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Rationale: This study presents the first comprehensive analysis and mapping of scientific research on point‐of‐care testing (POCT) in infectious diseases, filling a gap in understanding the evolving landscape of this field. The identification of research themes and global contributions offers valuable insights. Aims and Objectives: This manuscript aims to analyse and map scientific research on POCT in the context of infectious diseases. Methods: The study employed a comprehensive search strategy using terms related to POCT and infectious diseases. The search was conducted on the Scopus database, refining results based on inclusion and exclusion criteria. The dataset of 1719 research articles was then subjected to descriptive analysis and mapping using VOSviewer. Results: The research findings indicate an exponential growth in POCT‐related publications, with 46.8% published post the COVID‐19 pandemic. Plos One journal led in publication frequency, and Biosensors and Bioelectronics received the highest citations per article. North America and Western Europe dominated contributions, with notable participation from China, South Africa, and India. The research landscape revealed the following research themes: detection technologies, human immunodeficiency virus (HIV)/sexually transmitted infection (STI) diagnosis, antibiotic optimisation, and schistosomiasis. Clinical trials focused on antibiotic prescribing, HIV, STIs, and specific infections. The findings suggest a shifting landscape towards POCT, emphasising the need for future planning and investment in healthcare systems. The research identifies areas for future exploration, such as the impact of POCT on antibiotic prescribing and its role in combating infectious diseases in low‐ and middle‐income countries. Conclusion: Implementation of POCT has the potential to revolutionise infectious disease management, improve patient outcomes, and reduce the global burden of diseases. Better public awareness, healthcare team management, and planning for POCT at entry points are crucial for societal benefit. Results demonstrated the evolving role of POCT in infectious disease management and prevention. [ABSTRACT FROM AUTHOR]

Despite recent gains, South Africa is yet to fully develop its economic potential in the medical technologies industry. Yet it remains uncertain which parts of the extended medical technologies industry South Africa should prioritise. This paper uses the input-output product space (IO-PS) methodology to identify key areas in the medical technologies industry that are likely to unlock the industry’s potential in South Africa. The analysis involved using a hierarchical mapping of the industry as input to the IO-PS analysis. Thereafter, the outputs of the methodology were analysed and interpreted. The most promising products for further development under various scenarios were identified. [ABSTRACT FROM AUTHOR]

Background: COVID‐19 necessitated emergency telepractice for student‐led speech‐language therapy clinical practicals in training institutions, with limited preparation and evidence‐based guidelines. Beyond the pandemic, practitioners and university training sites are likely to continue to offer telepractice necessitating thorough preparation for telepractice services underpinned by a comprehensive understanding of the complexities involved in online therapy. Aims: Adopting realist evaluation principles, our aim in this paper was to explore broadly what works and does not work in a set of student‐led telepractice sessions in a diverse, resource‐limited context. The broader goal of this project was to provide evidence‐based support to enhance the efficiency and success of telepractice sessions in student clinical training contexts. Methods & Procedures: We used qualitative observational methods with reflexive thematic analysis to analyse 28 video recordings and 61 observation notes of student‐led paediatric telepractice sessions from a South African university clinic as part of a pilot study. Outcomes & Results: We identified four overarching considerations for student‐led telepractice: (1) additional, specific preparation is required, (2) with greater management of technology and adaptation of tasks, especially during times of poor connectivity; (3) telepractice relies heavily on caregiver input and collaboration; and (4) promoting engagement online, holding a client's attention, building rapport and offering reinforcement are critical skills that are complicated by the lack of face‐to‐face contact. Conclusions & Implications: Our findings indicate that telepractice pedagogy needs to be explicitly taught and students require practical assistance as they learn how to use this service delivery approach effectively. There are some aspects peculiar to telepractice that require unique consideration and planning, especially in contexts where service providers and users may be unfamiliar with this form of service provision. The findings of this pilot study can be used by clinical educators and student clinicians to enhance clinical training opportunities involving telepractice. WHAT THIS PAPER ADDS: What is already known on this subject: Many speech‐language therapy (SLT) student clinicians had to transition quickly to telepractice service provision during COVID‐19 with limited existing guidelines and support, especially in contexts where teletherapy is typically non‐existent or difficult to access. Although there is some literature available on experiences of telepractice, there is very little evidence‐based research which explores the mechanics of such sessions in real‐time and which offers practical support to student clinicians and clinical educators engaging in this mode of service delivery. What this study adds: This pilot study examined video‐recorded, student‐led, paediatric, speech‐language teletherapy sessions to understand challenges and considerations involved in using telepractice as a clinical training tool. Findings show that additional preparation for telepractice sessions is required, particularly in contexts of poor digital literacy; students must learn to manage technology, especially when connectivity poses a challenge, and adapt therapy tasks for online work with clients; telepractice relies heavily on caregiver input and collaboration, more so than in in‐person consultations, and this relationship requires careful management; and promoting engagement online, holding a client's attention, building rapport and offering reinforcement are critical yet challenging skills in telepractice. What are the potential or actual clinical implications of this work?: Our findings highlight a need to teach telepractice pedagogy explicitly and support students practically in learning how to provide therapy effectively via this mode of service delivery. Observational methods for studying practices in recorded telepractice sessions can be used as part of a reflective approach to clinical training. Using already available data allowed us to unpack the 'messy reality' of clinical training using telepractice. [ABSTRACT FROM AUTHOR]

