Health Professions Council Of South Africa Research Articles

National Health Insurance interprofessional practice implementation in hand rehabilitation service delivery in South Africa.

Interprofessional rehabilitation framed in the ICF Core Set, accompanied by inclusive interprofessional education opportunities according to the Health Professions Council of South Africa (HPCSAs) scope of practice, will benefit South Africans who sustained hand injuries to fully recover and maximise their functional performance considering the type of injuries sustained.

Social media and electronic communication usage by South African dietitians

Objectives: This study investigated to what extent South African dietitians make use of social media and electronic communication and their compliance with the ethical guidelines set by the Health Professions Council of South Africa (HPCSA). Design: Cross-sectional descriptive design. Setting: South Africa. Subjects: Registered South African dietitians. Methods: Data were collected using an online survey (N = 125) and an observational checklist for selected digital platforms (N = 135). Both parts assessed demographic characteristics, usage of digital platforms and awareness or adherence to ethical guidelines. Results: Most participants used Instagram (45.5%) and Facebook (31.6%) as these platforms were regarded as user friendly, quick and suitable for their target audiences. Barriers to social media usage included time constraints (53.0%) and being unfamiliar with some platforms (37.3%). Enablers to social media usage included better reach of target population (61.4%) and ease of use (56.6%). The majority of survey participants were aware of the HPCSA Ethical Guidelines for Good Practice (n = 68/75, 90.7%). Overall compliance with the HPCSA guidelines was observed, yet nearly half (37/89, 41.6%) of the dietitians who shared information on digital platforms never provided references. Forms of touting/canvassing were observed on 20.7% (n = 28/135) of the platforms, while 15.6% of dietitians (n = 21) sold products on their websites, mostly meal-plans and supplements. Conclusion: South African dietitians actively engage with digital platforms to a varied extent, highlighting the importance of being cognisant of, and applying, the HPCSA Ethical Guidelines for Good Practice. The study can be useful in guiding future research on this unexplored, emerging topic.

Psychologists' experiences with telepsychology during the COVID-19 pandemic in South Africa.

During the COVID-19 pandemic, South African psychologists started to use telepsychology to continue providing services. However, diverse factors may influence psychologists' decisions regarding the use of telepsychology. To investigate South African psychologists' experiences with using telepsychology during the COVID-19 pandemic. Health Professions Council of South Africa (HPCSA)-registered psychologists practising in South Africa. A quantitative, cross-sectional study was conducted. Psychologists were invited to complete an online survey on the REDCap platform. Convenience sampling was used for respondent selection (n = 179). The study explored demographic variables, telepsychology use, changes in psychotherapy format, guidelines, ethical considerations, training, socio-economic factors, and individual patient and psychotherapist factors. Descriptive statistics, including categorical variables (frequencies and percentages) and numerical variables (medians and percentiles) were utilised for the data analysis. A bivariate analysis with backward selection was subsequently used, and significant variables were integrated into the logistic regression model. Most respondents (84.8%) used telepsychology, with 72.8% considering it a positive experience. Private psychologists used electronic means for delivering services significantly more than public sector psychologists. The public sector psychologists had more challenges relating to changes in the therapeutic format, additional training requirements and technology access. During the COVID-19 pandemic, psychologists turned to telepsychology as a valuable tool for providing services while navigating the unique challenges it presented. This study provides insights into the utility of telepsychology in the South African context during COVID-19. It underscores the experiences, importance of guidelines, and needs regarding training and technology access among psychologists.

Ocular therapeutics and the profession of optometry in South Africa.

The role of an optometrist as defined by the World Council of Optometry includes the management of ocular diseases. In 2015, the scope of optometry in South Africa was expanded to include ocular therapeutic drugs. To date approximately 27 optometrists have obtained full certification to exercise ocular therapeutic privileges. This study aimed to determine the interest, readiness, as well as challenges, of optometrists for the inclusion of ocular therapeutics into daily practice. The study was set in South Africa. A descriptive, cross-sectional study design was employed. Convenience sampling was used to recruit 420 participants from a study population of optometrists registered with the Health Professions Council of South Africa, with data collected using an online questionnaire hosted on social media platforms and distributed by professional organisations. Data were analysed using the Statistical Package for Social Science version 27. The majority of respondents (73.3%) reported keenness for ocular therapeutics certification. While 75.7% of respondents had obtained diagnostics certification, only 9.5% were registered with the Health Professions Council of South Africa (HPCSA) with ocular therapeutics certification. Most (92.1%) respondents reported the required minimum of 600 h of clinical training as a major challenge to obtaining ocular therapeutics certification. Almost all (96.9%) of the respondents agreed that ocular therapeutics certification will improve provision of optimal eyecare. South African optometrists support and are personally interested in ocular therapeutics certification. However, while there is a preponderance of diagnostically qualified optometrists, very few are certified for ocular therapeutics with completion of the required clinical training for certification perceived as the greatest challenge.Contribution:This findings in this study highlight that, current requirements to support ocular therapeutics certification of South African optometrists should be reviewed to ensure an enabling environment for the completion of the clinical training.

