Browsing by Subject "Policy"

Now showing 1 - 13 of 13
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    A qualitative study on South African policies governing youth access to alcohol
    (2025) Matee, Larona; Van Niekerk, Lauren-Jayne
    Alcohol abuse among youth continues to be a major concern worldwide in the 21st century. It has been suggested in various studies that the age of onset is decreasing rapidly and that admissions to treatment centres are increasing as young people fall prey to substance abuse. This raises serious concerns as alcohol abuse is linked to adverse health outcomes such as physical and mental health problems, social and legal consequences, as well as economic burdens. Zwelihle, a township in Hermanus, is one such community that faces various social issues, including high rates of alcohol abuse amongst the youth. This study used a qualitative research design based on the interpretivist position. Data were collected from twenty participants using a semi-structured interview guide. Fifteen young participants (aged 18 to 35) took part in focus groups, and five professionals with experience working with Zwelihle's youth were interviewed one-on-one. Data were analyzed following Tesch's qualitative data analysis steps. The study results revealed that factors such as a lack of parental involvement, unemployment, socialisation and culture as well as the availability of limited recreational activities were identified to be prominent factors which led Zwelihle's youth to alcohol and the abuse thereof. Other factors, such as alcohol outlet concentration and density in Zwelihle were argued to be one of the factors that facilitates easy access to alcohol in Zwelihle. This is also caused by the plight which comes with heightened levels of unemployment in South Africa, which drives people to alcohol dependency to forget and escape their harsh realities, or people open shebeens as a response to the harsh economic realities. At the backdrop of these concerns were the various alcohol trading policies, which were said to be ineffective in regulating the alcohol trade, and which have resulted in almost every street in Zwelihle having someone trading in alcohol and selling it to young people. One of the reasons participants cited for the failing alcohol policies was due to unreliable law enforcement agencies who were perceived to be corrupt
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    A situational analysis of child and adolescent mental health services in Ghana Uganda South Africa and Zambia
    (2010) Kleintjies, Sharon Rose; Lund, Christopher; Flisher, A J; MHaPP Research Programme Consortium
    Objective: Approximately one in five children and adolescents (CA) suffer from mental disorders. This paper reports on the findings of a situational analysis of CA mental health policy and services in Ghana, Uganda, South Africa and Zambia. The findings are part of a 5 year study, the Mental Health and Poverty Project, which aims to provide new knowledge regarding multi-sectoral approaches to breaking the cycle of poverty and mental ill-health in Africa. Method: The World Health Organization’s Assessment Instrument for Mental Health Systems (WHO-AIMS) Version 2.2 was used to collect quantitative information on mental health resources. Mental health policies and legislation were analysed using the WHO Policy and Plan, and Legislation Checklists. Qualitative data were collected through focus groups and interviews. Results: Child and adolescent mental health (CAMH) - related legislation, policies, services, programmes and human resources are scarce. Stigma and low priority given to mental health contribute to low investment in CAMH. Lack of attention to the impoverishing impact of mental disorders on CA and their families contribute to the burden. Conclusion: Scaling up child and adolescent mental health services (CAMHS) needs to include anti-stigma initiatives, and a greater investment in CAMH. Clear policy directions, priorities and targets should be set in country-level CAMH policies and plans. CAMHS should be intersectoral and include consideration of the poverty- mental health link. The roles of available mental health specialists should be expanded to include training and support of practitioners in all sectors. Interventions at community level are needed to engage youth, parents and local organizations to promote CAMH.
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    An evaluation of the policy on incentives: to what extent do incentives enhance the policy objectives of South Africa?