Introduction: Multipurpose prevention technologies (MPTs) simultaneously prevent HIV, other sexually transmitted infections, and/or unintended pregnancy. Key gatekeepers, [healthcare providers (HCPs) and key stakeholders] require proactive engagement before product implementation. This manuscript identifies HCP demand creation strategies, key stakeholder considerations for the adoption of MPTs in South Africa. Methods: Formative research was conducted in three districts in three South African provinces (July to November 2022). Nurses initiating oral PrEP at facility and mobile study sites participated in 4-hour participatory workshops, exploring HIV prevention, including MPTs, demand creation strategies, and preferred MPTs training packages. Activities were observed, transcribed, and thematically analysed. Five online in-depth interviews (IDIs) with Key informants (KIs) (National/district programme implementers and technical leads) and one in person, exploring key programmatic and policy considerations for MPT adoption. IDIs were approximately 40 min long, audio recorded, transcribed, and thematically analysed. Results: Twenty-one Professional Nurses completed workshops: 19 female. Six IDIs were conducted with 4 Facility Managers, 1 NDoH representative and 1 DoH Provincial Deputy Director. All participants were females, aged 30-60+ years with >10 years' in SRH/HIV policy/advocacy/research. Community conversations and information at the clinic were the best MPT demand creation methods among HCPs. KIs identified five considerations for future MPT implementation: HCP training; demand creation and messaging; existing PrEP policy amendments; preparing users for additional choice; and sustaining MPT provision. Conclusion: Contraceptive implant and oral PrEP implementation lessons learned should be proactively considered when preparing for MPT introduction. HCP training and demand creation are of particular importance before MPT introduction. [ABSTRACT FROM AUTHOR]

The South African bioeconomy strategy did not clearly articulate the measurement framework to monitor the implementation of the strategy. This paper provides an analysis of bioeconomy patents, the most prolific organizations and citations at the EPO and USPTO for South Africa, BRICS, Egypt and Nigeria during the Ten-Year Innovation Plan 2008–2018. The terms 'biotechnology', 'medical technology', 'pharmaceuticals' and 'selected environment-related technologies' were used to search for patents. The OECD patents by technology, the EPO PATSTAT and the USPTO PatFT databases were used to map patents and citations. The results show that South Africa ranked last in the BRICS group but produced a higher number of patents than Egypt and Nigeria. The number of patents generally decreased for the selected countries except for China. The total citations for the selected countries was generally inconsistent. The important innovators for South Africa in the bioeconomy are mainly universities and public research institutions. A new fiscal approach to encourage knowledge application in bioeconomy in South Africa is required. Incentives from government that encourage collaboration between research institutions and industry to direct research with industry application are required. The study contributes to the development of metrics to monitor the bioeconomy in South Africa. [ABSTRACT FROM AUTHOR]

The prospects presented by digital transformation holds the potential of greatly increasing the capacity of medical libraries, which in turn it will make it possible for these libraries to provide better services and increasing accessibility. But how can digital technologies be adopted in transforming medical libraries' services and operations, in the digital transformation era? This study looked at the opportunities and challenges associated with implementing digital technologies in medical libraries through digital transformation. The study thus reviewed literature on digital transformation of medical libraries services, as a way to support healthcare systems in South Africa. The chapter revealed that digital transformation has the potential to enhance libraries processes, practices, performance, and to stay relevant in their increasingly competitive environment. [ABSTRACT FROM AUTHOR]

While South Africa has some experience in various forms of health technology assessment (HTA), it is currently fragmented across numerous players. Additionally, there is a lack of systematic and consistently applied HTA processes that inform priority-setting and budget allocations. To address this, the country is journeying toward more institutionalized use of HTA. This will begin with the establishment of a Ministerial Advisory Committee on HTA for National Health Insurance (NHI) and will gradually embed HTA processes in decision-making. The goal is to create an independent HTA agency. Although these reforms will be intrinsically linked to the wider health financing reforms envisaged under NHI, such as formulating the benefits package, they will also assist in strengthening South Africa's health system. As a country facing a highly constrained fiscal environment, with limited space for additional funding for the health sector, evidence-based priority-setting will be critical to ensure that value for money is achieved in the government's investments in health care services in NHI. [ABSTRACT FROM AUTHOR]

The use of technology in healthcare settings was identified as a crucial priority in many countries to provide quality healthcare services. eHealth or digital health technology is found to have a positive influence on improving the efficiency and quality of healthcare services. It has been proven to provide opportunities to strengthen health systems. This study aims to assess eHealth literacy, pre-existing knowledge and the nursing students' perceptions and attitudes towards eHealth. A quantitative, descriptive, cross-sectional survey was used in this study. The population of this study comprised 266 nursing students in the undergraduate programme of the Department of Nursing, among which 244 consented to participate in the study. A standardised and self-administered tool was utilised to collect data from nursing students across the four levels of study. Results showed that students in level four exhibit high scores of knowledge in the use of eLearning technology as compared to first-entry university nursing students. Nursing students used the internet frequently, especially to access social media and search for health and medical information for their study. Attitudes towards eHealth and technology were also found to be positive. The study recommends that digital literacy should be enhanced in the nursing education curriculum in other to further strengthen the knowledge and skills towards the use of eHealth and health technology among nursing students. [ABSTRACT FROM AUTHOR]

