African Healthcare Research Articles

The adoption of telemedicine by healthcare practitioners in South Africa

Orientation: Telemedicine plays an important role in patient-centred healthcare, diagnosing and treating diseases and developing treatment plans. It includes both provider-to-provider and provider-to-patient communication, which can be synchronous (telephone and video) or asynchronous (messaging and electronic consultations).Research purpose: The coronavirus disease 2019 pandemic sparked interest and awareness of telemedicine; however, there is a need to explore the adoption of telemedicine in the context of South Africa. This study examined South African healthcare practitioners’ adoption of telemedicine using the Unified Theory of Acceptance and Use of Technology (UTAUT) model.Motivation for the study: The adoption of telemedicine by healthcare practitioners in South Africa has not been extensively researched.Research design, approach and method: A positivistic approach using quantitative methods of analysis was adopted. The target population was registered healthcare practitioners practising in South Africa and 96 healthcare practitioners participated in the study.Main findings: The study established that the independent factors of Performance Expectancy, Facilitating Conditions, Social Media Technology and Attitude all have a significant positive relationship with the dependent factor, Behavioural Intention to adopt telemedicine.Practical and/or managerial implications: The need for healthcare practitioners to be trained in telemedicine technology is an essential prerequisite for its adoption.Contribution and/or value-add: Gender significantly influenced the dependent factor, behavioural intention to adopt telemedicine. Males rated the behavioural intention more positively than females. The theoretical contribution of the study is the extension of the UTAUT model for telemedicine adoption.

Educational interventions to improve pediatric emergency care: A qualitative assessment of the perspectives of African healthcare workers.

Pediatric emergency care (PEC) training for health care workers (HCWs) is commonly offered in the form of short courses. This study gathers the perspectives of HCWs from eight African countries on how to best deliver and implement short training courses in PEC. This is a qualitative study using semi-structured key informant (KI) interviews. Utilizing the African Federation for Emergency Medicine (AFEM) member list serve, we identified African HCWs who had previous experience participating in and/or delivering short training courses in PEC. From this cohort, four interviewers were selected. These interviewers all received training in qualitative interviewing and then each recruited five KIs in their respective settings using convenience sampling. All interviews were recorded, transcribed, translated as necessary, and coded using thematic analysis. A total of 20 interviews were completed. Most KIs (75%) were physicians. Several themes on short training courses in PEC emerged: there was strong motivation to participate in PEC trainings, interactive sessions were preferred over didactic sessions, the recommended course structure was a half-day format with longitudinal follow-up, and the ideal for course instructors was a mix of local trainers and visiting trainers. KIs reported several potential negative consequences of short training courses in PEC, including clinical staffing gaps during courses and PEC content taught that was incongruous with local protocols. Future curricular development and implementation of short training courses in PEC should incorporate the preferences and best practices identified by African HCWs, namely interactive sessions with longitudinal follow-up given by a mix of local and visiting trainers. Our study limitations include the number of participants and potential for selection bias.

Professional Oversight in AI Healthcare Implementation: A Multi-Country Analysis of Trust, Clinical Outcomes, and Implementation Success in African Healthcare Systems

Professional Oversight in AI Healthcare Implementation: A Multi-Country Analysis of Trust, Clinical Outcomes, and Implementation Success in African Healthcare Systems

Preparation of nursing students in nursing informatics competencies for the South African healthcare practice environment

