scholarly journals Legal duties, professional obligations or notional guidelines? Screening, treatment and referral of domestic violence cases in primary health care settings in South Africa

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Lillian Artz ◽  
Talia Meer ◽  
Gray Aschman
Keyword(s):  
South Africa ◽  
Health Care ◽  
Domestic Violence ◽  
Ad Hoc ◽  
Service Providers ◽  
Natural Extension ◽  
Psychosocial Care ◽  
International Treaties ◽  
Screening Guidelines ◽  
The Right

Background: Since 2013, approximately 4400 women have been murdered by their partners in South Africa. This is five times higher than the per capita global average. Domestic violence is known to be cyclical, endemic and frequently involves multiple victims. It also becomes progressively more dangerous over time and may lead to fatalities. In 2012, the Health Professions Council of South Africa released a domestic violence protocol for emergency service providers. This protocol, or screening guidelines, includes assessing future risk to domestic violence, providing physical and psychosocial care, documentation of evidence of abuse and informing patients of their rights and the services available to them. The extent to which these guidelines have been circulated and implemented, particularly by general health care practitioners (HCPs), is unknown.Aim: We review international treaties to which South Africa is a signatory, as well as national legislation and policies that reinforce the right to care for victims of domestic violence, to delineate the implication of these laws and policies for HCPs.Method: We reviewed literature and analysed national and international legislation and policies.Results: The ‘norms’ contained in existing guidelines and currently practiced in an ad hoc manner are not only compatible with existing statutory duties of HCPs but are in fact a natural extension of them.Conclusion: Proactive interventions such as the use of guidelines for working with victims of domestic violence enable suspected cases of domestic violence to be systematically identified, appropriately managed, properly referred, and should be adopted by all South African HCPs.

When roles within interpreter-mediated psychiatric consultations speak louder than words

2020 ◽  
pp. 136346152093376 ◽  
Author(s):  
Sanja Kilian ◽  
Leslie Swartz ◽  
Xanthe Hunt ◽  
Ereshia Benjamin ◽  
Bonginkosi Chiliza
Keyword(s):  
South Africa ◽  
Health Care ◽  
Health Care Workers ◽  
Ad Hoc ◽  
Psychiatric Hospitals ◽  
Best Interests ◽  
Western Cape ◽  
Structured Interviews ◽  
Care Workers ◽  
Professional Interpreting

In South Africa, clinicians working in public psychiatric hospitals are mainly fluent in English and Afrikaans, while the majority of patients are not proficient in these languages. Due to a lack of professional interpreting services, informal, ad hoc interpreters are commonly employed in public psychiatric hospitals. We collected data on language practices in public psychiatric care in South Africa, and provide a detailed account of what happens when bilingual health care workers and cleaners haphazardly take on the additional role of interpreter. Data were collected during 2010 at a public psychiatric hospital in the Western Cape, South Africa. Thirteen interpreter-mediated psychiatric consultations were video-recorded, and 18 audio-recorded semi-structured interviews were conducted with the interpreters and clinicians who participated in the interpreter-mediated psychiatric consultations. Patients were proficient in isiXhosa (one of the 11 official languages of South Africa), the clinicians (all registrars) were first language English or Afrikaans speakers, while the health care workers (nurses and social workers) and cleaners were fluent in both the patients’ and clinician’s language. Our findings suggest that interpreters took on the following four roles during the interpreter-mediated psychiatric consultations: regulating turn-taking, cultural broker, gatekeeper and advocate. Our findings suggest that, despite interpreters and clinicians having the patient’s best interests at heart, it is the patient’s voice that becomes lost while the clinician and interpreter negotiate the roles played by each party.

Varying Perspectives on the Treatment of Domestic Violence in New Zealand

2008 ◽  
Vol 30 (3) ◽  
pp. 50-53 ◽  
Author(s):  
Hillary Haldane
Keyword(s):  
Domestic Violence ◽  
New Zealand ◽  
Violence Against Women ◽  
Service Providers ◽  
Elder Abuse ◽  
National Level ◽  
International Treaties ◽  
Front Line ◽  
Government Officials ◽  
Cultural Backgrounds

Women's refuges have existed in New Zealand since 1973 and today over two hundred various community and national level organizations work with victims and perpetrators of domestic violence, sexual assault, elder abuse, and child endangerment. New Zealand service providers and government officials view their work in the area of violence against women as part of an international effort with an obligation to uphold the Convention on the Elimination of All Forms of Discrimination against Women, or CEDAW as it is widely known, a treaty ratified by the country in 1985. While there is considerable governmental and nongovernmental support for those whose lives are touched by violence, there is also considerable tension over how to best design and deliver the services to those who need them. New Zealand is a diverse nation with a large indigenous population and growing Pasifika and Asian communities. Many of the recent debates center on how to best design programs for a multicultural population while still privileging the rights of the indigenous Maori. New Zealand's experience in addressing violence against women illustrates the disjunction between transnational discourses of violence against women, and the proposed international solutions to the problem, and the local efforts to help survivors from diverse cultural backgrounds. First, I will provide a brief description of how services are designed and delivered in New Zealand. Second, I will outline the main philosophical disagreements found among social service providers. Third, I discuss why research on the front-line has the potential to tell us a great deal about the limits of international treaties and enhance our response to violence against women.