The World Health Assembly has encouraged WHO member-states to establish capacity in health technology assessment (HTA) as a support for achieving universal health coverage (UHC). Simultaneously, the WHO has stated that UHC is "a practical expression of the concern for health equity and the right to health." This has prompted questions about potential tensions between priority-setting efforts and the right to health on the road to UHC. South Africa (SA) is an ideal setting in which to explore how the priority-setting work of an HTA body may be integrated with an existing rights framework. [ABSTRACT FROM AUTHOR]

This paper explores South African manufacturing of medical devices, focusing on firms' acquisition of imported and domestic technologies through technology transfer and their related absorptive capacity. Using an exploratory sequential mixed-methods approach, this paper demonstrates that technology transfer does occur in the medical device industry in South Africa, and that the absorptive capacity displayed by firms in the industry is sufficient to facilitate technology transfer. The results of the analysis suggest that there is room for policymakers to create and promote sectoral coherence and to coordinate the various stakeholders for the industry to grow. This study contributes to the scarce literature on technology transfer in the medical device industry in Africa. [ABSTRACT FROM AUTHOR]

This study discussed the reports by participants in a randomised controlled trial of a novel intervention for spinal cord injury (SCI) rehabilitation in Cape Town, South Africa. Sixteen participants were randomised to rehabilitation involving the use of robotic locomotor training, a novel technology, or to a group receiving an activity-based intervention. All participants were interviewed before the intervention and at six months follow-up. In a context in which rehabilitation services for SCI are virtually non-existent, all participants approached the study with enthusiasm and expressed gratitude for participation. They had high hopes for what the programme could achieve, with many believing, perhaps incorrectly, that the programme would help them walk independently again. While hope and enthusiasm are useful for adherence to experimental intervention studies, there is a danger, especially in poorly resourced contexts, for participants to experience considerable disappointment following false hope not being realised. This raises important ethical issues for researchers interested in the potential of new technologies to promote health in poorly resourced contexts. For clinicians, the path between supporting positive emotions (which may lead to positive outcomes), and confronting unrealistic hope (which may lead to negative outcomes) may be difficult. Follow-up with participants after re-integration into their communities is important to determine long-term psychological impact. Pan African Clinical Trial Number: PACTR201608001647143 In low-resource contexts where there is a low level of access to rehabilitation services, such access in the context of a trial of a new intervention may engender hope in a group of people with spinal cord injury. This hope may increase when a new technology is used, as was the case in this study. Hope can be very helpful to people entering rehabilitation, but unrealistic hope and expectations may have negative implications in the longer term. In this study, expectations of participants centred, unrealistically, around regaining the ability to walk again, despite past experiences and medical advice suggesting otherwise. A thin line exists between supporting high expectations and confronting unrealistic hope. This conundrum is difficult for the clinician, as both inappropriate hope and undue pessimism about an intervention have the potential to cause harm. Participant follow-up after the end of any innovative trial is important, not just to monitor physical progress, but also, where necessary, to support participants through a potential period of disillusionment when they find their expectations have not been fully met. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Globally, the healthcare industry is plagued by fragmentation, and this fragmentation of the health system has become one of the major problems facing especially low- and middle-income countries. Likewise, the current health system in South Africa is highly fragmented and segmented, with two-tiered systems characterised by a multiplicity of health information systems. This fragmentation has inhibited the efficient delivery of healthcare services and resulted in limited access to integrated health data across healthcare providers. This paper proposes a Digital Health Ecosystem framework to address fragmentation of the health system in South Africa. A qualitative approach was employed, using desktop-based research. A literature review was conducted to elucidate the need for a framework to address fragmentation of the health system in South Africa. It emerged from the literature that the coexistence of subsystems operating independently contributes to health system fragmentation in South Africa. The proposed framework aims to address the ubiquitous problem of health system fragmentation and to enhance data-sharing capabilities across healthcare facilities. A Digital Health Ecosystem offers capabilities to create a digital environment for cooperation, data sharing and information exchange between a network of healthcare organisations. The technology offers South African healthcare facilities a new way to work seamlessly together to provide multidisciplinary and collaborative healthcare services to patients. Healthcare facilities in South Africa are urged to embrace a Digital Health Ecosystem to improve the safety and quality of healthcare and increase access to and availability of clinical, patient and administrative data. [ABSTRACT FROM AUTHOR]

In the article, the author discusses the issues and accomplishments in the efforts to achieve universal health care in the U.S. Also cited are the key tensions in achieving said objective like the availability of resources, the need to assign priority-setting to accountable government actors rather than through court orders, and reasonableness as standard of justifiable bases for priority setting.

South Africa's move towards implementing National Health Insurance includes a commitment to establish a health technology assessment (HTA) body to inform health priority-setting decisions. This study sought to analyse health rights cases in South Africa to inform the identification of country-specific procedural values related to health priority-setting and their implementation in a South African HTA body. The focus on health rights cases is motivated in part by the fact that case law can be an important source of insight into the values of a particular country. This focus is further motivated by a desire to mitigate the potential tension between a rights-based approach to healthcare access and national efforts to set health priorities. A qualitative content analysis of eight South African court cases related to the right to health was conducted. Cases were identified through a LexisNexis search and supplemented with expert judgement. Procedural values identified from the health priority-setting literature, including those comprising Accountability for Reasonableness (A4R), structured the thematic analysis. The importance of transparency and revision-two elements of A4R-is evident in our findings, suggesting that the courts can help to enforce elements of A4R. Yet our findings also indicate that A4R is likely to be insufficient for ensuring that HTA in South Africa meets the procedural demands of a constitutional rights-based approach to healthcare access. Accordingly, we also suggest that a South African HTA body ought to consider more demanding considerations related to transparency and revisions as well as explicit considerations related to inclusivity. [ABSTRACT FROM AUTHOR]