BackgroundRapid technology advancements highlight the importance for nursing education to prepare competent nurses in informatics and technology integrated practice. This study examined nursing informatics in an undergraduate curriculum and competency levels at a selected South African university.MethodA survey measured nursing informatics competencies among undergraduate nursing students using the TANIC© nursing informatics scale. In addition, curriculum mapping was done to assess the inclusion of relevant content in the undergraduate curriculum. Mean scores out of 4 indicated competency levels from novice to proficient. Descriptive analysis was undertaken and 95% confidence intervals were computed for computer literacy, clinical information management, and information literacy domains. Independent Samples Wilcoxon U Tests compared competency level differences by year per domain. Curriculum mapping assessed technology-related activities across the four-year programme.ResultsOf the 222 respondents (79.9% response rate), competence levels increased by year level. Computer literacy had the highest rating (3.33/4, ± 0.48), nearing proficient levels. This was followed by information literacy (2.81/4, ± 0.68), falling within a comfortable competency range, and clinical information management, (2.73/4, ± 0.77) indicating advanced beginner competency. Curriculum mapping revealed the absence of information management training.ConclusionA need exists to increase NI integration in the curriculum, and better equip nurse educators to prepare students for technologically infused healthcare environments.

Barriers and recommendations for the implementation of robot-assisted minimally invasive surgery in Africa.

Robotic surgery offers several advantages to the African setting, including shorter hospital stays, faster return to work, and increased overall productivity. However, its adoption has been limited by several factors. This review aims to present the barriers to implementation, and recommendations for integrating robotic surgery into the African healthcare system. Use of robotic surgery in Africa is primarily limited to Egypt and South Africa. Barriers faced by other countries were categorized into economic, infrastructural, systemic, and training-related. They include limited healthcare budgets, initial costs of robotic systems, patients' inability to afford robotic procedures, out-of-pocket healthcare financing, inadequate power supply, limited internet connectivity, poor healthcare leadership, and insufficient surgeon training facilities. Public-private partnerships, provision of loans and subsidies, introduction of cheaper robotic systems, and local manufacturing of robotic equipment will serve as cost-effective innovations. It is also important to improve healthcare financing and strengthen healthcare leadership across Africa. To address the lack of surgeon training facilities, remote assistance for surgeon training can be used to create a mentor-mentee relationship between robotic surgeons in any part of the world and surgical trainees in Africa to facilitate knowledge transfer. Prior investment in electricity and network infrastructure is however necessary. Establishment of fellowships to provide early exposure to robotic surgery should also be explored. AI-integrated robotic surgery can also enhance precision and safety, and provide tailored training tools for surgeons. Similar barriers to the adoption of surgical robotics are faced across Africa. By implementing the provided recommendations, robotic surgery can still be widely adopted in African settings, despite the delay.

Trends and Outcomes of Laparoscopic Surgery in Low‐Resource Settings: Lessons From Two African Healthcare Systems–A Narrative Review

ABSTRACTIntroductionLaparoscopic surgery (LS) has been a promising development in surgical practice globally ever since its introduction. LS has exhibited many an advantage, including bettering patient outcomes, lowering the risk of postoperative infection, and displaying economical affluence. However, its implementation in the African continent still faces various challenges. In this review, we investigated the status of laparoscopic surgery integration in Africa.ObjectivesIn this review, we aimed to investigate the challenges posed by the implementation of LS in low resource countries as well as critically evaluating initiatives and their impact within said domiciles. We also provide recommendations that may assist in LS prosperity in these settings by focusing efforts on improving training and financial incentives.MethodsA comprehensive literature review was conducted to garner up‐to‐date evidence concerning the fate of LS adoption in low‐ to middle‐income countries. This comprised the analysis of different case studies from countries including Nigeria and Botswana, and investigated relevant recommendations and policies provided by other African countries.ResultsVarious challenges face the implementation of LS in countries with low resources comprising poor infrastructure, scarce training programs, and expert training personnel alongside financial boundaries. The adoption of LS in Africa has proved its benefits in improving patient outcomes and reducing hospital admissions. From a perspective of policy, it is crucial to sustain strong ties amongst institutions, stressing the importance of dynamic collaboration and locally tailored policies.ConclusionIt has been demonstrated that LS implementations in African nations lower infection rates and expedite recovery. A strong collaboration between governments, stakeholders, and healthcare providers is fundamental for successful integration of LS. Such extension in low‐resource environments may be achieved by providing proper training programs, funding infrastructure and equipment, and fostering effective financial initiatives.