The Master Of Medicine (Mmed) Component Of Specialization, Have We Addressed The Challenges?

Background: Since its inception by the health professions council of South Africa (HPCSA) as a mandatory requirement in 2011, conducting research has presented multiple challenges for clinical specialist trainees. Objective: We aim to evaluate the literature looking at challenges encountered by both the specialist trainees and research supervisors. Data source: PubMed, SciELo SA, Google scholar and ERIC were searched. References of included articles were also evaluated for relevant articles. Data extraction: Data extraction was performed by all 3 authors. The databases were searched from inception to the present day, for only English language articles and those that reported on challenges. Conclusion: Many challenges still exist for both student and supervisor. Co-supervision should be normalised and a significant part of the solution is reinforcing already existing protocols. Recommendations: There is no one size fit all for all the academic institutions but standardized protocols for each centre are encouraged. Co-supervision is strongly encouraged.

Impact of the COVID-19 pandemic on audiology services in South Africa: A preliminary study.

Hygiene-, work practices, travel, personal interactions and access to healthcare services changed for the majority of the world during the pandemic. This study aimed to discover the knowledge, impact and attitudes towards COVID-19 on the professional practices of public and private sector audiologists in South Africa. The study included 76 audiologists registered with the Health Professions Council of South Africa (HPCSA) and employed in the public, educational, tertiary or private practice and private sector in South Africa. A cross-sectional self-administered electronic survey study design was implemented. Audiologists had appropriate knowledge regarding COVID-19. During hard lockdown, 69% of respondents saw less than 40% of their usual patient load, only 31% saw 60% - 100% of their usual patient load. During lower lockdown levels, majority of respondents (73.7%) saw 60% - 100% of their patient load while 26.3% still saw less than 40% of their usual patient load. Only hearing aid reprogramming, hearing aid trouble shooting, cochlear implant pre-counselling and adult hearing screening could be offered via tele-audiology. The main challenges faced were fear of infection, infection control measures in the workplace, accessibility and limited services provided during the various lockdown levels. The pandemic and lockdown levels had a definite impact on audiological service provision and many adaptations regarding service delivery and infection control in the workplace were required. The relevance of this work for health services is the identification of the challenges experienced by audiologists during the pandemic and the opportunities to prepare for the future.

South Africa’s Psychiatric training capacity in 2008 and in 2018. Has training capacity improved?

Background: There is a deficit of psychiatrists in South Africa, and to our knowledge, there is no situational analysis of training posts for psychiatrists in the country.Aim: To compare the number of specialists and subspecialists in training and training posts available in 2008 and 2018.Setting: South African medical schools with departments of psychiatry.Methods: A situational analysis involving data collection through a survey completed by eight heads of academic psychiatric departments followed by a comparative analysis of the two aforementioned years.Results: Data shows an 11% increase in funded and unfunded posts combined and a 9.3% increase in funded posts. The occupancy of funded posts decreased (92% in 2008 to 82% in 2018). When considering both funded and unfunded posts, only three more psychiatrists were being trained in 2018. Supernumeraries appointed in unfunded posts can be expected to return to their countries of origin. As such, a decrease in filled funded posts likely reflects a decrease in training psychiatrists destined to work in South Africa. While child and adolescent psychiatry was the only sub-speciality with accredited training posts in 2008, all sub-specialities included on the questionnaire had accredited training posts in 2018, and the number of accredited training posts in child and adolescent psychiatry doubled. That said, many of the posts were unfunded and vacant.Conclusion: While there was an increase in posts from 2008 to 2018, many posts remained unfilled. As such, not only are additional funded training posts required but also strategies to increase post-occupancy and successful completion of training.Contribution: This study is the first situational analysis of specialist and subspecialist training posts in Psychiatry in South Africa, at two time points over a 10 year period, that draws on academic heads of departments of psychiatry as respondents. The study highlights the nominal increase in funded training posts over this period, especially subspecialist training posts. The majority of Health Professions Council of South Africa (HPCSA) accredited subspecialities in Psychiatry have no funded training posts which is particularly concerning.