What sets AI systems and AI-powered medical robots apart from all other forms of advanced medical technology is their ability to operate at least to some degree autonomously from the human health care practitioner and to use machine-learning to generate new, often unforeseen, analysis and predictions. This poses challenges under the current framework of laws, regulations, and ethical guidelines applicable to health care in South Africa. The article outlines these challenges and sets out guiding principles for a normative framework to regulate the use of AI in health care. The article examines three key areas for legal reform in relation to AI in health care. First, it proposes that the regulatory framework for the oversight of software as a medical device needs to be updated to develop frameworks for adequately regulating the use of such new technologies. Secondly, it argues that the present HPCSA guidelines for health care practitioners in South Africa adopt an unduly restrictive approach centred in the outmoded semantics of telemedicine. This may discourage technological innovation that could improve access to health care for all, and as such the guidelines are inconsistent with the national digital health strategy. Thirdly, it examines the common law principles of fault-based liability for medical negligence, which could prove inadequate to provide patients and users of new technologies with redress for harm where fault cannot clearly be attributed to the healthcare practitioner. It argues that consideration should be given to developing a statutory scheme for strict liability, together with mandatory insurance, and appropriate reform of product liability pertaining to technology developers and manufacturers. These legal reforms should not be undertaken without also developing a coherent, human-rights centred policy framework for the ethical use of AI, robotics, and related technologies in health care in South Africa. [ABSTRACT FROM AUTHOR]

The use of point-of-care ultrasound (PoCUS) is fast becoming a global standard of care. World over, training programmes are embracing the use of PoCUS to improve patient care, reduce risks to patients and reduce the burden of unnecessary referrals and investigations. The South African setting is particularly amenable to the benefits of this diagnostic modality to improve healthcare delivery to rural and marginalised populations. However, as with any technological advancements, the use of PoCUS is also not immune to deleterious consequences and patient harm from overdependence and over-zealous uptake. Family physicians, as the champions of primary care, should take the lead to ensure the effective and proper use of PoCUS in rural and primary care settings through advocacy, training and accreditation of clinicians to safely harness the benefits of PoCUS and minimise harm. [ABSTRACT FROM AUTHOR]

Concerns about medical non-compliance have generated interest in the potential of remote, digital reminder and surveillance technologies. Amidst a devastating HIV/AIDS epidemic and outbreaks of drug-resistant tuberculosis (TB), compliance technologies are touted by developers and medical researchers as a solution to the 'problem of non-compliance'. The appeal lies in the prospect of fashioning disciplined bodies, but at the cost of sacrificing the intimacy of care for technical expediency. Despite the growing popularity in global medicine to account for disease in terms of the 'social determinants of health', digital medical technologies reproduce discourses of health as an individual responsibility. I conducted research in a TB clinic in South Africa that experimented with an electronic reminder and monitoring device that sought to improve compliance to a new regimen of drugs for TB prevention. I found that patients embraced the apparatus through local framings of TB, and deployed it in their everyday struggles for care. [ABSTRACT FROM AUTHOR]

The World Health Organization (WHO) recommends that access to rehabilitation is a human right. To date, however, rehabilitation in South Africa has not been a health priority. The focus has rather been on saving lives from communicable diseases such as HIV/AIDs and TB, which has been increasingly successful. Whilst more South Africans are now living with pharmacologically managed chronic, communicable diseases, they often suffer significant challenges to their physical and mental health. Moreover, there are many health conditions in South Africa that have not attracted as much attention, and which also compromise individuals' capacity to contribute effectively to their own wellbeing, that of their families and communities, and to the general economy. These include birth trauma, degenerative neurological conditions, acquired injuries such as spinal cord damage, limb amputation or head trauma, and chronic noncommunicable diseases (heart or kidney disease, stroke). In the absence of robust prevalence studies, it is estimated that one-in-three adults suffer from at least one chronic health challenge. For South Africa not to invest in rehabilitation is counter-productive, as it means that a significant percentage of its population cannot contribute to its economy. In the face of scant health resources to underpin equitable rehabilitation services, evidence needs to be provided to demonstrate that for increased expenditure on rehabilitation, there will be increased return at individual, family, society, and country levels. This article presents challenges and solutions to ensure that South Africa can meet WHO 2030 Rehabilitation Goals for equitable provision of effective public rehabilitation services using the WHO's health system building block framework. To meet the challenge of providing rehabilitation for those in need requires country-specific, strategic, evidence-informed, and planned decisions in terms of best investment for highest return. Whilst there is sound international evidence for best-practice rehabilitation care, country-specific strategies are required to identify and address local barriers to evidence implementation. In South Africa, where rehabilitation has not been a priority to date, it is important that a planned and well-costed approach is taken to ensure provision of equitable, accessible, affordable, and evidence-based rehabilitation. Measuring social, economic, and educational return on investment from rehabilitation should be part of the South African service-delivery planning process. National data could be obtained through adding additional questions on disability to the national census and through local surveys and reports at various public health care facilities. [ABSTRACT FROM AUTHOR]