scholarly journals The Powers of the Court in terms of Section 7(2) of the Domestic Violence Act 116 of 1998: KS v AM 2018 (1) SACR 240 (GJ)

Obiter ◽  
2019 ◽  
Vol 40 (3) ◽  
Author(s):  
Moffat Maitele Ndou
Keyword(s):  
South Africa ◽  
Domestic Violence ◽  
Well Being ◽  
International Human Rights Law ◽  
Rights Of The Child ◽  
Legal Remedy ◽  
Wide Range ◽  
The Republic ◽  
Definition Of ◽  
The Right

The preamble of the Domestic Violence Act (116 of 1998) (DVA) recognises that domestic violence is a serious social evil and that there are high incidences of domestic violence in South Africa. The preamble further recognises that:a) victims of domestic violence are among the most vulnerable members of society;b) domestic violence takes many forms and may be committed in a wide range of domestic relationships; andc) the remedies previously available to victims of domestic violence have proved to be ineffective.The Constitution of the Republic of South Africa, 1996 (the Constitution) provides various rights that are also applicable to victims of domestic violence. The Constitution guarantees the right to dignity and to freedom and security of the person (see ss 10 and 12 of the Constitution respectively). Domestic violence against any person is a violation of these rights. The DVA further recognises that South Africa has international commitments to end violence against women and children in terms of the United Nations Convention on the Elimination of all Forms of Discrimination against Women and the Convention on the Rights of the Child. A right not to be subjected to domestic violence may not be specifically mentioned in international human rights law instruments, but freedom from all kinds of violence and the right to equality and human dignity is generally emphasised.The purpose of the DVA is to provide a legal remedy in the form of an interdict that prohibits a person from violating the rights of the complainant. In order to give effect to this purpose, section 7(1) of the DVA provides that the court may grant a protection order to protect the rights of the complainant. Section 7(2) of the DVA further grants the court the power to impose any additional conditions that it deems reasonably necessary to protect and provide for the safety, health or well-being of the complainant.In KS v AM (2018 (1) SACR 240 (GJ)), the court found that section 7(2) of the DVA empowered the court to order the seizure of the respondent’s digital equipment to remove any photograph, video, audio and/or records relating to the complainant. This case note examines the decision in KS v AM (supra) and determines whether the decision is justifiable in law. The definition of domestic violence is discussed first and thereafter the remedies available in terms of the DVA are examined. A discussion of the judgment in KS v AM (supra) follows.

scholarly journals The utilisation of the right of children to shelter to alleviate poverty in South Africa

2017 ◽  
Vol 7 (1) ◽  
pp. 107
Author(s):  
I Mc Murray ◽  
L Jansen Van Rensburg
Keyword(s):  
South Africa ◽  
Health Care ◽  
Human Dignity ◽  
Health Care Services ◽  
The State ◽  
Economic Rights ◽  
Care Services ◽  
The Republic ◽  
The Right ◽  
Right Of Access