Assessing the need for a standardised paediatric assessment tool for podiatrists in South Africa

There is no literature to support the existence of an effective standardised assessment tool in South Africa that aids the podiatrist in the early diagnosis of developmental delay in the paediatric patient from age one to five. Podiatrists in South Africa (SA) need a suitable assessment tool to evaluate child development. A potential proforma that could be used by South African podiatrists is the Gait and Lower Limb Observation Proforma (GALLOP) Assessment Tool. AimThe aim of this research was to evaluate the “ease of use” and “usefulness” of the GALLOP Assessment Tool for podiatrists to effectively assess the paediatric patient from age one to age five. MethodsThe study was of a mixed methods descriptive design type, targeting all Health Professions Council of South Africa (HPCSA) registered podiatrists in the Johannesburg Metropolitan Municipal area. After allowing the participants to use the GALLOP Assessment Tool for a period of time, a survey was conducted to establish the “ease of use” and “usefulness” of the GALLOP Assessment Tool. ResultsAll participants agreed that the GALLOP Assessment Tool would be beneficial to South African podiatrists and that the assessment tool does not need to be improved upon.

South Africa's Psychiatric training capacity in 2008 and in 2018. Has training capacity improved?

There is a deficit of psychiatrists in South Africa, and to our knowledge, there is no situational analysis of training posts for psychiatrists in the country. To compare the number of specialists and subspecialists in training and training posts available in 2008 and 2018. South African medical schools with departments of psychiatry. A situational analysis involving data collection through a survey completed by eight heads of academic psychiatric departments followed by a comparative analysis of the two aforementioned years. Data shows an 11% increase in funded and unfunded posts combined and a 9.3% increase in funded posts. The occupancy of funded posts decreased (92% in 2008 to 82% in 2018). When considering both funded and unfunded posts, only three more psychiatrists were being trained in 2018. Supernumeraries appointed in unfunded posts can be expected to return to their countries of origin. As such, a decrease in filled funded posts likely reflects a decrease in training psychiatrists destined to work in South Africa. While child and adolescent psychiatry was the only sub-speciality with accredited training posts in 2008, all sub-specialities included on the questionnaire had accredited training posts in 2018, and the number of accredited training posts in child and adolescent psychiatry doubled. That said, many of the posts were unfunded and vacant. While there was an increase in posts from 2008 to 2018, many posts remained unfilled. As such, not only are additional funded training posts required but also strategies to increase post-occupancy and successful completion of training. This study is the first situational analysis of specialist and subspecialist training posts in Psychiatry in South Africa, at two time points over a 10 year period, that draws on academic heads of departments of psychiatry as respondents. The study highlights the nominal increase in funded training posts over this period, especially subspecialist training posts. The majority of Health Professions Council of South Africa (HPCSA) accredited subspecialities in Psychiatry have no funded training posts which is particularly concerning.

Attrition of dental therapists in South Africa-A 42-year review.

Dental therapists are mid-level oral healthcare providers introduced in 1977 to the South African health system to improve access to oral health services. There has, however, been anecdotal evidence of their unusually high rate of attrition that is cause for concern. This study aimed to determine the demographic profile and attrition rate among members of the South African Dental Therapy profession. A retrospective time series review of records of all dental therapists who were previously registered and who are still registered with the Health Professions Council of South Africa (HPCSA) between 1977 and 2019 was conducted. A total of 1232 dental therapists were registered from 1977 to 2019. The majority (64%) were Africans. Most practicing dental therapists were based in KwaZulu-Natal (44%) and Gauteng (27%), which are the provinces where dental therapists are trained. The overall attrition rate between 1977 and 2019 was 40%, with a figure of 9% for the last 10 years of the study (2010 to 2019). This study has provided the first evidence of the high attrition rate of dental therapists in South Africa. The high attrition warrants further investigation to address the loss of valuable human resources from an already overburdened and under-resourced public oral health sector.

