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Instructions 1. Watch the video ‘The Journey of your child’s vaccine’. 2. You can find this in Week 5: Session 6. 3. There are 2 questions in this worksheet. Answer the questions below. 4. Upload your worksheet to your Ulwazi Portfolio Question 1: Unpacking the Donabedian Model. Based on the video-case study, complete the table to identify different indicators at different points in the development of childhood vaccines. Question 2: Implementing EPI in SA Review the Vaccination Schedule that is followed in implementing EPI in South Africa. a. What challenges do you think affect the implementation of EPI? Think about these in terms of structural and process challenges. b. Consider the current context of the roll-out of the COVID-19 vaccine. With reference to the Donabedian Model, what can we do to ensure the success of this programme? a) There could be a shortage of staff to be able to administer the vaccines. There could be a lack of infrastructure, clinics too small or bad roads, for health care professionals to administer the vaccine. There could be a lack of communication between the health professional and the patient on the schedule of receiving vaccines. b) More temporary facilities and human resources for health should be put in place for people to access the vaccine, this will alleviate the amount of people that have to go wait at a hospital or clinic to receive the vaccine.

Overview There are 2 steps to this activity. In the first step, you will watch a video on the role of a discussant. In the second step, you will reflect on the qualities we need to give constructive feedback. Take some time to complete this activity before you continue with this tutorial’s content. Step 1: Watch a video and take notes Watch the video, “How to be an effective discussant”, taking notes as you go. In the video, Megan Haselschwerdt outlines the role, preparation and delivery of a discussant at a conference. As you make your notes, avoid using the same language as the presenter; your learning will be deeper if you internalise the ideas and use language that comes naturally to you. While you watch, observe how the presenter has structured the slide presentation. In particular, note how new information has been chunked and what visual rhetoric has been applied to make it easier to follow. Taking notes is a skill. As a discussant, you need to take notes and respond to a presentation. Click here to access an additional resource called ‘Tips on Being a Good Discussant’. You can take notes on a piece of paper, or include them: Adds additional insight and perspective, introspective. Comes at the end of presentation. Summary of presentation and connecting or how different speakers’ presentation. Strengthens session. Shows the audience key aspects of presented papers. Reads all submitted papers. Makes connections between papers. Identify the main ideas between one and three of the papers. Plan discussant presentation approach. Outline strengthens of paper. Have a slide with key points to stay on track. Have five minutes to summaries at end of a presentation and to conclude session. Leave audience with question to think about. Illustrates strength and weaknesses of limitations of presentations. Speak in audibly good voice. Don’t talk about you, provide constructive feedback and synthesize. Connect studies and broader literature. Step 2: Giving Constructive Feedback Sometimes, it is hard to receive criticisms from other people on your work. With this in mind, when we give feedback on someone else’s work, we need to do so in a constructive and productive manner. Briefly respond to the following questions: How do you give constructive feedback? What should you avoid when being critical of other people’s work? When giving constructive feedback I make sure to be kind and acknowledge the work and effort that the person has put into the project. However, I also try to be a straightforward and also provide reasons that I believe my criticisms are valid and a good enough reason to be brought up.

Instructions There are 2 questions for this activity worksheet. Read THIS TWITTER FEED. Submit your completed worksheet to your Ulwazi portfolio. Remember, once you have completed the worksheet, be sure to label the document as Activity 2.4.6: Dimensions of Quality Question 1 From THIS TWITTER FEED, identify possible barriers and facilitators that relate to the different ‘dimensions of quality’ in the table below. Note that barriers and facilitators can be: ● people, qualities of people, or non-animate aspects of the health system. ● can be formally part of the health system, or external NB* Write as many barriers/facilitators as you can. Question 2 With reference to the quality improvement cycle, identify one key challenge in the Twitter feed. Address this challenge by answering the questions below:

Guidelines There are 2 steps to this worksheet. To begin, you will apply a free writing technique. This is where you write whatever comes into your mind without stopping. Simply, let the ideas flow and don’t be too concerned about editing. Once you have completed Step 1, return to the session on Ulwazi and work through the different points. At the end of the session, complete Step 2 where take note of your initial ideas about good presentations and what you have learnt. Step 1: Practice Free writing For this part of the activity, you need to let your ideas flow by writing continuously without stopping for at least 5 minutes. Don’t worry about spelling or grammer, just let ideas come to you. This is a great technique to allow your ideas to flow without limiting yourself. Start with the following sentence and keep writing: An inspiring presentation I will never forget … An inspiring presentation that I’ll never forget was humorous, the presenter made memorable jokes, gave interesting facts and statistics, made use of analogies that made concepts that are usually difficult to understand easy, the slides of the presentation were not too busy or over filled with information. The presenter added information the slides, using the slides a guide instead of reading the slides to the audience. Tips for Free writing Free writing Try to include aspects of ‘free writing’ when approaching activities for the first time: ● Use coloured, unlined paper. ● Use colour felt-tip pens. ● Orientate the paper in a landscape direction. ● Be non-critical of your writing. The aim of the above ‘rules’ in free-writing is for you to break through the resistance that comes from formal writing, assessments and computer work, allowing for your thought-making process to come to the fore (Badenhorst, 2007). Want to learn more about Free writing? Have a look at these resources: Campbell, A. Freewriting Techniques Available at: https://www.lynchburg.edu/academics/writing-center/wilmer-center-online-writing-lab/drafting-a-document/freewriting-techniques/ (Last accessed: 22 July 2019). Friedlander, J. (2010) Unleash Your Creativity: How To Freewrite Available at: https://www.thebookdesigner.com/2010/04/unleash-your-creativity-now-how-to-freewrite/ (Last accessed: 22 July 2019). Step 2 – Make notes about your initial ideas and what you have learnt. Before continuing, engage with the content in Session 2. Once you have watched the videos and read the content, make notes about the similarities or differences regarding the points that have been made, and the ideas you expressed in your free writing in Step 1. Similarities to Free writing: - An engaging presentation is like a narrative, effectively conveying the message of what needs to be presented. - Provides information required and that the audience will be able to understand and remember. - Facts are categories that is easy for the broken down into audience to understand. - Slide must be eye-catching but not busy. Acknowledge and reference images and information per slide. - Use of minimum words per slide, with easy to read font. - Use of different text colours and fonts only when necessary, such as titles and for emphasis. - Not writing full length sentences or paragraphs. - Asking question and summarising talk points. - The presenter was passionate and made use of voice and hand gestures as well as body.

Step 1: Having watched the first video about ‘Conflict Resolution Techniques’, click here to complete the Thomas-Killmann assessment. Step 2: Based on the results from the Thomas-Killmann questionnaire, what is your preferred mode for dealing with conflict? In relation to your style of managing conflict, describe your strengths and weaknesses [200 words min]. My preferred mode of dealing with conflict is accommodating, comprising, and collaborating. Accommodation (Low assertion/High cooperation): People who choose accommodation put others' needs ahead of their own and cooperate with others' desires. They frequently forego all of their personal objectives in favor of maintaining a positive relationship with the other person (or people). Collaboration (High assertiveness/High cooperation) - People that have a collaborative mindset seek out a solution that benefits all parties. They meticulously define the problems, analyze the situation, and carry out the decisions made. This tactic promotes group collaboration and teamwork. Working together does not produce winners and losers. It doesn't acquire authority over others. The application of this strategy also generates chances for innovation and experimentation. The Dual Concern/Conflict Grid Model. Compromise: People who prefer to reach a compromise are flexible and willing to give up some of their interests. All parties must agree on a compromise. Each party will have to forfeit something in exchange for receiving something from the other parties.

