Running head: SOUTH AFRICA HEALTH                                  1 2 SOUTH AFRICA HEALTH SYSTEM 3 SOUTH AFRICA HEALTH SYSTEM South Africa Health System Diamond DeWindt December 22, 2019 Author Note This paper was prepared for BHS380: Global Health and Health Policy, Session 2019NOV11FT- 1, Module 3, SLP 3 Assignment, taught by Dr. Michael Mucedola. South Africa Health System South Africa has a healthcare system which is structured at different levels. There are clinics, community health centers, and hospitals. The first level in the hospital structures are the clinics which treat the common needs of the people. It is these clinics that will refer someone further to the hospitals when one needs the further treatment. The clinics are either satellite or mobile clinics which are run by primary healthcare nurses. The community health centers are larger than the clinics and they have both nurses and doctors taking care of the patients. The last level of healthcare facilities are hospitals. The hospitals are for surgery, serious illnesses or emergency treatment that cannot be handled at the clinic levels. An individual can only go to the hospitals if they are referred by doctors in the clinics or in the case of an emergency. Basic healthcare is provided for free by the government through the healthcare services at the provincial level (Masquillier et al., 2015). There is also private healthcare insurance and those who get it receive tax benefits. There are several gaps that are present in the healthcare gaps in South Africa that have contributed to the rapid spread of the HIV pandemic. South Africa has one of the highest HIV epidemics in the world with over seven million people living with it (Masquillier et al., 2015). The spread of HIV has been caused by gaps which are there in dealing with healthcare awareness for marginalized groups. There are several demographics who do not get the sexual health care that they need such as sex workers, transgender women, gay men, as well as those who inject themselves with various drugs. The second gap that is there is lack of sufficient funds to get people to test for HIV. There is also lack of sufficient facilities to serve poor populations especially in slums to give them access to critical drugs such as ARVs. The healthcare system does not have sufficient capacity to deal with nutritional issues. One strategy that can be used to deal with the HIV/AIDs issue in South Africa is raising of public awareness through door to door campaigns especially in the slum areas. It is important for everyone to understand the importance of HIV/AIDS treatment and prevention. The local community needs also to realize that it is not good to have stigmatization of the minority groups such as gay men who do not get the healthcare which they deserve. All of this should be done to ensure that these groups of people are getting the care that they nee ...

1. Running head: SOUTH AFRICA HEALTH
1
2
SOUTH AFRICA HEALTH SYSTEM
3
SOUTH AFRICA HEALTH SYSTEM
South Africa Health System
Diamond DeWindt
December 22, 2019
Author Note
This paper was prepared for BHS380: Global Health and Health
Policy, Session 2019NOV11FT- 1, Module 3, SLP 3
Assignment, taught by Dr. Michael Mucedola.
South Africa Health System
South Africa has a healthcare system which is structured at
different levels. There are clinics, community health centers,
and hospitals. The first level in the hospital structures are the
clinics which treat the common needs of the people. It is these

2. clinics that will refer someone further to the hospitals when one
needs the further treatment. The clinics are either satellite or
mobile clinics which are run by primary healthcare nurses. The
community health centers are larger than the clinics and they
have both nurses and doctors taking care of the patients. The
last level of healthcare facilities are hospitals. The hospitals are
for surgery, serious illnesses or emergency treatment that
cannot be handled at the clinic levels. An individual can only go
to the hospitals if they are referred by doctors in the clinics or
in the case of an emergency. Basic healthcare is provided for
free by the government through the healthcare services at the
provincial level (Masquillier et al., 2015). There is also private
healthcare insurance and those who get it receive tax benefits.
There are several gaps that are present in the healthcare gaps in
South Africa that have contributed to the rapid spread of the
HIV pandemic. South Africa has one of the highest HIV
epidemics in the world with over seven million people living
with it (Masquillier et al., 2015). The spread of HIV has been
caused by gaps which are there in dealing with healthcare
awareness for marginalized groups. There are several
demographics who do not get the sexual health care that they
need such as sex workers, transgender women, gay men, as well
as those who inject themselves with various drugs. The second
gap that is there is lack of sufficient funds to get people to test
for HIV. There is also lack of sufficient facilities to serve poor
populations especially in slums to give them access to critical
drugs such as ARVs. The healthcare system does not have
sufficient capacity to deal with nutritional issues.
One strategy that can be used to deal with the HIV/AIDs issue
in South Africa is raising of public awareness through door to
door campaigns especially in the slum areas. It is important for
everyone to understand the importance of HIV/AIDS treatment
and prevention. The local community needs also to realize that
it is not good to have stigmatization of the minority groups such
as gay men who do not get the healthcare which they deserve.
All of this should be done to ensure that these groups of people