Professional nurses' perspectives on the implementation of integrated chronic disease management model.

The integrated chronic disease management (ICDM) model is seen to be a promising strategy as it is gaining global acceptance as an approach to enhance healthcare delivery. The study objectives were to explore and describe professional nurses' perspectives on the model, identify challenges experienced during implementation and identify factors that could improve the model implementation. An explorative, descriptive qualitative design was used, nine professional nurses from three selected facilities were interviewed. Data obtained from semi-structured individual interviews were analysed using thematic analysis and NVivo software. Three main themes emerged: the professional nurses' perceived benefits of the model, challenges experienced during implementation and recommendations to ensure effective implementation of the model. The perceived benefits of the model included the integration of care, adequate medication and the alleviation of stigma related to diseases. However, the challenges of the model included a shortage of staff, poor infrastructure and patients missing scheduled appointments. The study noted the need for adequate staff, infrastructure and ongoing training for the successful implementation of the model. Despite challenges in the South African healthcare system, professional nurses perceived the implementation of the model positively. The study highlighted the need for adequate staff, adequate infrastructure and ongoing training for staff.Contribution:This study outlined the challenges and recommendations identified, enabling healthcare organisations, policymakers and educators to develop targeted strategies for successful implementation. The findings will also inform future research focussed on optimising the utilisation of the model in the study setting and similar contexts.

Nurses' knowledge to identify, prevent and manage hypertensive disorder of pregnancy.

Hypertensive disorders of pregnancy are major contributors to maternal mortality in South Africa. Preventative strategies in low- and middle-income countries emphasise frequent antenatal visits, symptom identification, patient education and the prophylactic use of calcium and low-dose aspirin to prevent HDP for nurses because they are the frontline workers at antenatal clinics countrywide. This was a cross-sectional study where a self-administered questionnaire was conducted among nurses (midwives and professional nurses) employed at hospitals and clinics in Durban, South Africa, to assess their understanding and practices regarding identification and initial management of HDP, particularly for eclampsia and PE with severe features. The questionnaires were distributed in person by the researcher. Of the 106 respondents, most (88.7%) worked in the public sector, with over 5 years of experience (64.9%). There was a varied understanding of HDP categories: 72.6% identified gestational hypertension correctly; 49.1%, chronic hypertension; 93.4% PE and 83.0% eclampsia. Knowledge of the recommended treatments for severe PE (55.7%) and eclampsia (66.0%) was moderate with respect to the recommended anticonvulsant and rapid-acting antihypertensive agents, with only 10% recognising the role of aspirin for the prevention of HDP. Substantial knowledge deficiencies existed among nurses in managing HDP.Contribution:Their crucial role in both emergency and preventative care in South African healthcare settings, enhancing educational training on clinical management by providing continuous training and regular updates are imperative to reduce maternal and perinatal complications associated with HDP.

Development and validation of a Knowledge, Attitudes and Practices (KAP) questionnaire for healthcare professionals on environmental sustainability in healthcare in Southern Africa