Uptake of contraceptive implants has declined in South Africa since their introduction in 2014, with side effects and inadequate health provider training cited as primary contributors underlying a poor community perception of implants. In this paper we explore a theme that emerged unexpectedly during analysis of our research in Cape Town that may be an additional factor in this decline: narratives of women being assaulted by robbers who physically remove the implants for smoking as drugs. Narratives were described consistently across interviews and focus groups with youth (aged 18–24 years) and in interviews with health providers, with six participants (two young people, four health providers) sharing personal experiences of robbery. While there was a range of perspectives on whether narratives are based on real experiences or are myths, there was strong consensus that narratives of implant robbery may be influencing women's decisions around implant use in Cape Town. This is a potent example of how perceptions of new products can affect uptake and offers important lessons for implementers to reflect on in planning for rollout of other health technologies. [ABSTRACT FROM AUTHOR]

Background: The rapid growth of mobile technology has given rise to the development of mobile health (mHealth) applications aimed at treating and preventing a wide range of health conditions. However, evidence on the use of mHealth in high disease burdened settings such as sub-Sharan Africa is not clear. Given this, we systematically mapped evidence on mHealth for disease diagnosis and treatment support by health workers in sub-Saharan Africa.Methods: We conducted a scoping review study guided by the Arksey and O'Malley's framework, Levac et al. recommendations, and Joanna Briggs Institute guidelines. We thoroughly searched the following databases: MEDLINE and CINAHL with full text via EBSCOhost; PubMed; Science Direct and Google Scholar for relevant articles from the inception of mHealth technology to April 2020. Two reviewers independently screened abstracts and full-text articles using the eligibility criteria as reference. This study employed the mixed methods appraisal tool version 2018 to assess the methodological quality of the included studies.Results: Out of the 798 articles identified, only 12 published articles presented evidence on the availability and use of mHealth for disease diagnosis and treatment support by health workers in SSA since 2010. Of the 12 studies, four studies were conducted in Kenya; two in Malawi; two in Nigeria; one in South Africa; one in Zimbabwe; one in Mozambique, and one in Lesotho. Out of the 12 studies, one reported the use of mHealth for diseases diagnosis; three reported the use of mHealth to manage HIV; two on the management of HIV/TB; two on the treatment of malaria; one each on the management of hypertension; cervical cancer; and three were not specific on any disease condition. All the 12 included studies underwent methodological quality appraisal with a scored between 70 and 100%.Conclusions: The study shows that there is limited research on the availability and use of mHealth by health workers for disease diagnosis and treatment support in sub-Saharan Africa. We, therefore, recommend primary studies focusing on the use of mHealth by health workers for disease diagnosis and treatment support in sub-Saharan Africa. [ABSTRACT FROM AUTHOR]

Background: Constant appraisal of healthcare workforce trends is vital; this measure determines the adequacy of the workforce in meeting its society's healthcare demands. This includes determining the number of the incoming workforce (students, interns) and the active or practising workforce relevant registries. Objective: This study aimed to examine patterns of workforce growth in the medical technology profession (students, interns and practitioners) from 2008 to 2018 in South Africa. Methods: Student, intern and practitioner medical technology registries, from the 2012/2013, 2016/2017 and 2017/2018 Health Professions Council of South Africa (HPCSA) annual reports, were analysed. The number of National Health Laboratory Service and private laboratory posts were secured from the National Health Laboratory Service plan performance report. A comparison between the total number of South African medical technology (private and public) posts occupied versus the HPCSA practitioner 2016 register was completed, to determine the saturation status. Results: Annual student, intern, and practitioner registries indicated a mean growth of 6.8%, 28.9%, and 0.7% from 2008 to 2018. The transition of interns to practitioners is progressively dwindling (2015–2018). The practitioner register showed a 1.2% decline in registration from 2013 until 2018. In 2016, only 55.9% of the HPCSA registered medical technologists were employed (p < 0.001). Conclusion: There are more medical technologists than available public and private sector posts. The progressively growing student register compared to the dwindling practitioner register indicates attrition in the profession. An investigation identifying the reasons why graduates neglect to register as practising medical technologists should be undertaken. [ABSTRACT FROM AUTHOR]

Aim/Purpose The paper's objective is to examine the challenges of using the mobile phone to mine location data for effective contact tracing of symptomatic, pre-symptomatic, and asymptomatic individuals and the implications of this technology for public health governance. Background: The COVID-19 crisis has created an unprecedented need for contact tracing across South Africa, requiring thousands of people to be traced and their details captured in government health databases as part of public health efforts aimed at breaking the chains of transmission. Contact tracing for COVID-19 requires the identification of persons who may have been exposed to the virus and following them up daily for 14 days from the last point of exposure. Mining mobile phone location data can play a critical role in locating people from the time they were identified as contacts to the time they access medical assistance. In this case, it aids data flow to various databases designated for COVID-19 work. Methodology: The researchers conducted a review of the available literature on this subject drawing from academic articles published in peer-reviewed journals, research reports, and other relevant national and international government documents reporting on public health and COVID-19. Document analysis was used as the primary research method, drawing on the case studies. Contribution: Contact tracing remains a critical strategy in curbing the deadly COVID-19 pandemic in South Africa and elsewhere in the world. However, given increasing concern regarding its invasive nature and possible infringement of individual liberties, it is imperative to interrogate the challenges related to its implementation to ensure a balance with public governance. The research findings can thus be used to inform policies and practices associated with contact tracing in South Africa. Findings: The study found that contact tracing using mobile phone location data mining can be used to enforce quarantine measures such as lockdowns aimed at mitigating a public health emergency such as COVID-19. However, the use of technology can expose the public to criminal activities by exposing their locations. From a public governance point of view, any exposure of the public to social ills is highly undesirable. Recommendations for Practitioners: In using contact tracing apps to provide pertinent data location caution needs to be exercised to ensure that sensitive private information is not made public to the extent that it compromises citizens' safety and security. The study recommends the development and implementation of data use protocols to support the use of this technology, in order to mitigate against infringement of individual privacy and other civil liberties. Recommendations for Researchers: Researchers should explore ways of improving digital applications in order to improve the acceptability of the use of contact tracing technology to manage pandemics such as COVID-19, paying attention to ethical considerations. Impact on Society: Since contact tracing has implications for privacy and confidentiality it must be conducted with caution. This research highlights the challenges that the authorities must address to ensure that the right to privacy and confidentiality is upheld. Future Research: Future research could focus on collecting primary data to provide insight on contact tracing through mining mobile phone location data. Research could also be conducted on how app-based technology can enhance the effectiveness of contact tracing in order to optimize testing and tracing coverage. This has the potential to minimize transmission whilst also minimizing tracing delays. Moreover, it is important to develop contact tracing apps that are universally interoperable and privacy-preserving. [ABSTRACT FROM AUTHOR]