Children being the most vulnerable members of society are the one's most affected by living in poverty. This unacceptable situation can inter alia be attributed to the disastrous effects of Apartheid. During this unfortunate period in our nation's history millions of people were unjustly evicted from their homes and forced to live in deplorable conditions. Moreover, many of these people were left homeless or without the necessary adequate shelter. Children who were born into these circumstances were denied basic resources such as proper shelter, food, water and health care services. These unfortunate circumstances existed at the adoption of South Africa 's democratic Constitution. The preamble of the Constitution of the Republic of South Africa , 1996 reaffirms government's commitment to heal the inequalities of the past and improve the quality of life of all citizens. The Constitution is based on certain fundamental values, most importantly, human dignity, freedom and equality. The fact that these values are denied to those people living without access to basic resources such as adequate housing/shelter, food, water or health care services cannot be dismissed. To facilitate South Africa 's development as a democratic state based on human dignity, freedom and equality, the problem of poverty must be addressed. The Constitutional Court , in Government of the Republic of South Africa and Others v Grootboom and Others 2000 11 BCLR 1169 (CC), has recently stated that the effective realisation of socio-economic rights is key to the advancement of a value based democratic South Africa . Section 26 of the Constitution grants everyone the right to have access to adequate housing and section 28 that grants every child the additional right to basic shelter among others. By virtue of section 28(1)(b) the primary responsibility to provide children with the necessary adequate housing/shelter is vested in their parents, unless the parents are unable to fulfil their duty or the children are removed from their care. This does not in the least mean that the state has no responsibilities to children living with their parents. The state must still provide the framework in which parents can facilitate the realisation of their children's rights. The state can fulfil this obligation by taking reasonable legislative and other measures within its available resources to realise everyone's right of access to adequate housing progressively.  Therefore, it is submitted that the measures taken to realise section 26 also indirectly ensures the realisation of children's right to basic shelter (section 28(1)(c)). It has been largely accepted by the courts and academics alike that all fundamental human rights are indivisible and interrelated. Clearly then, the state's obligations in terms of section 28(1)(c) cannot be properly interpreted without referring to the interpretation of those obligations conferred upon it by section 26(2) and the other socio-economic rights in the Constitution. Hence, section 28(1)(c) must be seen in the context of the Constitution as a whole. Put simply, the state must take reasonable legislative and other measures within its available resources to realise children's right to basic housing/shelter progressively. This article will focus on the utilisation of the right to shelter of the child to alleviate poverty. Essential to this discussion is an effective understanding of the right to basic shelter as entrenched by section 28 of the Constitution in conjunction with the right of access to adequate housing conferred on everyone by virtue of section 26. This will be achieved by studying the general working of such rights including their limitations and enforcement. 

scholarly journals Paramedics' experiences of financial medicine practices in the pre-hospital environment. A pilot study

2016 ◽  
Vol 21 ◽  
pp. 103-109
Author(s):  
Craig Vincent-Lambert ◽  
Richard-Kyle Jackson
Keyword(s):  
South Africa ◽  
Health Care ◽  
Pilot Study ◽  
South African ◽  
Emergency Care ◽  
Health Care Professionals ◽  
Service Providers ◽  
Hospital Environment ◽  
Patient Treatment ◽  
Unethical Conduct

Background: The term “financial medicine” refers to the delivery of health-related services where the generation of financial gain or “profit” takes precedence over the provision of care that is reflective of evidence-based best practice. The practicing of financial medicine includes over-servicing and overbilling, both of which have led to a sharp rise in the cost of health care and medical insurance in South Africa. For this reason, the practicing of financial medicine has been widely condemned both internationally and locally by the Health Professions Council of South Africa (HPCSA) and allied Professional bodies.Objectives: This qualitative pilot study explored and described the experiences of South African Paramedics with regard to the practicing of financial medicine in the local pre-hospital emergency care environment.Method: A sample of South African Paramedics were interviewed either face-to-face or telephonically. The interviews were audio recorded and transcripts produced. Content analysis was conducted to explore, document and describe the participants' experiences with regard to financial medicine practices in the local pre-hospital environment.Results: It emerged that all of the participants had experienced a number of financial medicine practices and associated unethical conduct. Examples included Over-servicing, Selective Patient Treatment, Fraudulent Billing Practices, Eliciting of kickbacks, incentives or benefits and Deliberate Time Wasting.Conclusion: The results of this study are concerning as the actions of service providers described by the participants constitute gross violations of the ethical and professional guidelines for health care professionals. The authors recommend additional studies be conducted to further explore these findings and to establish the reasons for, and ways of, limiting financial medicine practices in the South African emergency care environment.

scholarly journals Comparing Provider and Client Preferences for HIV Prevention Services in South Africa among Men Who Have Sex with Men

2017 ◽  
Vol 16 (6) ◽  
pp. 562-571 ◽  
Author(s):  
John Shaver ◽  
Patrick Sullivan ◽  
Aaron Siegler ◽  
Alex de Voux ◽  
Nancy Phaswana-Mafuya ◽  
...  
Keyword(s):  
South Africa ◽  
Health Care ◽  
Hiv Prevention ◽  
Health Care Providers ◽  
Service Providers ◽  
Post Exposure Prophylaxis ◽  
Care Providers ◽  
Prevention Services ◽  
Sex With Men ◽  
Exposure Prophylaxis

Combination prevention efforts are now recommended toward reducing HIV incidence among men who have sex with men (MSM). Understanding the perceptions of both MSM and service providers is critical to informing the development of prevention packages and ultimately improving intervention effectiveness. This study assessed the preferences of MSM and health service providers in the administration of HIV-prevention efforts. Qualitative data were gathered from a series of separate MSM and health care provider focus groups in 2 South African cities. Participants discussed HIV-prevention services and MSM client experiences within South Africa and identified the 3 most important clinic characteristics and 3 most important HIV-prevention services for MSM clients. Priorities indicated by both MSM and health care providers were confidentiality of visit, friendly staff, and condoms, while discrepancies existed between MSM and providers regarding provider consistency and the provision of pre-exposure prophylaxis/post-exposure prophylaxis (PrEP/PEP) and lubricant as prevention methods. Effective interventions must address these discrepancies through the design of intervention and provider training to optimally accommodate MSM.