Background Global environmental degradation is increasingly driving poor health outcomes worldwide. Healthcare systems and services are often not environmentally sustainable and compound the problem, while healthcare professionals are also recognised as key leaders in advancing sustainable healthcare. To adopt this leadership position, healthcare professionals’ knowledge, attitudes, and practices regarding environmental sustainability in healthcare must be established. This article reports the development and validation of a new instrument for this purpose that corresponds to the specificities of the Southern African context. Methods Questionnaire development followed a seven-stage process. Information was obtained from a 2021 study titled ‘South African Healthcare Professionals’ Knowledge, Attitudes, and Practices Regarding Environmental Sustainability in Healthcare: A Mixed-Methods Study’ to develop the instrument. Information was also sourced from the literature regarding environmental sustainability and healthcare to generate the first questionnaire with 29 items. The following stages included two rounds of expert input, separated by a pilot study with the target population to receive feedback regarding the instrument’s structure, relevance, and length. Content validity was determined through statistical analysis. Results Feedback was received from nine experts in stage two and 13 pilot-study participants in stage four and incorporated to improve the questionnaire. In stage six, the questionnaire was rated by seven experts. The content validity index of the questionnaire was calculated at two different stages, after which the indices were compared. Following a final edit, the questionnaire has 24 questionnaire items. The closing analysis calculated the scale content validity index average (S-CVI/Ave) of 0,922; this indicates that the final questionnaire has excellent content validity. Conclusion A questionnaire that assesses the knowledge, attitudes and practices of healthcare professionals regarding environmental sustainability in Southern Africa has been developed and validated. This questionnaire can now be used for further studies in Southern Africa.

Tobacco use and readiness to treat tobacco users among primary healthcare professionals in Soweto.

Despite its hampering influence on the willingness of healthcare professionals (HCPs) to implement tobacco cessation treatments, the tobacco use status of these professionals remains understudied in South Africa. This cross-sectional study, which sampled 444 HCPs, was conducted in five community health centres in Soweto. A self-administered questionnaire collected information on socio-demography, tobacco use, quit attempts and readiness to implement tobacco cessation treatments for their patients. The mean age was 41 years. Most were female, 80% (n= 355); single, 54.1% (n= 240) and black professionals, 91.6% (n= 405). About 22% (n= 96) were ever-users of tobacco, 12.6% (n= 56) current users and 9% (n= 40) ex-users. About 56.6% (n= 30) of current users had contemplated quitting in the past year. Approximately 68% (n= 300) and 82.2% (n= 365) of respondents were ready and willing to implement tobacco cessation treatments, respectively. Only 32% (n= 143) of respondents had received any training on tobacco use and cessation treatments. There was no significant association between tobacco use and readiness to implement cessation treatments (p= 0.50). Tobacco use is prevalent among HCPs and does not influence the implementation of cessation treatments in South African primary health care. Although most reported readiness and willingness to quit tobacco use, more training is required in both formal education and continued professional development.Contribution:This study demonstrates the alarming rate of tobacco product use among primary health care professionals in South Africa. While there is a strong willingness to implement tobacco cessation treatments for their patients, most healthcare professionals still require training to enhance their self-efficacy.

Quality of life among patients with end-stage renal disease undergoing haemodialysis in Africa: a systematic review

ABSTRACT Chronic kidney disease affects every aspect of patients’ lives, particularly burdening those in 44low- and middle-income countries. This systematic review aims to explore the quality of life of haemodialysis patients in Africa. Following the PRISMA guidelines, inclusion and exclusion criteria were pre-established for this systematic review, leading to the selection of eight articles on life quality of haemodialysis patients in Africa. This review reveals, on the one hand, that studies carried out in Africa on the quality of life of haemodialysis patients are rare and, on the other hand, that the different domain scores of the Kidney Disease Quality of Life (KDQOL) questionnaire show a deterioration in the quality of life of haemodialysis patients in Africa. According to the results of this review, African healthcare systems need to pay more attention to haemodialysis patients, especially in countries where resources are limited.

Adolescent mental health services in West Africa: a comparative analysis of Burkina Faso, Ghana, and Niger