    (2025) Batwa, Lindile Matthews; Roeleveld, Jennifer
    The global trends show that developing countries and economies in transition such as South Africa are now primary foreign direct investment (FDI) destinations, and their importance as FDI recipients continues to increase. This research paper evaluates the usefulness of incentives in driving the investment policy direction of South Africa, the role of stakeholders involved in incentive schemes, and the impact on the tax base. It contributes to the assessment of the usefulness of incentives in enabling the government to achieve its policy objectives. This research commends the government's approach to drafting its policy objectives in line with National Development Plan 2030. It is a plan that has consideration of global trends, and it is an appropriate panacea for the domestic policy framework that brings about foreign direct investment through initiatives such as incentives. Tax incentives are not the primary determinant of the decision to invest. Most investors base their investment decisions not only on economic and commercial factors. Incentives function as a reward to investors who would invest without incentives rather than encouraging investors who would otherwise not invest or go elsewhere. It is clear that non-tax incentive considerations outweigh tax incentive considerations, but it is also argued that tax incentives could effectively address environmental challenges and change consumer behaviour. However, these incentives are generally more effective in combination with other policy instruments. Furthermore, this research finds that — because of the corruption or perception thereof — the deteriorating economic environment has exerted huge pressure on South Africa's public debt, due to the pressure placed on the government to finance its budget. The fiscal challenges that South Africa faces cannot be solved with ‘more' incentives but rather a strategic balance with other measures. The scale and variety of South Africa's investment incentives will continue to be a contested debate. However, while it is also clear that the revenue base is shrinking, it is difficult to envisage an investment policy strategy without incentive schemes. Incentives should be seen not as a problem and a drain on the fiscus but as an integral part of the solution.
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    Biomedical research, a tool to address the health issues that affect African populations
    (BioMed Central Ltd, 2013) Peprah, Emmanuel; Wonkam, Ambroise
    Traditionally, biomedical research endeavors in low to middle resources countries have focused on communicable diseases. However, data collected over the past 20years by the World Health Organization (WHO) show a significant increase in the number of people suffering from non-communicable diseases (e.g. heart disease, diabetes, cancer and pulmonary diseases). Within the coming years, WHO predicts significant decreases in communicable diseases while non-communicable diseases are expected to double in low and middle income countries in sub-Saharan Africa. The predicted increase in the non-communicable diseases population could be economically burdensome for the basic healthcare infrastructure of countries that lack resources to address this emerging disease burden. Biomedical research could stimulate development of healthcare and biomedical infrastructure. If this development is sustainable, it provides an opportunity to alleviate the burden of both communicable and non-communicable diseases through diagnosis, prevention and treatment. In this paper, we discuss how research using biomedical technology, especially genomics, has produced data that enhances the understanding and treatment of both communicable and non-communicable diseases in sub-Saharan Africa. We further discuss how scientific development can provide opportunities to pursue research areas responsive to the African populations. We limit our discussion to biomedical research in the areas of genomics due to its substantial impact on the scientific community in recent years however, we also recognize that targeted investments in other scientific disciplines could also foster further development in African countries.
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    Comment: silent burden no more: a global call to action to prioritize perinatal mental health
    (2022-04-11) McNab, Shanon; Fisher, Jane; Honikman, Simone; Muvhu, Linos; Levine, Rebecca; Chorwe-Sungani, Genesis; Bar-Zeev, Sarah; Hailegebriel, Tedbabe D; Yusuf, Ifeyinwa; Chowdhary, Neerja; Rahman, Atif; Bolton, Paul; Mershon, Claire-Helene; Bormet, Mona; Henry-Ernest, Diana; Portela, Anayda; Stalls, Suzanne
    Common perinatal mental disorders are the most frequent complications of pregnancy, childbirth and the postpartum period, and the prevalence among women in low- and middle-income countries is the highest at nearly 20%. Women are the cornerstone of a healthy and prosperous society and until their mental health is taken as seriously as their physical wellbeing, we will not improve maternal mortality, morbidity and the ability of women to thrive. On the heels of several international efforts to put perinatal mental health on the global agenda, we propose seven urgent actions that the international community, governments, health systems, academia, civil society, and individuals should take to ensure that women everywhere have access to high-quality, respectful care for both their physical and mental wellbeing. Addressing perinatal mental health promotion, prevention, early intervention and treatment of common perinatal mental disorders must be a global priority.
