannesburg, South Africa. This descriptive survey profiled disease conditions through a retrospective review patient files, documented on predesigned case report form. The data were analysed using statistics. A total 240 visits reviewed from January–December 2016. Several...
The objectives of this study were to assess the knowledge and perceptions final year medical students about antibiotic resistance use assist in development an stewardship curriculum for teaching South Africa Nigeria principles prudent prescribing.A cross-sectional was conducted determine one African three Nigerian universities use, stewardship. A 26-item questionnaire administered electronically schools a paper-based copy fourth.A difference gap between two countries identified; however,...