The perceived role and relevance of South African optometric professional and regulatory bodies

Background: Healthcare professions in South Africa are regulated through legislative bodies such as the Health Professions Council of South Africa (HPCSA) towards the protection of the public. Professional associations, on the other hand, enhance professional practice aspirations and advocate for recognition of their profession and membership that is voluntary in nature. These specific mandates are sometimes confused or conflated by the profession. Aim: To assess practitioner perceptions on the role and relevance of optometric professional and regulatory bodies in South Africa. Setting: The study was conducted amongst practicing optometrists and dispensing opticians in South Africa. Methods: A cross-sectional, descriptive study that used a quantitative approach involving 208 optometric professionals was conducted via an online survey. Results: Approximately two-thirds (65.5%) of the 208 respondents, 65.0% of whom were members of the South African Optometric Association (SAOA), believed that the SAOA is relevant. However, more respondents (72.9%) in the sample believed that the HPCSA was relevant, the majority (56.1%) of whom were also SAOA members. Most respondents did not believe that either the SAOA (68.0%) or the HPCSA (61.0%) protects the practice of optometry. A lack of action against perceived negative practices of optometry networks and violations by registered and unregistered individuals emerged as strong reasons for dissatisfaction amongst respondents. High membership fees were cited as a membership deterrent by 67.0% of non-SAOA members. Despite reporting adequate knowledge of the SAOA (84.7%) and HPCSA (94.6%), factual assessment revealed only 42.4% and 69.5% were accurate on the respective mandates of the two organisations. Conclusion: Although many practitioners were unclear of the actual mandates of both the SAOA and HPCSA, they believed that both bodies were relevant and should improve advocacy and sanctioning of errant practitioners within the optometric arena in South Africa.

Reporting quality of Master of Medicine (MMed) mini-dissertations using the STROBE checklist


 
 
 
 Background. The 2011 Health Professions Council of South Africa (HPCSA) directive to make a research component compulsory for specialist registration has been decried in some circles as encouraging low-quality research.Objective. To assess the reporting quality of South African (SA) MMed mini-dissertations using the STROBE checklist.Methods. A total of 100 monograph-format mini-dissertations reporting retrospective observational research were extracted from a pool of 335 mini- dissertations. Analysis of each was undertaken using a 24-point STROBE Statement checklist. Scoring was as follows: 1 = the item was compliant with STROBE recommendations; 0.5 = partially described; and 0 = not addressed at all. Satisfactory compliance was set at 66%, thus a STROBE score of 17-24 was considered satisfactory. Data were entered into an Excel spread sheet and analysed descriptively.
 Results. STROBE item compliance for individual mini-dissertations was at a mean of 83.1%; range 50-97%; median 85% and mode 89%. Sixteen mini- dissertations were non-compliant, scoring below 17 as per the set threshold of 66%. This indicates an 84% satisfactory sample. Only Item 5 (Key settings and locations) was at 100% compliance. The four lowest scores were for STROBE items (9) Bias (29.5%); (10) Study size/power analysis (52%); (1) Title (69%) and (14) Missing data (69%).
 Conclusion. The majority of sampled mini-dissertations, evaluated as per STROBE recommendations, are transparently reported to allow the reader to follow what was planned, done, found and which conclusions were drawn. As such the results confer a measure of reporting quality on the SA MMed research endeavour. The use of dissertation templates, commonly using STROBE-type headings and prompts, might have contributed to the good scores obtained. Importantly, areas of weakness in the writing of the SA MMed mini-dissertations have been highlighted and show which items require attention.
 
 
 

Food and nutrition labelling as a nutrition education tool: understanding, perspectives and practices of South African dietitians.