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    From mental health policy development in Ghana to implementation: What are the barriers?
    (2010) Awenva, A D; Read, U M; Ofori-Attah, A L; Doku, V C K; Akpalu, B; Flisher, Alan; Lund, Crick; Osei, A O; Flisher, A J; MHaPP Research Programme Consortium
    Objective: This paper identifies the key barriers to mental health policy implementation in Ghana and suggests ways of overcoming them. Method: The study used both quantitative and qualitative methods. Quantitatively, the WHO Mental Health Policy and Plan Checklist and the WHO Mental Health Legislation Checklist were employed to analyse the content of mental health policy, plans and legislation in Ghana. Qualitative data was gathered using in-depth interviews and focus group discussions with key stakeholders in mental health at the macro, meso and micro levels. These were used to identify barriers to the implementation of mental health policy, and steps to overcoming these. Results: Barriers to mental health policy implementation identified by participants include: low priority and lack of political commitment to mental health; limited human and financial resources; lack of intersectoral collaboration and consultation; inadequate policy dissemination; and an absence of research-based evidence to inform mental health policy. Suggested steps to overcoming the barriers include: revision of mental health policy and legislation; training and capacity development and wider consultation. Conclusion: These results call for well-articulated plans to address the barriers to the implementation of mental health policy in Ghana to reduce the burden associated with mental disorders.
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    Government policy interventions to reduce human antimicrobial use: protocol for a systematic review and meta-analysis
    (BioMed Central, 2017-12-13) Rogers Van Katwyk, Susan; Grimshaw, Jeremy M; Mendelson, Marc; Taljaard, Monica; Hoffman, Steven J
    Background: Antimicrobial resistance (AMR) is a recognized threat to global public health. Increasing AMR and a dry pipeline of novel antimicrobial drugs have put AMR in the international spotlight. One strategy to combat AMR is to reduce antimicrobial drug consumption. Governments around the world have been experimenting with different policy interventions, such as regulating where antimicrobials can be sold, restricting the use of last-resort antimicrobials, funding AMR stewardship programs, and launching public awareness campaigns. To inform future action, governments should have access to synthesized data on the effectiveness of large-scale AMR interventions. This planned systematic review will (1) identify and describe previously evaluated government policy interventions to reduce human antimicrobial use and (2) estimate the effectiveness of these different strategies. Methods: An electronic search strategy has been developed in consultation with two research librarians. Seven databases (MEDLINE, CINAHL, EMBASE, CENTRAL, PAIS Index, Web of Science, and PubMed excluding MEDLINE) will be searched, and additional studies will be identified using several gray literature search strategies. To be included, a study must (1) clearly describe the government policy and (2) use a rigorous design to quantitatively measure the impact of the policy on human antibiotic use. The intervention of interest is any policy intervention enacted by a government or government agency in any country to change human antimicrobial use. Two independent reviewers will screen for eligibility using criteria defined a priori. Data will be extracted with Covidence software using a customized extraction form. If sufficient data exists, a meta-analysis by intervention type will be conducted as part of the effectiveness review. However, if there are too few studies or if the interventions are too heterogeneous, data will be tabulated and a narrative synthesis strategy will be used. Discussion: This evidence synthesis is intended for use by policymakers, public health practitioners, and researchers to inform future government policies aiming to address antimicrobial resistance. This review will also identify gaps in the evidence about the effectiveness of different policy interventions to inform future research priorities. Systematic review registration: PROSPERO CRD42017067514.
