Reproductive health services “improvement is ongoing”

Reproductive health services “improvement is ongoing”

Minister in the Presidency Jackson Mthembu says South Africa will continue working to improve access to reproductive health care services.

Speaking at the International Conference on Population and Development (ICPD), which is currently underway in Nairobi, Kenya, Mthembu said the newly completed five-year plan for the country’s 6th democratic administration affirmed that South Africa will in the next five years continue to improve access to reproductive health services, including targeting adolescent sexual and reproductive health and rights in order to address pregnancies and risky behaviour.

The plan also includes upscaling existing campaigns and programmes on new HIV infections among youth, women and persons with disabilities and develop targeted programme on adolescent sexual and reproductive health and rights, including gender mainstreaming, youth and disability issues in programmes, and addressing teenage pregnancies.

Mthembu said South Africa will strive to further reduce child and maternal mortality and to improve access to reproductive health services and anti-retroviral treatment.

Highlighting some of the country’s interventions in ensuring access to quality health services, Mthembu said the country is currently piloting the National Health Insurance (NHI) in order to enhance universal access to quality health care as well as to bridge the quality gaps that exist in the private and public sectors.

“South Africa has also embraced the importance of extending free dignity packs to poor women and girls with a view to improve women’s reproductive health and contribute to the retention of girl children in schools who often miss school during their cycle.

“We are confident that these interventions will ensure that we continue to place people at the centre of our developmental agenda,” Mthembu said.

He said South Africa continues to commit itself to tackling the challenges identified for the 2019 Nairobi Summit on #ICPD25.

The ICPD Programme of Action commitments are centred around achieving zero unmet needs for family planning information and services; zero preventable maternal deaths; zero sexual and gender-based violence and harmful practices against women and girls referred to as Ukuthwalwa; and providing detail for implementing second phase of the democratic transition.

Reproductive health care programmes

South Africa has also expanded reproductive health care through various programmes such as the Integrated School Health Programme which focuses on addressing both the immediate health problems of learners, including barriers to teaching and learning as well as implementing interventions that can promote their health and well-being during childhood and beyond.

The National Department of Health has introduced programmes such as B-Wise – a young person’s interactive cell phone health platform to empower adolescents and youth to make the right choices based on accurate information; and She Conquers Campaign – A youth-led campaign which will run for 3-years collaborating with government, NGOs, business, and civil society to address the major issues that adolescent girls and young women face in South Africa today.

South Africa has over the last 25 years embarked on a number of legislative and policy interventions which focus on the sexual health and wellbeing of young people, as well as providing for women to choose a contraceptive method that they prefer. The Choice on Termination of Pregnancy Act which was passed in 1996 has ensured deaths from unsafe abortion has declined by more than 90%. Access to Primary Health Care Services measured in terms of visits per annum, increased from some 67 million in 1998 to over 128 million in March 2018. Furthermore, the total numbers of new HIV infections declined from 270 000 in 2016 to 231 000 in 2018.

South Africa is currently also in the process of decriminalising sex work to ensure that the sex work industry is regulated and that women are protected.

Health Summit and other mixed messaging

This is billed as being about the Checka Impilo or National Wellness Campaign … but some how it got to be more about a failing health system. Take a look.

 Checka Impilo


Deputy President Mabuza used the Health Summit to launch Checka Impilo, a national wellness campaign that focuses on testing and treating people who have HIV, TB, sexually transmitted infections and non-communicable diseases such as diabetes and hypertension.

The campaign will focus on the provision of comprehensive health and wellness services targeted at men, adolescent girls and young women, as well as key and vulnerable population groups.

The success of the campaign, Mabuza said, depends on coordinated collaboration among all social partners in respect to planning, implementation and monitoring.

Checka Impilo is a call to action for South Africans to move from a curative response to health to preventative approaches and the adoption of healthy lifestyles.

The campaign will focus on increased information, education and communication activities, promotion of HIV testing, widespread distribution of condoms, and provision of pre- and post-exposure prophylaxis against HIV.

“All of us must, therefore, go out in great numbers to test for HIV and screen for STIs, TB and non-communicable diseases such as diabetes and hypertension.

“Within 24 months of this campaign, we must have found and put two million more people on ARVs. We must also have found and put at least 80 000 more people with TB on anti-TB treatment. We must also have identified thousands more with diabetes, high blood pressure and cancer, and put them on treatment,” Mabuza said.

Growing problem of HIV and NCDs

Three-quarters of people on antiretroviral treatment at a clinic in Khayelitsha were also being treated for hypertension. Yet there is not enough information about how HIV and common NCDs such as hypertension and diabetes interact, or how medicines to treat them interact.

This is according to Dr Tolu Oni from the University of Cape Town, who is investigating the “collision” between HIV and NCDs.

“As people living with HIV are living longer, we are facing a new challenge. NCDs pose a new threat to people with HIV but there are many unanswered questions,” Oni told the international AIDS conference.

These questions include the extent of NCD co-infection, medicine interactions and how to co-diagnose and co-treat these.

Fattest nation

Aside from having the largest HIV population in the world, South Africa is the fattest nation on the continent.

Up to 70% of South African women and a third of men are overweight or obese, while a quarter of girls and one in five boys between the ages of 2 and 14 years are overweight or obese. Obesity is associated with type 2 diabetes, heart disease, stroke, hypertension, joint pain and certain cancers.

“Some NCDS are related to HIV infection itself and to the side effects of some of the medicines used to treat HIV infection,” according to UNAIDS. “Several of the opportunistic illnesses associated with HIV infection are NCDs in their own right, such as HIV-associated lymphoma and cervical cancer.”

Australian Professor Andrew Grulich reported that “the pattern of cancer and HIV is beginning to collide” as the population of people with HIV ages.

“There is an exponential increase in cancer as a person ages,” said Grulich.

A skin cancer called Kaposi’s Sarcoma was common in people with low immunity, but could be treated once a person was on ARVs. However, lymphoma was the most common cancer in people with HIV with mildly suppressed immunity, he said.

Californian epidemiologist Dr Melissa Frasco reported that two classes of ARVs were associated with an increase in diabetes, while “untreated HIV could lead to metabolic syndrome” (including obesity), which put patients at risk of heart attacks and strokes.

Supporting this, a Kenyan study has shown that HIV positive people who were not on treatment had significantly higher rates of hypertension than HIV negative people.

“Ageing with HIV is a huge issue in Europe, where people started ARV treatment earlier. Addressing this needs both a medical and psycho-social approach,” said Tamas Bereczky, who is both living with HIV and a researcher with the European AIDS Treatment Group. – Health-e News.