Introduction: Food and nutrition labelling is an effective tool to address diet-related non-communicable diseases (NCDs), in which nutrition education plays an integral role. Objectives: To investigate South African dietitians’ understanding, perspectives and practices of food and nutrition labelling as a nutrition education tool. Design: A quantitative descriptive cross-sectional study was conducted. Setting: A nationwide survey was undertaken of dietitians from all sectors of practice. Subjects: Dietitians registered with the Health Professions Council of South Africa (HPCSA) (n  = 137). Outcome measures: A self-administered electronic survey was used for data collection. Results: Awareness of labelling regulations was high (86.9%); however, confidence in knowledge of regulations was lacking (53.3%), as well as knowledge regarding food-labelling regulations (R146) (52.6%). More than half (57.7%) regarded labels as relevant to their daily work and 51.8% used labels frequently, varying use depending on client needs. For education purposes, the nutrition information table (75.2%), client-specific nutrients (70.0%) and health endorsement logos (HELs) (59.2%) were most frequently used. Product healthiness was mainly evaluated using the cooking method (86.1%), level of processing (67.9%) and product category (63.5%). Least used aspects were origin/certification claims (39.4%) and animal husbandry (34.3%). Highly rated aspects included belief in label efficacy (88.3%), accuracy (81.8%), a positive attitude (87.6%) and relevance (80.2%). Conclusion: To promote optimal use of labelling as a nutrition education tool, standardisation, trustworthiness and continuing education should be addressed. Furthermore, the urgent promulgation of the draft food labelling regulations will address existing barriers to label use.

Nutrigenomics: Perceptions of South African Dietitians and General Practitioners

Introduction: Although investigations into the emerging field of nutrigenomics are relatively limited and more research in this field is required, experts agree that there is potential for it to be incorporated into health care practice. If health care professionals can promote healthy dietary behavior based on nutrigenomic testing, it can assist in addressing the health consequences of poor diet and lightning the strain on the South African health care system. Methods: Registered dietitians (RDs) and general practitioners (GPs) registered with the Health Professions Council of South Africa (HPCSA) who obtained their qualification in South Africa (SA) were eligible to participate in this cross-sectional study. Participants were identified using convenience and snowball sampling. A self-administered electronic survey using EvaSys Software® was completed by those that agreed to participate. Results: Nearly all RDs (97.3%), but less than a third of GPs (30.4%), had heard of the term nutrigenomics. Approximately three-quarters of RDs (74.7%) and GPs (73.9%) had or would personally consider undergoing genetic testing. More than 40% (43.5%) of RDs ranked direct-to-consumer genetic testing companies as the most equipped, while 31.8% of GPs ranked RDs as the most equipped to provide patients with nutrigenomic services. Both RDs and GPs ranked similar reasons as “strongly agree” for why consumers were motivated to make use of nutrigenomic services, which included “motivated by a desire to prevent or manage disease” (56.7%), “prevent a disease based on family history” (65.9%), “control health outcomes based on family history” (54.9%), and “improve overall health-related quality of life” (48.6%). Cost concerns were reported as the greatest barrier to implementing nutrigenomic services (75.7%). Other barriers included confidentiality issues (47.8%) and moral concerns (37.3%). Greater individualization of diet prescription (66.5%), stronger foundations for nutrition recommendations (62.4%), and dietary prescriptions that would manage or prevent certain diseases more effectively (59.0%) were all perceived as benefits of including nutrigenomics in practice. Conclusion: This study identified perceived consumer motivators and barriers that might affect the willingness to seek nutrigenomic services in SA. In addition, the need for more nutrigenomic training opportunities, including the planning of personalized diets based on genetic testing results and interpretation of results, was confirmed. However, both RDs and GPs felt that the emerging field of nutrigenomics needs further development before it can be applied effectively in routine private and public health care in SA.

Disciplinary proceedings against healthcare practitioners facing criminal charges: The role of the Health Professions Council of South Africa


 
 
 
 The purpose of this article is to address the questions as to whether a criminal conviction of a healthcare practitioner should affect his or her professional standing, and whether such conviction constitutes ‘unprofessional conduct’ in terms of the Health Professions Act. The article also explores a related matter, namely whether the Health Professions Council of South Africa (HPCSA) has a legal duty to refer complaints regarding unprofessional conduct that displays criminal elements for criminal prosecution. After considering relevant case law on these issues, the article concludes that a practitioner, after being convicted of an offence, should be afforded an opportunity to explain him- or herself to the board, not only in extenuation of the conduct in question, but also in response to the question of whether the conduct constitutes improper or disgraceful conduct. Moreover, the article explains why the HPCSA and professional boards have a legal duty to refer matters of unprofessional conduct with criminal elements in terms of section 34 of the Prevention and Combating of Corrupt Activities Act to law enforcement agencies.
 
 
 

Simulations as a mode of clinical training in healthcare professions: A scoping review to guide planning in speech-language pathology and audiology during the COVID-19 pandemic and beyond.