Most sub-Saharan African countries acted early and aggressively in response to the WHO COVID-19 warning by closing schools, international borders, limiting domestic travel and restricting large gatherings. The six most populous sub-Saharan African countries, at the beginning of July 2020 with the exception of Republic of South Africa, all had relatively modest COVID-19 case counts compared with European, North and South American and some Asian countries in spite of access to more limited medical resources and technologies. Shutdowns or shelter-in-places were put in place for 5 out of 6 countries surveyed well before the first reported COVID-19 death. Timely action to enact comprehensive public health measures are irreplaceable and cannot be substituted by later use of medical resources or technologies. In the case of Republic of South Africa, earlier and multiple instances of virus introduction may have made infection control much more difficult compared with other sub-Saharan African countries. [ABSTRACT FROM AUTHOR]

Objective To implement and evaluate a community-based hearing and vision screening programme for preschool children in the Western Cape, South Africa, supported by mobile health technology (mHealth) and delivered by community health workers (CHWs). Methods We trained four CHWs to provide dual sensory screening in preschool centres of Khayelitsha and Mitchells Plain during September 2017-December 2018. CHWs screened children aged 4-7 years using mHealth software applications on smartphones. We used logistic regression analysis to evaluate the association between screening results and age, sex and test duration, and, for hearing, excessive background noise levels. Results CHWs screened 94.4% (8023/10 362) of eligible children at 271 centres at a cost of 5.63 United States dollars per child. The number of children who failed an initial hearing and visual test was 435 (5.4%) and 170 (2.1%), respectively. Hearing test failure was associated with longer test times (odds ratio, OR: 1.022; 95% confidence interval, CI: 1.021-1.024) and excessive background noise levels at 1 kilohertz (kHz) (e.g. OR for left ear: 1.688; 95% CI: 1.198-2.377). Visual screening failure was associated with longer test duration (OR: 1.003; 95% CI: 1.002-1.005) and younger age (OR: 0.629; 95% CI: 0.520-0.761). Of the total screened, 111 (1.4%) children were diagnosed with a hearing and/or visual impairment. Conclusion mHealth-supported CHW-delivered hearing and vision screening in preschool centres provided a low-cost, acceptable and accessible service, contributing to lower referral numbers to resource-constrained public health institutions. [ABSTRACT FROM AUTHOR]

This study distinguished between the application of e-health and m-health technologies in sub-Saharan African (SSA) countries based on the dimensions of use, targeted diseases or health conditions, locations of use, and beneficiaries (types of patients or health workers) in a country specific context. It further characterized the main opportunities and challenges associated with these dimensions across the sub-region. A systematic review of the literature was conducted on 66 published peer reviewed articles. The review followed the scientific process of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines of identification, selection, assessment, synthesis and interpretation of findings. The results of the study showed that m-health was prevalent in usage for promoting information for treatment and prevention of diseases as well as serving as an effective technology for reminders towards adherence. For e-health, the uniqueness lay in data acquisition and patients' records management; diagnosis; training and recruitment. While m-health was never used for monitoring or training and recruitment, e-health on the other hand could not serve the purpose of reminders or for reporting cases from the field. Both technologies were however useful for adherence, diagnosis, disease control mechanisms, information provision, and decision-making/referrals. HIV/AIDS, malaria, and maternal (postnatal and antenatal) healthcare were important in both m-health and e-health interventions mostly concentrated in the rural settings of South Africa and Kenya. ICT infrastructure, trained personnel, illiteracy, lack of multilingual text and voice messages were major challenges hindering the effective usage of both m-health and e-health technologies. • A comparative review of m-health and e-health in sub-Saharan Africa was conducted. • The key opportunities and challenges of using these technologies were addressed. • Differences in utilization were found between the two technologies. • Both technologies were useful for adherence, diagnosis, and disease control. [ABSTRACT FROM AUTHOR]