BackgroundAdolescent mental health (AMH) is a critical issue worldwide, particularly in West Africa, where it is intensified by socio-economic, cultural, and security challenges. Insecurity and the presence of mining sites expose adolescents to hazardous environments, substance abuse, and adulterated alcohol, further aggravating their mental health. Despite these severe issues, research on AMH in this region remains limited. This study aims to analyze the provision of AMH services in Burkina Faso, Ghana, and Niger, highlighting the unique challenges these countries face within the broader West African healthcare context.MethodsThe study adopted a multi-stage, stratified sampling design to collect data from primary healthcare centers (PHCs) in the three countries. Using STATA.17, Descriptive analysis was conducted on the data related to availability of AMH services, types of mental health disorders treated, resources available, and OPD attendance rates. The analysis also incorporated factors such as the rural-urban divide and the presence of national guidelines for AMH services.ResultsThe findings reveal a significant shortfall in the provision of AMH services across the region, with less than 30% of PHCs across all the countries offering these services. The study also highlights a pronounced rural-urban disparity in AMH service availability, a general absence of national guidelines for AMH care, and low OPD attendance rates.ConclusionThe study highlights the urgent need for comprehensive policy reform and targeted interventions to enhance AMH services in West Africa. Key policy reforms should include the development and implementation of national guidelines for AMH care and integration of AMH services into primary healthcare. Additionally, efforts should focus on capacity building through the training of mental health professionals, increasing public awareness to reduce stigma, and ensuring equitable resource allocation across rural and urban areas. Improving AMH care is essential not only for the well-being of adolescents but also for driving broader socio-economic development in the region.

AI Methods and Algorithms for Diagnosis of Intestinal Parasites: Applications, Challenges and Future Opportunities

Artificial intelligence (AI) transforms intestinal parasite diagnosis, particularly through deep learning models like convolutional neural networks (CNNs). This paper reviews the application of AI, especially CNNs, in automating parasite detection and classification from microscopic images. Integrating AI into parasitology diagnostics speeds up the process, reduces human error, and enhances treatment and patient outcomes. However, there is a need for more datasets reflecting the African context to ensure accurate ground-truthing, particularly in low- and middle-income countries (LMICs) across Africa. Most AI models for medical diagnosis are trained on datasets from high-income countries, which may not capture the unique epidemiological, genetic, and environmental factors prevalent in African populations. This can lead to less accurate diagnoses and treatment recommendations in African LMICs. For example, intestinal parasitic infections are common in many African regions, yet the datasets used to train AI models often lack sufficient representation from these areas. Developing datasets that reflect the diverse African context is crucial for improving the accuracy and reliability of AI-based diagnostic tools. Issues like overfitting, data privacy, and cost also require attention. Collaboration between researchers, healthcare professionals, and technologists is essential to address these challenges. Standardized protocols for data collection, model training, and validation are necessary for reliable AI systems. Combining AI with traditional techniques holds promise for better parasite diagnosis, ultimately improving African healthcare outcomes

Digital entanglements: Medical drones in African healthcare systems

ABSTRACT The intensified scramble for the digitalisation of healthcare across Africa, coupled with the general drive for digital economies, has ushered in digital health innovations that are reconfiguring national discourses on humanitarian and development contexts. Through these innovations, imaginaries of health have become entangled with aspirations for universal health coverage (UHC) and the actualisation of the health-related sustainable development goals (SDGs). Among these innovations, drones promise to leapfrog and transform conventional African healthcare systems, which have suffered from structural bottlenecks for years, offering citizens on the margins of care critical biomedical gazes. By using drones, African states hope to improve revenue collection, curb corruption, redress health insecurities and deliver life-saving medicines, vaccines and laboratory diagnostics through a last-mile distribution schedule. Ethnographic fieldwork from 2022 to 2023 in Ghana and Malawi on the use of drones found distortions to the health workforce, disruptions to health work, and a pervasive internal brain drain, all exacerbating health-worker shortages. This paper explores how drones are reconfiguring health work and its available labour force in practice amid persistent shortages of health-workers.