BackgroundSimulation plays an important role as an alternative method for training of students, particularly in health education. As a result of coronavirus disease 2019 (COVID-19) restrictions of face-to-face interactions, traditional teaching methods have been disrupted, increasing the need for alternative methods to supplement modes of student clinical training in healthcare programmes.ObjectivesThe scoping review aimed to determine what has been documented about simulation as a mode of clinical training in healthcare professions (HCPs) in order to guide speech-language pathology and audiology (SLP&A) professions during the COVID-19 pandemic and beyond.MethodA scoping review was conducted. Electronic bibliographic databases including Science Direct, PubMed, Scopus MEDLINE, ProQuest, Google Scholar and WorldCat were searched to identify peer reviewed publications, published in English, between January 2011 and December 2021, and related to the use of simulation in HCPs clinical training programmes.ResultsA total of 32 articles met the inclusion criteria for this scoping review. Three themes emerged when reviewing the studies: (1) face-to-face simulations as a mode of clinical training, (2) virtual reality simulation and telesimulation as modes of clinical training and (3) simulation as a complementary mode of clinical training. Evidence suggests that whilst simulations are cost-effective, accessible and efficacious as clinical training modes, they need to be combined with other modes of training such as the traditional clinical training to yield better learning outcomes.ConclusionsCurrent findings highlight the role and value of simulation as a clinical training mode during COVID-19 and beyond. However, there are aspects that need to be considered to ensure that this mode of clinical training is effective, with endorsement and regulations by the SLP&A Professional Board of the Health Professions Council of South Africa (HPCSA). Simulations need to be complemented with traditional clinical training methods. In the context of SLP&A, particularly in low- and middle-income countries (LMICs), simulation can be used to better prepare students for their clinical placement where clinical training platforms are limited and where simulation combined with teletraining or telesupervision can be utilised to increase access to training.

Medicine and the Law.

The case involving Dr Tim De Maayer in Gauteng Province, South Africa (SA), raises the question whether there is a legal and ethical duty on public sector doctors whose complaints to hospital administrators have been ignored, to inform the public about harm to child patients due to intentional maladministration, negligence or indifference by the local and provincial authorities. An analysis of the SA Constitution, the National Health Act No. 61 of 2003, the Children's Act No. 38 of 2005, the Health Professions Act No. 56 of 1974 and the Rules and Guidelines of the Health Professions Council of South Africa (HPCSA) established in terms of the Health Professions Act indicates that Dr De Maayer acted both legally and ethically to protect the child patients at Rahima Moosa Hospital. As the complaints of harm caused to the patients because of conditions in the hospital were raised three times with the official functionaries concerned, and ignored by them, he was fully justified to try other measures to protect the patients. It seems that he hoped that by bringing the conditions at the hospital to the attention of the media, the public reaction would be such as to pressurise the administrators to redress the situation. The irony is that the officials who sought to discipline him were themselves guilty of violating the Constitution, the National Health Act and the Children's Act, and should be disciplined. Furthermore, if they are registered with the HPCSA, they should be reported and disciplined for violating the HPCSA's Ethical Rules of Conduct and its Ethical Guidelines on good practice.

Temporal Trends in the South African Diagnostic Radiology Workforce (2002-2019).