Despite significant advances to the HIV epidemic, prevention remains a challenge globally. Adolescent girls and young women in southern and Eastern Africa are still at high risk of acquiring HIV infection with limited prevention options. The expanding product pipeline of novel drugs and delivery approaches has highlighted the importance of acceptability and uptake of these anti-retroviral based products to realize their full prevention potential. Community engagement is now imperative to inform both product development and uptake; with research directed to understand what potential users are willing to use given the broader cultural-gender context in which HIV prevention product choices are made/negotiated. We conducted ten gender specific discussion groups with 112 participants in three of the eight highest HIV prevalence districts in urban, peri-urban, and rural KwaZulu-Natal. The participants where purposively selected according to age, location and sex. The data was analysed thematically in terms of the key enablers and barriers of accepting three key HIV dosing strategies; the oral pill, the vaginal ring and the injectable among men and women. The study found that women are willing to consider HIV prevention options that align with their current sexual and reproductive health routines, offers the longest duration of protection, and requires minimal/no partner involvement, in contrast most men were not supportive of their partners using of any form of PrEP, irrespective of dosing strategies and formulations as it raised questions of infidelity and side effects on men. The findings is indicative of the complexities of women’s product choices, which are often embedded in a system of personal preference on an intrapersonal level, but also of male dominance, gender norms and cultural contexts at an interpersonal level. Understanding this intrapersonal-interpersonal interplay can enhance PrEP messaging and promotion; further highlighting the need to expand biomedical innovations for women initiated technologies. [ABSTRACT FROM AUTHOR]

Ontologically, what we do know is that healthcare big data do exist across South African health facilities. Epistemologically, the patients and some health practitioners do not know how the big data exist and, most importantly, what to expect from the data sets. This is due to the rawness and complexity of big data evolution, which many health practitioners do not know how to socio-technically analyze, and get an understanding of why things happen in the way that they do within patients’ big data. Thus, the objective of this study was to develop a framework, which could be used to guide analysis that can translate and transform big data into a more useful and purposeful resource for health practitioners, thereby improving services that they provide to the patients. The qualitative approach methods were employed, following the interpretivist approach. Existing literature relating to the study was gathered. Actor network theory was applied as a lens to guide the analysis of the data. Based on the analysis, a model and framework were developed. The model creates an analysis platform that enacts the use of actor network theory (ANT) as lens for data analysis. ANT offers a different type of analysis through its focus on the relational effect that is shaped by interaction that happen between humans and non-humans in their heterogeneous networks. The framework provides a guide for the transformation of healthcare big data from ontological to epistemological positions, towards improving patients’ care. Through the use of ANT for analysis and transformation of healthcare big data, the challenges of analytics of healthcare big data in technological, social, and policy barriers can be addressed, making this study useful to both the health profession and academia. [ABSTRACT FROM AUTHOR]

A multipurpose prevention technology (MPT) that combines HIV and pregnancy prevention is a promising women's health intervention, particularly for young women. However, little is known about the drivers of acceptability and product choice for MPTs in this population. This paper explores approval ratings and stated choice across three different MPT delivery forms among potential end-users. The Trio Study was a mixed-methods study in women ages 18-30 that examined acceptability of three MPT delivery forms: oral tablets, injections, and vaginal ring. Approval ratings and stated choice among the products was collected at baseline. Factors influencing stated product choice were explored using multivariable multinomial logistic regression. The majority (62%) of women in Trio stated they would choose injections, 27% would choose tablets and 11% would choose the ring. Significant predictors of choice included past experience with similar contraceptive delivery forms, age, and citing frequency of use as important. Ring choice was higher for older (25-30) women than for younger (18-24) women (aRR = 3.1; p < 0.05). These results highlight the importance of familiarity in MPT product choice of potential for variations in MPT preference by age. [ABSTRACT FROM AUTHOR]

Introduction:Despite South Africa’s rapidly growing population, the number of patients evaluated by our trauma unit remains static. However, after presentation, increased delays in time to surgery is an issue. With a vast array of technological advancements having been implemented since 2008 at our institution, a clear problem exists at some stage of the patient management process. The aim of this study is to evaluate the efficacy of the management of neurotrauma patients and determine whether there is an association with technological advancements. Methods:An ambispective study was performed to assess the management of neurotrauma patients. A comparative timeline of 7 months (1 January to 31 July 2007 retrospectively and 1 January to 31 July prospectively 2015) was chosen to evaluate several parameters involved in the management of the neurotrauma patient and the factors affecting these. The year 2007 was chosen as this is the last year prior to implementation of technological improvements. Results:The demographics, age group and gender of the respective patient populations was remarkably similar. There was more rapid emergency medical service dispatch and hospital transfer in 2015. The time taken for a patient to get to computed tomography (CT) scan has increased and as has the time period between CT scanning and neurosurgical consultation. Time to ultimate neurosurgical intervention after referral, however, has decreased over the years. Conclusion:One of the greatest sources of delay to surgical management seems to be due to delays in CT scanning where inappropriate prioritization of cases occurs as a result of abuse of the booking and lack of human decision-making and triage. Similarly, after hours needs are not being met with current CT services. As a result of the restriction of human involvement in terms of reviewing scan requests and results there are delays to the neurosurgical service. [ABSTRACT FROM PUBLISHER]

Information and Communication Technology (ICT) solutions (e.g. e-health, telemedicine, e-education) are often viewed as vehicles to bridge the digital divide between rural and urban healthcare centres and to resolve shortcomings in the rural health sector. This study focused on factors perceived to infl uence the uptake and use of ICTs as e-health solutions in selected rural Eastern Cape healthcare centres, and on structural variables relating to these facilities and processes. Attention was also given to two psychological variables that may underlie an individual's acceptance and use of ICTs: usefulness and ease of use. Recommendations are made with regard to how ICTs can be used more effectively to improve health systems at fi ve rural healthcare centres where questionnaire and interview data were collected: St. Lucy's Hospital, Nessie Knight Hospital, the Tsilitwa Clinic, the Madzikane Ka-Zulu Memorial Hospital and the Nelson Mandela General Hospital. [ABSTRACT FROM AUTHOR]