3. are getting the care that they need. The importance of ARVs
should also be emphasized for those already suffering from the
disease to get the treatment that they deserve. The healthcare
clinics in the community should also be encouraged to teach
people on the value of nutrition when dealing with HIV.
There are various options that are there for financing of this
strategy. Internally, the government has a healthcare budget and
such a strategy can get funding from there. It is important for
the government to improve its healthcare allocation specifically
to HIV to deal with the situation before it gets worse. Globally,
organizations such as USAID and the World Healthcare
Organization (WHO) can come in and deal with the problem.
References
Masquillier, C., Wouters, E., Mortelmans, D., & le Roux
Booysen, F. (2015). The impact of community support
initiatives on the stigma experienced by people living with
HIV/AIDS in South Africa. AIDS and
Behavior, 19(2), 214-226.
Running head: CHOLERA IN AFRICA
1
2
CHOLERA IN AFRICA
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CHOLERA IN AFRICA
Cholera In Africa
Diamond DeWindt
December 8, 2019

4. Author Note
This paper was prepared for BHS380: Global Health and Health
Policy, Session 2019NOV11FT- 1, Module 2, SLP 2
Assignment, taught by Dr. Michael Mucedola.
Cholera In Africa
Africa is the second-largest continent in the world with quite
the large population of human beings. It has been home of the
most significant outbreaks of cholera in the world over the past
years. Africa takes the most extensive record of global disease
burden where cholera is among the rampant diseases that have
been taken history by the world health organization. African
countries report about forty-six percent of suspects that were
made by world health organization, globally. (Abubakar at el
2018) Many conditions in the continent make it fertile for the
occurrence and rapid transmission of cholera. There is
inadequate access to clean water and sanitary facilities, mainly
in the urban areas where necessary infrastructure is not
sufficient.
Cholera is an infectious disease that causes severe watery
diarrhea that can result to dehydration and death within a small
duration of time if not treated. Individuals who are
malnourished or living with HIV have high risks of death if they
contract the infection. The bacteria can be transmitted from one
person to another using the fecal-oral route. Also, by consuming
contaminated food and water. When the disease has infected a
human being, it is shown by symptoms that include severe

5. diarrhea, vomiting dehydration that is caused by a lot of
vomiting and diarrhea. (Dalhart at el 2014) When the patient is
not treated at an early stage, it can lead to weakening and,
finally, death.
When a human host has not yet been infected, vibrio’s, survival
strategy in the water environment is the most common
interaction that happens between the bacteria and copepod that
becomes the first host before finding its way to human beings’
body system. The bacteria develops in the copepod until it gains
strength that can be able to move in water bodies on its own.
When the bacteria have aggregated on the copepod, it produces
means of transmission to the human host.
Some communities do not believe in hospital treatments;
instead, they take local herbal medicine that does not provide a
full dose of the medication to the patient. Through this method,
they retain strains of the disease in the community. Mountain
burial has a high impact on increasing cholera attack rates
because the water sources go from the mountain towards the low
laying places. (Moore at el 2017) This will result in carrying
out the disease pathogens in the water; once a person drinks
such water, they get infected. Understanding the community’s
perceptions of exposing people to risks and illnesses can help
public health agencies to have the proper response of outbreaks.
Communities speak different languages and call names that have
different meanings but are similar things. Some communities
regard cholera as a deadly disease, and it is a serious matter in
the community while other cities perceive the illness as a
common ailment that can be handled like any other disease. The
diet that human beings eat contribute to illnesses that they are
likely to suffer from. In the African communities, they mainly
eat food that is more of vegetables and fruits, which have more
water content than cereals. (Hemson at el 2015) Fruits are
imported to patients who are suffering from vomiting and
diarrhea; equally, when they are planted in cholera-stricken
places and swamps, they become hosts of the bacteria.
Expectations of health care on patients who are suffering from