Influencing Policy to Advance Paediatric Surgery in Africa

My aim in this lecture was to address the critical role of policy in advancing paediatric surgery in Africa. I highlight the policy gaps hindering progress in paediatric surgery, discuss supportive ongoing policy initiatives and outline the short-term impacts of these initiatives. Globally, an estimated 1.7 billion children lack access to safe and timely surgical care. In Nigeria, policy gaps have contributed to significant challenges in paediatric surgical care, including poor access and inequities in the distribution of paediatric surgeons and anaesthesiologists. To address this situation, key innovations including inclusion of children's surgery in Nigeria’s National Surgical, Obstetrics, Anaesthesia, and Nursing Plan (NSOANP) has led to infrastructure improvements, critical care training, and the creation of a birth defects registry. These initiatives have shown significant gains, such as increased surgical volumes and cost-effective infrastructure investments. Efforts to strengthen the workforce for paediatric surgery through mentoring, training, and tasksharing are underway to address the shortage of paediatric surgeons and paediatric anaesthesiologists. Furthermore, children's surgery is gaining emphasis in new policies and plans across Africa, including initiatives such as the Africa Surgical Initiative and Pan African Surgical Healthcare Forum. Paediatric surgeons must actively engage in public health policy and decision-making to create sustainable impacts on global child surgical healthcare. Continued efforts are needed to broaden engagement beyond surgical networks and platforms to achieve lasting improvements in paediatric surgical care.

The African Medicines Agency and Medicines Regulation: Progress, challenges, and recommendations.

In response to the situation of the African healthcare system, the African Medicines Agency (AMA) was established by the African Union (AU) to regulate access to medicines and support the local manufacture of medications. This study aimed to describe the factors that enabled the establishment of the African Medicines Agency and its successes, challenges, and perceived benefits. We reviewed data sources that explored the progress and challenges of the African Medicines Agency and Medicines Regulation in Africa. The SPIDER framework was used to organise the research focus and to extract the keywords for the literature search. The study data were obtained from PubMed Central, ScienceDirect, and Google Scholar. Out of 249 studies screened, 19 were selected for this narrative review. Critical successes observed in the agency's establishment include the appointment of a Special Envoy, the selection of its headquarters, and the signing of its treaty by 37 member states. However, it is hindered by poor political commitment, differences in risk-benefits interpretation and organizational structure, weak legal and regulatory frameworks, inadequate financial mechanisms, and inadequate political and policy leadership in some member states. The value of AMA in achieving optimal health outcomes and its other benefits must be considered despite the challenges being encountered. Therefore, all member states should adopt the best procedures in signing and ratifying the treaty and implementing associated commitments to improve efficiency and accountability in African medicine regulation.

Managerial practices for app-based primary care telemedicine service acceptance in South Africa

Purpose: This study addresses the qualitative research phase of a mixed methods study conducted to investigate patient acceptance of an app-based telemedicine service for primary care aimed at South African public health care sector patients.Design/methodology/approach: Qualitative data were collected by means of semi-structured individual interviews with patients who had exposure to an existing app-based primary care telemedicine service in South Africa named Kena Health. Thematic analysis of the qualitative data using ATLAS.ti software was conducted to identify the relevant antecedents of telemedicine service acceptance in the study’s context.Findings/results: Eight antecedents of app-based primary care telemedicine service acceptance among South African patients (who are predominantly reliant on public health care sector services to receive medical care) were identified, namely, perceived compatibility, perceived ease of use, relative advantage, price value, trust, innovativeness, privacy perception and care perception.Practical implications: To date, prior literature has not yet identified the specific antecedents that would apply to the acceptance of an app-based telemedicine service for primary care among South African individuals who are predominantly reliant on the country’s public health care system to receive medical care.Originality/value: Our study contributes to the literature by identifying which existing factors of technology acceptance apply to primary care telemedicine service acceptance, predominantly in the South African public health care sector context. Furthermore, additional antecedents of telemedicine service acceptance that have not been included in technology acceptance theory until present, that is, (positive) privacy perception and care perception are identified.