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    A pandemic recap: lessons we have learned
    (2021-09-10) Coccolini, Federico; Cicuttin, Enrico; Cremonini, Camilla; Tartaglia, Dario; Viaggi, Bruno; Kuriyama, Akira; Picetti, Edoardo; Ball, Chad; Abu-Zidan, Fikri; Ceresoli, Marco; Turri, Bruno; Jain, Sumita; Palombo, Carlo; Guirao, Xavier; Rodrigues, Gabriel; Gachabayov, Mahir; Machado, Fernando; Eftychios, Lostoridis; Kanj, Souha S; Di Carlo, Isidoro; Di Saverio, Salomone; Khokha, Vladimir; Kirkpatrick, Andrew; Massalou, Damien; Forfori, Francesco; Corradi, Francesco; Delibegovic, Samir; Machain Vega, Gustavo M.; Fantoni, Massimo; Demetriades, Demetrios; Kapoor, Garima; Kluger, Yoram; Ansari, Shamshul; Maier, Ron; Leppaniemi, Ari; Hardcastle, Timothy; Vereczkei, Andras; Karamagioli, Evika; Pikoulis, Emmanouil; Pistello, Mauro; Sakakushev, Boris E.; Navsaria, Pradeep H.; Galeiras, Rita; Yahya, Ali I; Osipov, Aleksei V; Dimitrov, Evgeni; Doklestić, Krstina; Pisano, Michele; Malacarne, Paolo; Carcoforo, Paolo; Sibilla, Maria G.; Kryvoruchko, Igor A; Bonavina, Luigi; Kim, Jae I; Shelat, Vishal G; Czepiel, Jacek; Maseda, Emilio; Marwah, Sanjay; Chirica, Mircea; Biancofiore, Giandomenico; Podda, Mauro; Cobianchi, Lorenzo; Ansaloni, Luca; Fugazzola, Paola; Seretis, Charalampos; Gomez, Carlos A.; Tumietto, Fabio; Malbrain, Manu; Reichert, Martin; Augustin, Goran; Amato, Bruno; Puzziello, Alessandro; Hecker, Andreas; Gemignani, Angelo; Isik, Arda; Cucchetti, Alessandro; Nacoti, Mirco; Kopelman, Doron; Mesina, Cristian; Ghannam, Wagih; Ben-Ishay, Offir; Dhingra, Sameer; Coimbra, Raul; Moore, Ernest E; Cui, Yunfeng; Quiodettis, Martha A.; Bala, Miklosh; Testini, Mario; Diaz, Jose; Girardis, Massimo; Biffl, Walter L; Hecker, Matthias; Sall, Ibrahima; Boggi, Ugo; Materazzi, Gabriele; Ghiadoni, Lorenzo; Matsumoto, Junichi; Zuidema, Wietse P; Ivatury, Rao; Enani, Mushira A; Litvin, Andrey; Al-Hasan, Majdi N.; Demetrashvili, Zaza; Baraket, Oussama; Ordoñez, Carlos A; Negoi, Ionut; Kiguba, Ronald; Memish, Ziad A; Elmangory, Mutasim M; Tolonen, Matti; Das, Korey; Ribeiro, Julival; O’Connor, Donal B; Tan, Boun K; Van Goor, Harry; Baral, Suman; De Simone, Belinda; Corbella, Davide; Brambillasca, Pietro; Scaglione, Michelangelo; Basolo, Fulvio; De’Angelis, Nicola; Bendinelli, Cino; Weber, Dieter; Pagani, Leonardo; Monti, Cinzia; Baiocchi, Gianluca; Chiarugi, Massimo; Catena, Fausto; Sartelli, Massimo
    On January 2020, the WHO Director General declared that the outbreak constitutes a Public Health Emergency of International Concern. The world has faced a worldwide spread crisis and is still dealing with it. The present paper represents a white paper concerning the tough lessons we have learned from the COVID-19 pandemic. Thus, an international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making. With the present paper, international and heterogenous multidisciplinary panel of very differentiated people would like to share global experiences and lessons with all interested and especially those responsible for future healthcare decision making.