6. cholera is high since the disease kills in hours. Traditional
healing is another factor that has held people in African
hostage. They believe in local treatment rather than medication
in hospitals. Local medicine is not keen to affect immediately in
the human body; thus, many deaths result in such therapies.
Climate change has influenced human beings to change their
activities because of use of untreated sewage waste and farm
activities that have facilitated the spread of cholera. Due to the
prolonged drought that results in scarcity of food, people end up
growing vegetables on sewage grounds where plants cannot dry
up since there is no rain.(Weill at el 2017) This activity has
fueled the spread of cholera because of eating food that is not
safe for human consumption. When there is an outbreak of
cholera, the government imposes money to protect people for
suffering and to prevent it from spreading further to other
people. Through this method, the economy of the country is
confiscated by budgets that were not planned. Politically, it
affects the ruling government when it fails to put measures that
will facilitate the prevention of cholera in the future.
Reference
Abubakar, A., Bwire, G., Azman, A. S., Bouhenia, M., Deng, L.
L., Wamala, J. F., ... & Martin, S. (2018). Cholera
epidemic in South Sudan and Uganda and the need for
international collaboration in cholera control. Emerging
infectious diseases, 24(5), 883.
Dalhart, M. M., Isa, A. N., Nguku, P., Nasir, S. G., Urban, K.,
Abdulaziz, M., ... & Poggensee, G. (2014). Descriptive
characterization of the 2010 cholera outbreak in Nigeria. BMC
public health, 14(1), 1167.
Hemson, D., & Dube, B. (2015). Water services and public
health: the 2000-01 cholera outbreak in KwaZulu-
Natal, South Africa.
Moore, S. M., Azman, A. S., Zaitchik, B. F., Mintz, E. D.,
Brunkard, J., Legros, D., ... & Lessler, J. (2017). El

7. Niño and the shifting geography of cholera in
Africa. Proceedings of the National Academy of
Sciences, 114(17), 4436-4441.
Sinyange, N., Brunkard, J. M., Kapata, N., Mazaba, M. L.,
Musonda, K. G., Hamoonga, R., ... & Nanzaluka, F.
(2018). Cholera epidemic—Lusaka, Zambia, October 2017–May
2018. Morbidity and Mortality Weekly
Report, 67(19), 556.
Weill, F. X., Doman, D., Njamkepo, E., Tarr, C., Rauzier, J.,
Fawal, N., ... & Bercion, R. (2017). The genomic history
of the seventh pandemic of cholera in Africa.
Science, 358(6364), 785-789.
Running head: KEY HEALTH INDICATO
1
2
KEY HEALTH INDICATORS
3
KEY HEALTH INDICATORS
Key Health Indicators
Diamond DeWindt
November 19, 2019

8. Author Note
This paper was prepared for BHS380: Global Health and Health
Policy, Session 2019NOV11FT- 1, Module 1, SLP 1
Assignment, taught by Dr. Michael Mucedola.
Key Health Indicators
Health indicators are generally characteristics of a population
that allows researchers to have supporting evidence to help
them describe the health of that particular population.
(Wikipedia, 2019) To gather information about the health of a
population, surveys have been conducted. A great example of a
health indicator would be Life Expectancy. Systems can be used
to collect data on ages at the time of death which is later used to
support statements about the national life expectancy.
Infant Mortality Rate
Infant mortality rate is recorded as the death of an infant before
their first birthday. This is rate is by number of infant deaths
per every 1,000 live births. (CDC, 2019) Some of the causes of
infant deaths before their birthday are birth defects, low birth
weight, preterm birth, or Sudden Infant Death Syndrome or
SIDS. The Center for Disease Control has been trying to
improve these birth outcomes. The CDC has been working to
understand Sudden Infant Deaths which is an unexpected death
of an infant under 1 years old. States that are involved show
data of trends to help the CDC develop strategies that they hope
will reduce the chance of SIDS. (CDC, 2017)
Life Expectancy at Birth
Life expectancy at birth is the average of how long a
newborn is expected to live at birth. (OECD Data, n.d.) This is
actually one of the most used health status indicators by
researchers. Having a high life expectancy at birth can show
that the living standards of that area has improved lifestyle,
education, and access to quality healthcare. If mortality is high
in age groups that are young, the life expectancy at birth can be