Optometrists’ experience of healthcare fraud, waste and abuse (FWA) and strategies to combat it

Background: South African private healthcare is funded through medical aids and out-of-pocket payments. Annually, R22 billion is lost to medical fraud, waste and abuse (FWA) threatening the sustainability of healthcare delivery. Healthcare providers are often accused of unethical practices and various forms of FWA.Aim: To assess the optometrists’ experience of FWA and the strategies to combat FWA.Methods: A quantitative study was conducted amongst optometrists using a structured questionnaire and data was analysed using descriptive statistics.Results: Most (75%) respondents were aware of FWA. About 41% of respondents were audited for FWA, of whom two-thirds were Black males. The Preferred provider Negotiators conducted 27% audits, followed by Discovery (16.5%), Government Employees Medical Scheme (7.8%) and Medscheme (5%). Iso Leso and Opticlear networks conducted 3.9% each. About 7.8% were found guilty of FWA, of whom 87.5% were Black practitioners and 12.5% Indian practitioners. Claiming for spectacles but dispensing sunglasses (5.9%) and over-servicing (4%) were highest ranked offences. Common sanctions were claw-back (75%) and indirect payment (37.5%). Practitioners implement identity checks (94%–96%), coding training (89%) and accurate record keeping (93%) as anti-FWA strategies. Excessive codes and lack of standardised tariffs were challenges to fighting FWA.Conclusion: Optometrists use identity checks, coding and billing training as anti-FWA strategies. Coding and billing complexities are the main sources of FWA cases. Black and Indian practitioners were more likely to be identified for FWA and found guilty than White practitioners.Contribution: The study highlights the forms of FWA and suggest integration of controls to effectively curb FWA.

Barriers and enablers to breast cancer screening in rural South Africa

Background: The breast cancer burden on the South African healthcare system is severe, with rural South African women often diagnosed at an advanced stage of the disease. South Africa’s rural areas are classified as low-resource settings with limited medical services and infrastructure. The impact of breast cancer on rural communities in South Africa requires ongoing research to better understand the severity of this disease among one of the most vulnerable populations.Objectives: This study aimed to explore the barriers and enablers of breast cancer screening among rural South African women.Method: An exploratory qualitative study was utilised. A semi-structured interview was conducted with 22 rural South African women. Data were analysed using thematic analysis. This study utilised the care-seeking behaviour theory as its theoretical framework.Results: Participants identified many barriers to breast cancer screening, including individual affordability, transportation, rural services, infrastructure, health professional behaviour, and the lack of educational materials. Several factors are suggested to enable the screening of breast cancer in rural South Africa, including breast cancer campaigns, health education, the involvement of key stakeholders, and promotional materials.Conclusion: Despite the many barriers to breast cancer screening among rural South African women, there is still hope in implementing the various promotional tools outlined in this study and ensuring that breast self-examination is an alternative, affordable screening method.Contribution: The purpose of this article is to contribute to the attainment of the Sustainable Development Goal (SDG) 3, which focusses reducing premature mortality from non-communicable diseases, including cancer.

Electronic health records model to improve the quality of patients' healthcare.

Electronic health records (EHR) has been acknowledged for bringing down healthcare costs and enhancing hospital service standards. The aim of this study was to develop an EHR model to lower patient treatment costs and enhance healthcare quality in South African public healthcare. In this study, a cross-sectional quantitative methodology was used. The research data for this study were provided by medical healthcare professionals, at Dr. George Mukhari Academic Hospital (DGMAH). This included doctors, nurses, pharmacists, radiologists, and radiographers who completed a semi-structured questionnaire. The final model's findings show that the use of EHR significantly improves information quality (IQ) and positively influences medical errors reduction (MER). Knowledge quality (KQ) has a positive significant impact on MER, whereas IQ has a considerable negative impact on MER. Furthermore, cost reduction in patient treatment (CRPT) has a positive significant influence on MER. Patients obtain better medical care when medical professionals have access to complete and accurate information. Medical errors can be reduced or even prevented with the use of EHRs, which can lead to better patient outcomes. The quality of patient care at South African public hospitals and in other developing countries can be enhanced by using this framework as a guide to reduce treatment costs.