BackgroundTo facilitate imaging resource planning and address key health targets of the United Nations (UN) 2030 Sustainable Development Goals, accurate data are required on imaging personnel at the country level. Such data are currently limited.ObjectivesThis study aims to analyze trends in the number, geographical distribution, and demographics of South African (SA) diagnostic imaging personnel between 2002 and 2019.MethodA retrospective analysis of the Health Professions Council of South Africa (HPCSA) database of imaging personnel from 2002 to 2019 was done. The total number of personnel and personnel per million people were calculated for the country and for each professional group (radiologist, diagnostic radiographer, and sonographer) by calendar year, province, and demographic profile. Population data were provided by Statistics SA.ResultsThe total imaging personnel, number per million people, and national population increased by 283% (3,095 versus 8,753), 119% (68 versus 149/106), and 29% (45.45 versus 58.77/106), respectively.Diagnostic radiographers constituted more than 80% of the workforce throughout the review period, increasing by 185% (2,540 versus 7,242). Sonographers, the smallest cohort, recorded the highest (49 versus 503; 906%) and radiologists (506 versus 1,007; 99%) the lowest proportional growth.Although radiologists showed persistent male predominance, the male proportion decreased from 82% to 69%, while that of females increased from 18% to 31%. The average annual percentage increase in female radiologists (14%) was more than three times that of males (4%).Diagnostic radiographers showed female predominance, but the proportion decreased from 90% to 83%, while that of males increased from 10% to 17%. Sonographers showed overwhelming female predominance (94% versus 92%). The average annual percentage increase in male diagnostic radiographers (21%) was more than double that of females (9%).In 2002, 48% (n = 1,475) of imaging personnel identified as White, and 15% (n = 467) identified as Black African. By 2019, those identifying as White and Black African were 36% (n = 3,122) and 35% (n = 3,045), respectively.The Western Cape Province (WCP) maintained the highest overall number of imaging personnel per million people (165 versus 233/106) and Limpopo the lowest (12 versus 54/106). However, Limpopo recorded the highest proportional growth in imaging personnel/106 people (368%) and the WCP the lowest (41%). The differential between the best- and least-resourced provinces thus decreased from 14:1 in 2002 to 4:1 in 2019.ConclusionIn the review period, the SA imaging workforce has shown substantial expansion and transformation and has assumed a more equitable distribution.

Safe caesarean sections in South Africa: Is internship training sufficient?

Background. In Africa, the maternal mortality rate after caesarean section (CS) is 50 times higher than that in high-income countries. In South Africa (SA), women who undergo CS have a three times higher mortality rate than those who deliver vaginally. Anaesthetic complications and obstetric haemorrhage are major drivers of poor outcomes, and the case fatality rate for CS at district hospitals is particularly high. Objectives. To assess the adequacy of anaesthetic and obstetric internship training in preparing interns to perform CS independently and safely. Methods. This was an observational cross-sectional survey of all community service officers (CSOs) in KwaZulu-Natal (KZN), SA, in 2020. Data were collected via an electronic survey that comprised 68 questions in 4 domains, covering personal information, obstetric surgical training, obstetric anaesthetic training and support received as a CSO. Results. Surveys were sent to 228 CSOs in KZN, with 160 responses received (70% response rate). Respondents included participants from 8 medical schools and 33 internship facilities across the country. One in 8 interns (n=21/160) did not perform the required 10 CSs. Supervision in theatre was provided by an obstetric specialist for at least 1 CS in n=57/160 (35.62%; 95% confidence interval (CI) 28.54 - 43.39) participants, and n=45/160 (28.13%; 95% CI 21.66 - 35.64) interns never performed an emergency CS. Interns had limited opportunity to be the primary surgeon for complicated cases. Only 1/5 interns performed >5 obstetric general anaesthetics. Conclusions. This survey showed that there are deficiencies in the current CS-related training of interns in SA. A lack of exposure to adequate obstetric surgical training and obstetric general anaesthesia is likely to impact on the performance of CSOs and on the safety of the CS service provided at district hospitals. The content and quality of the CS-related intern training programme needs to be enhanced to improve the competence of CSOs. The Health Professions Council of South Africa (HPCSA)’s stipulations for internship training must be adhered to and should look to include simulation training, basic surgical skills courses and prioritisation of exposure to complicated surgical scenarios

Telehealth in South Africa: A guide for healthcare practitioners in primary care.

The use of telehealth is becoming a prevalent feature in clinical practice worldwide, partly because of advances in medical and telecommunications technology. The coronavirus disease 2019 (COVID-19) pandemic has been a key driver in justifying the accelerated use of telehealth, leading to healthcare practitioners (HCPs) utilising virtual consultations more avidly. Although challenges remain, recent data have shown that remote consultations are feasible, safe and effective in South Africa (SA) and that HCPs should become proficient in conducting telehealth, virtual or remote consultations. These guidelines are based on the revised Health Professions Council of South Africa (HPCSA) General Ethical Guidelines for Good Practice in Telehealth (Booklet 10) and guidelines on remote or video consultations from the University of Oxford, the Royal Australian College of General Practitioners and the Royal College of Psychiatrists. These guidelines aim to equip HCPs with the basic knowledge and skills pertaining to medicolegal, communication and practical aspects of telehealth and how to practise telehealth safely and effectively in primary care settings in SA during the COVID-19 pandemic and beyond.