9. low, but if a person can live past their childhood mortality then
they can expect to live longer. Different populations will have
different life expectancies at birth because some countries are
not as developed as others. A great example is comparing South
Africa’s 59.5 years of age expectancy to the United States 81.2
years. (Population Pyramid, n.d.)
Maternity Mortality Ratio
The Maternity Mortality Ratio represents the risks that are
associated with each pregnancy. (WHO, 2014) Some of the
complications that arise during childbirth are the leading causes
of death and disability among women in developing countries.
Measuring this ratio can be quite difficult unless the death and
cause of death is documented. Other estimates are formed from
census, and surveys over maternal mortality. Maternal mortality
ratio and maternal mortality rate should not be confused with
each other. Maternal mortality rate is the number of maternal
women who have died per women while maternal mortality ratio
is the number of maternal deaths per live birth. (Morse, 2019)
Under 5 Mortality Rate
The Under 5 Mortality Rate is the probability of an
individual from newborn to age 5 dying per 1,000 births.
(WHO, 2019) Last year alone, it was reported that 5.3 million
children under the age of 5 years old died. Currently, the
African region has the highest risk of children dying under the
age of 5 years old. It has 5 of 6 countries having the death rate
at 100 deaths per 1,000 live births. The Sustainable
Development Goals have come up with a target to end
preventable deaths of children from birth to 5 years old. All
countries are to try to reduce under 5 mortality to as low as 25
deaths per 1,000 live births. Currently, 21 countries are on track
to reach this target by 2030.
Health Adjusted Life Expectancy
Health Adjusted Life Expectancy is a measure of a
populations health that takes into report mortality and
morbidity. (Health Knowledge, 2010) It tweaks overall life
expectancy by the amount of time that is lived in less than

10. perfect health. The formula is A + (f)B = life expectancy. A =
years lived healthy, B = years lived with disability, and f =
disability level. One of the concerns has been who gets to
decide what level a disability is. The global health adjusted
expectancy for both male and female together was 63.1 years
old in 2015.
Disability Adjusted Life Years
Disability Adjusted Life Years or DALY measure the
amount of life that is lost in a population as an outcome of
either premature death or disability. (Health Knowledge, 2010)
This helps researchers estimate the weight of a disease on a
population. A single DALY can be thought of as a single year
loss of healthy life. Measuring this across a population can help
show the gap between current health status and the wanted
health situation. DALY = Years of life lost + Years lost due to
disability.
Life expectancy at birth is a health indicator that could be
used to describe the overall health status of a developing
country. Life expectancy can show the living standards of the
developing country. The higher the life expectancy grows; it
shows that the country is improving and vice versa if it is
getting lower. Life expectancy will start to rise when the
country is showing improvement in public health, nutrition,
education, and medicine.
References
Wikipedia. (2019, October 14). Health indicator. Retrieved from
https://en.wikipedia.org/wiki/Health_indicator.
CDC. (2019, March 27). Infant Mortality. Retrieved from
https://www.cdc.gov/reproductivehealth/maternalinfanthealth/in
fantmortality.htm.
CDC. (2017, September 11). Infant Mortality: What Is CDC
Doing? Retrieved from

11. https://www.cdc.gov/reproductivehealth/maternalinfanthealth/in
fantmortality- cdcdoing.htm.
Health Knowledge. (2010, July 15). Health information: Life
tables, HALEs, DALYs, and PYLLs. Retrieved from
https://www.healthknowledge.org.uk/e-learning/health-
information/population-health-specialists/lifetables-hales-
dalys-pylls.
Morse, A. R. (2019, August 23). Definitions of Maternal
Mortality. Retrieved from https://www.pop.org/definitions-
of-maternal-mortality/.
OECD Data. (n.d.). Health status - Life expectancy at birth -
OECD Data. Retrieved from
https://data.oecd.org/healthstat/life-expectancy-at-birth.htm.
Population Pyramid . (n.d.). Life Expectancy At Birth, Female
(Years) 2015. Retrieved from
https://www.populationpyramid.net/hnp/life-expectancy-at-
birth-female-years/2015/.
WHO. (2014, March 11). Maternal mortality ratio (per 100 000
live births). Retrieved from
https://www.who.int/healthinfo/statistics/indmaternalmortality/e
n/.
WHO. (2019, October 24). Under-five mortality. Retrieved from
https://www.who.int/gho/child_health/mortality/mortality_under
_five_text/en/.