Bapedi traditional healers play a vital role in the primary health care of rural inhabitants in the Limpopo Province, South Africa. However, literature profiling their social and demographic variables, as well as their traditional healing practices is lacking. Convenience sampling were used to identify and select two traditional healers from 17 municipalities (resulting in 34 healers being used in this pilot survey) of the Limpopo Province in South Africa. Information on the social and demographic variables, and traditional healing practices of these healers was gathered from January 2013 to July 2013, using a semi-structured questionnaire, supplemented by field surveys for plant identification and collection used in the preparation of remedies. Males constituted nearly two-thirds of the participants. Forty eight percent of them became healers through the mentoring of another healer, while 38% acquired their traditional healing knowledge from parents and 14% from grandparents. In contrast to this, 62% of the females obtained theirs from their parents, 30% from fellow traditional healers, and 8% from grandparents. A total of 154 plant species were indicated as used by healers in the treatment of 52 health-related problems. A vast majority (89%) of these practitioners reported that prepared herbal remedies do expire, which is a temperature-dependent process. Determinations of the efficacy of remedies by most healers (67%) were via consultation with ancestors (90%). This study also found that none of the interviewees had any knowledge of provincial or national environmental legislation. The current study has shown that Bapedi traditional healers could play a leading role in both the preservation of indigenous knowledge and the primary health care sector. However, of concern is the traditional methods (via consulting ancestors) employed by most of these healers in determining efficacy of remedies, thus indicating a need for a scientific investigations to establish their safety and effectiveness. Equally, there is a need to educate traditional practitioners’ regarding the significance of various conservation legislations in their traditional healing. By addressing these, the national and provincial legislators, medical fraternity as well as environmental agencies will be able to better integrate them in primary health care systems and environmental management.

/pdf/bapedi-traditional-healers-in-the-limpopo-province-south-ex0lizy5ju.pdf

Bapedi traditional healers in the Limpopo Province, South Africa: Their socio-cultural profile and traditional healing practice

This Equinet paper evaluates how health services are currently funded, explores recent trends in health care financing and identifies lessons from the health care financing experience of African countries. The paper shows that the current level of health care funding from government tax revenue is relatively low in most African countries – in the majority of countries the health sector share of total government expenditure is below 10 per cent. One of the single largest sources of financing is that of out-of-pocket payments (OPP) which exceed 25 per cent of total health care expenditure in more than three-quarters of sub-Saharan African countries.

The paper recommends several actions in relation to health care financing within the African context including: explicit commitments by governments to move away from out-of-pocket funding of public health sector services; efforts to increase tax revenue through improved tax collection mechanisms; implementing effective mechanisms for identifying the poor and other vulnerable groups; equitable allocation of funds that are mobilised to ensure that all citizens have access to health services irrespective to whether they reside in a rural or urban area.

/pdf/promoting-equitable-health-care-financing-in-the-african-2o5w6qc1st.pdf

Promoting equitable health care financing in the African context: current challenges and future prospects

Identification of priorities for nursing research in Spain: a Delphi study



Aim. The aim of this work was to identify priorities for nursing research in Spain. The Co-ordination and Development of Nursing Research Centre (Investen-isciii group) carried out the study using the Delphi technique during the period April 1998 to January 1999.



Methods. Study subjects were professionals involved in different nursing activities. From 1250 eligible professionals initially contacted, 452 (38%) responded in round 1 and 258 (57%) in round 2. But only 189 filled out correctly the questionnaires from both rounds of data collection (overall response rate was 21·6%).



Results. The participants identified priorities related to continuity and co-ordination of nursing care, quality of nursing care, impact of invasive techniques and treatments on the quality of life of patients, needs of the primary care givers, quality of life among elders, satisfaction of customers and needs of terminal patients and their families.

Identification of priorities for nursing research in Spain: a Delphi study.

The escalating expenditure on patients with HIV/AIDS within an inadequately funded public health system is tending towards crowding out care for patients with non-HIV illnesses. Priority-setting decisions are thus required and should increasingly be based on an explicit, transparent and accountable process to facilitate sustainability. South Africa's public health system is eroding, even though the government has received extensive donor financing for specific conditions, such as HIV/AIDS. The South African government's 2007 HIV plan anticipated costs exceeding 20% of the annual health budget with a strong focus on treatment interventions, while the recently announced 2012-2016 National Strategic HIV plan could cost up to US$16 billion. Conversely, the total non-HIV health budget has remained static in recent years, effectively reducing the supply of health care for other diseases. While the South African government cannot meet all demands for health care simultaneously, health funders should attempt to allocate health resources in a fair, efficient, transparent and accountable manner, in order to ensure that publicly funded health care is delivered in a reasonable and non-discriminatory fashion. We recommend a process for resource allocation that includes ethical, economic, legal and policy considerations. This process, adapted for use by South Africa's policy-makers, could bring health, political, economic and ethical gains, whilst allaying a social crisis as mounting treatment commitments generated by HIV have the potential to overwhelm the health system.

Improving resource allocation decisions for health and HIV programmes in South Africa: Bioethical, cost-effectiveness and health diplomacy considerations.

Background: Although preventable, cervical cancer, an AIDS-related disease, is the second most common cancer amongst South African women and the most common cancer amongst black women. Objective: The objective of the study was to determine what women being treated for HIV and AIDS at a specific healthcare centre in Johannesburg knew about cervical cancer and cervical screening. Method: A survey design was used, with data gathered by means of a self-administered questionnaire. Convenience sampling selected 315 women to participate ( n = 315). Descriptive statistics were used to analyse the data and chi-square testing found associations between categorical variables. Results: The majority of respondents (78.7%;  n = 248) indicated that they had heard of cervical cancer and 62.9% ( n = 198) knew about the Pap smear, with nurses and doctors being the primary source of information. Of the women who knew about the Pap smear, less than one-third had had a smear done, the main reason being fear of the procedure. Conclusion: The study provided evidence that women attending the specific HIV clinic were more knowledgeable about cervical cancer and screening than those of unknown HIV status involved in previous studies. Knowledge was still at a low level, especially when their exceptionally high risk was taken into account. Once again it was found that having knowledge did not necessarily mean having had a Pap smear, which remains a huge challenge in the prevention of cervical cancer.

http://www.scielo.org.za/pdf/cura/v37n1/17.pdf

R.J. Inglis

Papers

Health care in south africa