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    Policies and clinical practices relating to the management of gestational diabetes mellitus in the public health sector, South Africa – a qualitative study
    (BioMed Central, 2018-05-10) Muhwava, Lorrein Shamiso; Murphy, Katherine; Zarowsky, Christina; Levitt, Naomi
    Background Women with a prior gestational diabetes have an increased lifetime risk of developing type 2 diabetes. Although post-partum follow-up for GDM women is essential to prevent progression to type 2 diabetes, it is poorly attended. The need for health systems interventions to support postpartum follow-up for GDM women is evident, but there is little knowledge of actual current practice. The aim of this study was to explore current policies and clinical practices relating to antenatal and post-natal care for women with GDM in South Africa, as well as health sector stakeholders’ perspectives on the barriers to -- and opportunities for -- delivering an integrated mother - baby health service that extends beyond the first week post-partum, to the infant’s first year of life. Methods Following a document review of policy and clinical practice guidelines, in-depth interviews were conducted with 11 key informants who were key policy makers, health service managers and clinicians working in the public health services in South Africa’s two major cities (Johannesburg and Cape Town). Data were analysed using qualitative content analysis procedures. Results The document review and interviews established that it is policy that health services adhere to international guidelines for GDM diagnosis and management, in addition to locally developed guidelines and protocols for clinical practice. All key informants confirmed that lack of postpartum follow-up for GDM women is a significant problem. Health systems barriers include fragmentation of care and the absence of standardised postnatal care for post-GDM women. Key informants also raised patient - related challenges including lack of perceived future risk of developing type 2 diabetes and non-attendance for postpartum follow up, as barriers to postnatal care for GDM women. All participants supported integrated primary health services but cautioned against overloading health workers. Conclusion Although there is alignment between international guidelines, local policy and reported clinical practice in the management of GDM, there is a gap in continuation of care in the postpartum period. Health systems interventions that support and facilitate active follow-up for women with prior GDM are needed if high rates of progression to type 2 diabetes are to be avoided.
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    Procedural environmental rights in regional trade agreements: trends, policy drivers and the case for multilateralisation within the World Trade Organization
    (2025) Bondi, Vyonna Achieng; Paterson, Alexander
    The World Trade Organization (WTO) is at the nexus between trade and the environment. The General Agreement on Tariffs and Trade (GATT), as amended in 1994 during the Uruguay Round, in effect established a new treaty structure to govern international trade and commerce. The underlying philosophy under the GATT/WTO regime is that states undertake to enter into mutually reciprocal agreements aimed at tariff reduction and removal of other barriers to trade, while eliminating any form of discrimination. Since the inception of GATT, Article XXIV has facilitated the conclusion of Regional Trade Agreements (RTAs), which constitute an exemption from the Most Favoured Nation (MFN) principle of non-discrimination. Multilateral negotiations within the WTO system have, therefore, been complemented by regionalism. Both trends have come to apparently coexist in the international trading system, raising important questions as to the future of the multilateral trading system. The core principles of non-discrimination underlying the trading system, have also been qualified to the extent that GATT Article XX paragraphs (b) and (g) enables states to ‘discriminate' based on the protection of human health and the environment. Therefore, many RTAs also include substantive environmental rights (SERs) in addition to procedural environmental rights (PERs), namely access to environmental information, public participation in environmental decision-making and access to justice in environmental matters. These three pillars of the Rio Principle 10 function as a mechanism for safeguarding fundamental rights to a clean environment included in RTAs, advancing the objectives of sustainable development, which is also a stated objective of the WTO. In light of the deadlock in multilateral trade negotiations, compounded by the paralysis within the WTO dispute settlement mechanism (DSM), states have increasingly turned to regional trade agreements (RTAs) as alternative frameworks for trade cooperation. However, this shift has largely occurred without sufficient regard for the harmonisation of these agreements, leading to what has been termed the ‘spaghetti bowl' or ‘noodle bowl' phenomenon. This refers to the intricate and often contradictory web of overlapping and diverging legal regimes that now govern international trade. As a result, states are left grappling with conflicting obligations, which complicate the uniform implementation of PER commitments. The lack of coherence across these frameworks exacerbates regulatory fragmentation, impeding legal certainty and fostering inconsistency in the application of trade rules. Thus, states are not only responding variably to the same commitments but are also facing significant challenges in navigating the complexities of these multifaceted and, at times, discordant legal obligations. This legal fragmentation poses substantial risks to the predictability and stability of the international trading system, further undermining the intended goals of PERs within RTAs. In order to ascertain to what degree PER commitments have converged or diverged, the thesis develops an assessment tool comprising key features to analyse the spaghetti bowl of trade agreements and, in particular, PER provisions to derive a typology of PER provisions. The thesis assesses possible avenues for the multilateralisation of PER provisions including the adoption of conditions in preferential trade agreements and the conclusion of plurilateral agreements on PERs, among others.