The HIV prevalence in South Africa is the highest in the world. In 2017 12.6% of the population 7.06 million people were HIV positive6. Almost two thirds of this cohort are on ARVS contributing to South Africa's ARV programme-making it the largest in the world2. Other sectors within the health industry have also contributed to addressing the burden of disease by developing their own sector specific HIV-AIDS programmes. Over time, these programmes have grown from strength to strength and have incorporated components to driver better performance within these programmes. A novel concept in health technology is that of artificial intelligence (AI) and machine learning, which is redefining the health industry and is fast becoming very popular locally and globally. AI has not been fully integrated into the HIV-AIDS field to date. This paper explores the artificial intelligence landscape in the HIV-AIDS arena and assesses if AI can enhance HIV-AIDS programme management. [ABSTRACT FROM AUTHOR]

On 1 March 2012, the South African Minister of Health operationalised section 71 of the National Health Act (NHA), ushering in a new phase of research regulation. When read with sections 1, 11 and 16 of the NHA, section 71 describes the legal norms for undertaking various forms of health research in South Africa. Three key terms used in the NHA now set the parameters of the legal framework for regulating health research: 'health research' (section 1), 'research or experimentation on a living person' (section 71), and the provision of a 'health service for research or experimental purposes' (section 11). Importantly, these three concepts delineate (i) what forms of health research are regulated by the legal framework, and (ii) the nature of the obligations placed on health researchers and others. Researchers and members of research ethics committees need to be aware that the NHA assigns different legal obligations to different forms of health research. This article describes the parameters of the new legal framework and the obligations that flow from each of the three categories of health research. It shows how the restrictions the framework imposes are not evenly spread across all forms of research, and concludes by identifying some of its strengths, weaknesses and anomalies. It further suggests that more conceptual elaboration is required to ascertain whether the differences are coherent and justified. [ABSTRACT FROM AUTHOR]

The article explores the effectiveness of using testosterone in treating postmenopausal women with female sexual dysfunction (FSD) such as hypoactive sexual desire disorder (HSDD) in South Africa. The author states that testosterone therapy for women is still on debate and can be safely used after excluding other causes of HSDD and informing patients that it is still off label therapy in the country.

An abstract of the article "African answers to African problems using mobile technology," by Jan Kuehne & Lianne Keiller is presented.

Background: Resource allocation in health is universally challenging, but especially so in resource-constrained contexts in the Global South. Pursuing a strategy of evidence-based decision-making and using tools such as Health Technology Assessment (HTA), can help address issues relating to both affordability and equity when allocating resources. Three BRICS and Global South countries, China, India and South Africa have committed to strengthening HTA capacity and developing their domestic HTA systems, with the goal of getting evidence translated into policy. Through assessing and comparing the HTA journey of each country it may be possible to identify common problems and shareable insights. Objectives: This collaborative paper aimed to share knowledge on strengthening HTA systems to enable enhanced evidence-based decision-making in the Global South by: Identifying common barriers and enablers in three BRICS countries in the Global South; and Exploring how South-South collaboration can strengthen HTA capacity and utilisation for better healthcare decision-making. Methods: A descriptive and explorative comparative analysis was conducted comprising a Within-Case analysis to produce a narrative of the HTA journey in each country and an Across-Case analysis to explore both knowledge that could be shared and any potential knowledge gaps. Results: Analyses revealed that China, India and South Africa share many barriers to strengthening and developing HTA systems such as: (1) Minimal HTA expertise; (2) Weak health data infrastructure; (3) Rising healthcare costs; (4) Fragmented healthcare systems; and (5) Significant growth in non-communicable diseases. Stakeholder engagement and institutionalisation of HTA were identified as two conducive factors for strengthening HTA systems. Conclusion: China, India and South Africa have all committed to establishing robust HTA systems to inform evidence-based priority setting and have experienced similar challenges. Engagement among countries of the Global South can provide a supportive platform to share knowledge that is more applicable and pragmatic. [ABSTRACT FROM AUTHOR]

The article reflects on the insight within the issue into both the complexity of establishing a simulation-based assessment tool for anesthesia and the techniques required to ensure the success of research in the particular field in South Africa. It states that the authors of the paper did not establish criterion validity and concurrent validity. It suggests that simulation centers in the country collaborate and establish a joint research plan.

Africa has seen a raft of biometrics-based e-id developments. The South African Department of Home Affairs has announced it will recall all old passports within the next 12 months, replacing them with a biometric passport. [ABSTRACT FROM AUTHOR]

Health care systems are under increasing pressure to cope with shifting demographics, the threat of chronic and noncommunicable disease, and rising health care costs. The uptake of innovations to meet these challenges and to advance medicine and health care delivery is not as rapid as the pace of change. Greater emphasis on the diffusion of innovation and greater understanding of the structural and organizational levers that can be used to facilitate systemwide improvement are essential. This article describes the results of a qualitative and quantitative study to assess the factors and behaviors that foster the adoption of health care innovation in eight countries: Australia, Brazil, England, India, Qatar, South Africa, Spain, and the United States. It describes the front-line cultural dynamics that must be fostered to achieve cost-effective and high-impact transformation of health care, and it argues that there is a necessity for greater focus on vital, yet currently underused, organizational action to support the adoption of innovation., (Project HOPE—The People-to-People Health Foundation, Inc.)