International human rights law and mental illness

2007 ◽  
Vol 24 (1) ◽  
pp. 31-39 ◽  
Author(s):  
John Tobin
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Illness ◽  
Mental Health Care ◽  
Standard Of Care ◽  
International Human Rights Law ◽  
International Treaties ◽  
Human Right ◽  
The Status ◽  
The Right

AbstractThe Irish State has been party to a collection of international treaties and declarations that directly affect the care of those who suffer from mental disorders. These documents set up what are considered as minimum core standards that outline the standard of care that should be provided as a basic human right. This article reviews the relevant sections of these documents and reflects as to how they have been applied in Ireland. International conventions, which have the status of a treaty, are monitored and interpreted by various commissions and committees. This article draws on the comments of these bodies as to how a state should provide for those with mental illness. Areas such as the rights of children who are mentally ill and those who are detained by the state are examined in detail. Other areas covered are the right to the highest attainable level of mental health care, the right not to be subjected to a clinical trial, equal access to mental health care, and the right to be safeguarded against unjust involuntary detention.

scholarly journals DOES THE RIGHT TO ACCESS TO HEALTH CARE SERVICES IN TERMS OF SECTION 27 OF THE CONSTITUTION OF SOUTH AFRICA, 1996 CATER FOR CANCER PATIENTS?

Obiter ◽  
2018 ◽  
Vol 39 (1) ◽  
Author(s):  
Charles Maimela
Keyword(s):  
South Africa ◽  
Health Care ◽  
Cancer Patient ◽  
Cancer Patients ◽  
Access To Health Care ◽  
Health Care Services ◽  
Right To Health Care ◽  
Care Services ◽  
Access To Health ◽  
The Right

Does the right to health care services as provided in terms of the Constitution of the Republic of South Africa, cater for cancer patients due to the expensive nature of cancer treatment and, if so, to what extent? One of the major socio-economic rights which cancer patients struggle to access is the right to health care services, which is currently dependent on the economic or financial position of a cancer patient, which is, unfortunately, the deciding factor in South Africa as well the entire continent of Africa. The financial or economic standing of a patient or a cancer patient, in this case, will determine if the patient will receive adequate cancer treatment or not. Does the economic or financial position of the cancer patient serve as a valid and justifiable reason for the right to access to health care services to the 75 per cent of people in South Africa who rely on public health care services for different health deformities that include cancer and, if so, to what extent?

scholarly journals Facilitators and barriers to detection and treatment of depression, anxiety and experiences of domestic violence in pregnant women attending Midwife Obstetric Units (MOUs) in Cape Town, South Africa: A qualitative study

2021 ◽  
Author(s):  
Zulfa Abrahams ◽  
Sonet Boisits ◽  
Marguerite Schneider ◽  
Simone Honikman ◽  
Crick Lund
Keyword(s):  
Mental Health ◽  
South Africa ◽  
Domestic Violence ◽  
Antenatal Care ◽  
Pregnant Women ◽  
Healthcare Workers ◽  
Service Providers ◽  
Qualitative Interviews ◽  
Depression And Anxiety ◽  
Facilitators And Barriers

Abstract Background In South Africa, symptoms of common mental disorders (CMDs) such as depression and anxiety are highly prevalent during the perinatal period and linked to experiences of domestic violence. However, limited routine detection and treatment is available to pregnant women with these problems. We investigated facilitators and barriers of service-providers and -users in detecting and treating pregnant women with symptoms of CMDs and experiences of domestic violence. Methods Service-provider perspectives were informed by qualitative interviews with 37 healthcare workers providing care to pregnant women attending four midwife obstetric units (MOUs) in Cape Town. Qualitative interviews with 38 pregnant women attending the same MOUs for their first antenatal care visit provided service-user perspectives. Results Facilitators identified included the availability of a mental health screening questionnaire and the perceived importance of detection and treatment. Barriers included service providers’ heavy workload and discomfort with discussing mental health issues; lack of standardised referral pathways and poor uptake of referrals; lack of confidentiality and feelings of shame related to experiences of domestic violence. Limitations: Difficulty in linking perceptions of care with specific healthcare providers; social desirability bias - pregnant women’s responses to questions on domestic violence, and service providers’ responses to their role in providing care. Conclusion The facilitators and barriers identified indicate the need to strengthen health systems by training antenatal care nurses to detect symptoms of CMDs and experiences of domestic violence in pregnant women, developing standardised referral pathways and training lay healthcare workers to provide treatment for mild symptoms of depression and anxiety.

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