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    Regulation of genomic and biobanking research in Africa: a content analysis of ethics guidelines, policies and procedures from 22 African countries
    (2017) de Vries, Jantina; Munung, Syntia Nchangwi; Matimba, Alice; McCurdy, Sheryl; Ouwe Missi Oukem-Boyer, Odile; Staunton, Ciara; Yakubu, Aminu; Tindana, Paulina
    Abstract Background The introduction of genomics and biobanking methodologies to the African research context has also introduced novel ways of doing science, based on values of sharing and reuse of data and samples. This shift raises ethical challenges that need to be considered when research is reviewed by ethics committees, relating for instance to broad consent, the feedback of individual genetic findings, and regulation of secondary sample access and use. Yet existing ethics guidelines and regulations in Africa do not successfully regulate research based on sharing, causing confusion about what is allowed, where and when. Methods In order to understand better the ethics regulatory landscape around genomic research and biobanking, we conducted a comprehensive analysis of existing ethics guidelines, policies and other similar sources. We sourced 30 ethics regulatory documents from 22 African countries. We used software that assists with qualitative data analysis to conduct a thematic analysis of these documents. Results Surprisingly considering how contentious broad consent is in Africa, we found that most countries allow the use of this consent model, with its use banned in only three of the countries we investigated. In a likely response to fears about exploitation, the export of samples outside of the continent is strictly regulated, sometimes in conjunction with regulations around international collaboration. We also found that whilst an essential and critical component of ensuring ethical best practice in genomics research relates to the governance framework that accompanies sample and data sharing, this was most sparingly covered in the guidelines. Conclusions There is a need for ethics guidelines in African countries to be adapted to the changing science policy landscape, which increasingly supports principles of openness, storage, sharing and secondary use. Current guidelines are not pertinent to the ethical challenges that such a new orientation raises, and therefore fail to provide accurate guidance to ethics committees and researchers.
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    The need to accelerate access to new drugs for multidrug-resistant tuberculosis
    (2015) Cox, Helen S; Furin, Jennifer J; Mitnick, Carole D; Daniels, Colleen; Cox, Vivian; Goemaere, Eric
    AbstractApproximately half a million people are thought to develop multidrug-resistant tuberculosis annually. Barely 20% of these people currently receive recommended treatment and only about 10% are successfully treated. Poor access to treatment is probably driving the current epidemic, via ongoing transmission. Treatment scale-up is hampered by current treatment regimens, which are lengthy, expensive, poorly tolerated and difficult to administer in the settings where most patients reside. Although new drugs provide an opportunity to improve treatment regimens, current and planned clinical trials hold little promise for developing regimens that will facilitate prompt treatment scale-up. In this article we argue that clinical trials, while necessary, should be complemented by timely, large-scale, operational research that will provide programmatic data on the use of new drugs and regimens while simultaneously improving access to life-saving treatment. Perceived risks – such as the rapid development of resistance to new drugs – need to be balanced against the high levels of mortality and transmission that will otherwise persist. Doubling access to treatment and increasing treatment success could save approximately a million lives over the next decade.
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    UCT Open Access Policy
    (University of Cape Town, 2014) University of Cape Town
    Central to the University’s core mission is the education and training of students, and the advancement, preservation and dissemination of knowledge. UCT encourages research and development and social outreach by creating a research culture that actively responds to the needs of the people of South Africa, while also contributing to the global research community.