Instructions Watch the video on Healthcare in Hong Kong. There are 4 questions in this worksheet. Answer the questions below. Upload your completed worksheet to your Ulwazi Portfolio. Remember, once you have completed the worksheet, be sure to label the document as Activity 1.2.6: Comparing Health Systems. Question 2 Having looked at the similarities and differences between these two frameworks, how could you redesign a framework that combines the strength of both frameworks? Draw out your ideas on a clean piece of paper. Take a picture of your new framework and paste it here: Question 3 Think back to the video on Healthcare in Hong Kong. Using the Rich Picture Approach (DrawToast), map out the challenges that you see in this health system. Using your new framework, identify which building blocks or domains should be addressed in finding solutions to the issues you have noted. Illustrate your ideas on a clean piece of paper. Take a photo of your illustration and paste it here: Question 4 Reflect back on Week 2 – Session: Types & Typologies. From the Rich Picture you have drawn above and thinking about the different content domains of health systems science, it is possible to compare and contrast some of the attributes and challenges evident in the Hong Kong health systems with similar challenges affecting the health systems in South Africa. Revising the types and typologies of health systems, choose one typology to describe the health system in Hong Kong (you can apply Fields, Roemers, or Cockerham’s typologies. Explain what you see as similar or different to the national health system in South Africa – expand and substantiate your answer. The health care system in Hong Kong can be best described by Fields Five typology. In Hong Kong healthcare is an insured or guaranteed consumer service, doctors are solo entrepreneurs and members of medical organizations (either part of the government public health system or one of the many private). Payments are direct and facilities are owed by both the private and the public. There are long waiting hours due to the shortage of doctors but even if it takes long for health services to be given to the patients the quality is still upheld. In South Africa healthcare is seen as predominantly a consumer good or service, doctors are solo entrepreneurs and members of medical organizations (either of private or public). Payments are direct or indirect and facilities are owned by private or public. There is also a shortage of staff and long waiting hours, but the quality of care is not upheld due to there being problems with other components of the health care system such as lack of medical supplies or electricity shortages.

Guidelines For this activity, you’ll have a chance to apply the ‘Draw Toast’ method to a case study. In order to use an authentic context, you will have to read a paper on childhood obesity. There are three steps to this activity worksheet. Make sure that you have watched the video on the DrawToast method before starting. Step 1: Read a Paper on Adolescent Obesity Having watched the video on DrawToast, read this paper by Finegood et al (2010) on addressing adolescent obesity, as a complex problem. Step 2: Draw Your Understanding of the Problem Apply the DrawToast, also known as the Rich Picture approach, by illustrating how you understand the problem of adolescent obesity described in the paper you have just read. You can use diagrams, drawings, and/or text to create a map of the problem as you see it. This activity is not about your drawing skills but more about how you see this problem. Use a separate piece of paper to illustrate your thinking. Remember that you will need to bring this illustration to class. Step 3: Take Picture of Your Illustration Once you have completed your illustration, take a photo of it, and copy this picture to this worksheet:

Instruction - There are 3 questions in this activity worksheet. - Having watched the video, discussed above, take some time to read a topical paper here. - Answer the questions below. - Upload your completed worksheet to your Ulwazi Portfolio. - Be sure to label the document as Activity 1.1.6 – Traditional African Medicine Question 1 – Opportunities for Teamwork a. THPs could play a role as part of a medical team, especially when it comes to issuing sick notes. With reference to the video, the discussion and the reading, what do you think are some of the barriers to including a traditional African health practitioner in a medical team? The history in South Africa of Apartheid and of Colonialism caused a marginalization of traditional medicine in medical care, systems, and practice. Apartheid and colonization was mainly done by people outside of the culture of the people living in the area. This makes it hard for them to see the value in whatever health systems the native people have in place, hence the marginalization as they controlled how health systems developed in the area for a long time. Fixing the marginalization takes work and time even when colonization and apartheid are no longer on going. However, the patterns of health-seeking behavior of South African traditional medicine users are poorly studied therefore cannot be integrated into quality health systems by health intervention and policy experts. In 2008 the Traditional Health Practioners Bill was approved by President Mbeki. Due to changes in government and as a consequence the Minister of Health, the bill has failed to be integrated into society and the health system as the incoming administration did not focus much attention on the subject. As a result that sick notes, medical aid payment to traditional healers and funding and protection of research on traditional medicine is delayed. b. What are the missed opportunities, resulting from this exclusion? Traditional health practitioners share similar cultural values to their patients and they are often the first point of call for healthcare for much of the population in South Africa. “THPs are considered to be cultural custodians within the African society and influence the interpretation. of illness and mode of behavior through cultural interpretations. They can control therapy, serving as a conduit transmitting general social values, and reshaping and reinterpreting those values in the healing process.” If they are included in the health system of South Africa, with some medical training, the trust people have in the health system will increase meaning that more ailments will be treated and addressed earlier rather than delaying and it being addressed when it is at a late stage and the person is in a much worse condition. Question 2 – How do we know what we know? In what ways do you think that different epistemologies of healing lead to dissention and conflicts of power between different healing practices? Different epistemologies of healing receive vary levels of resources and support by the government that is in power. This means that people who are following certain medicine practices are left out and devalued. For example, allopathic or biomedical medicine has for a long time been more valued, resourced and supported in South Africa which has caused employers and health policy makers to be detached from the values and beliefs of employees. Out of this rises dissentions, for example employees unable to use traditional healers issued sick notes, or conflicts of power, the resources currently being allocated to traditional healers in south Africa being insignificant due to allopathic/ biomedical medical being seen as the only right way to seek medical attention. Question 3 – Time to Reflect Below are three probing questions to get you to think about your own positioning as a health science student. Take some time to write reflectively in response to these questions: a) What did I learn today, that resonates with or is conflict with my prior understanding? b) What practices in my life could be called traditional? c) How have those traditions contributed to my epistemological position? a. What I learnt is that the only mode of traditional medicine that is not recognized in south Africa is the one practiced by the indigenous people of South Africa. I also learned that 80% of South Africa uses traditional medicine and 90% of HIV patients first see a traditional healer before seeking allopathic medicine. b. I don’t really have anything traditional in my day-to-day life. c. -not applicable-

Guidelines There are 5 short steps in this worksheet. Once you have completed each step, upload the worksheet to your Portfolio so that you have a record of your work. You will be able to use this worksheet as evidence of your engagement on this course. Also, remember that this activity needs to be completed in order to participate in Sessions 3 and 4 this week. Step 1: Having watched the two videos, embedded in Session 2, on Teamwork and Belbin’s Team Roles, complete an online assessment by clicking here. Step 2: Paste a screenshot of your results pie chart in the space below. Step 3: Complete the table below to score yourself. Step 4: What is your preferential team role and explain why you might excel in this role. [150 - 200 words]. My preferential team role is team worker. I believe that I am able to have a balance between making sure the group is on time with group work and up to date with what needs to be done as well as flexible, through ensuring co-operativity and diplomacy, enough to allow for the team members to have enough time to complete tasks, in other words not set an impossible to follow schedule. Being a team worker allows to me draw from my other skills as well, since it is a role to help team members get along as well as completing tasks that have not been actioned. I can draw on my monitor evaluator strengths which is strategic and makes decisions based on information available, meaning the solutions are often practical and easy to follow. I can also draw on my shape strengths which are because I don’t not want to fall behind on assignments, I make sure to get work done on time. Having good time management and the ability to make decisions on information available is a great strength to have when help team members and completing tasks. Step 5: From your experience, what qualities make a good team leader? [150 - 200 words] A good team leader can communicate effectively and clearly, has good time management, know how to prioritise tasks, motivate team members, and knows how to utilise that strengths of all the team members to achieve a goal that has been set. When there is clear communication that cannot be misunderstood or misinterpreted it decreases the chances for there to be conflict, which creates a peaceful working environment for team members. Effective communication means that the group can achieve the desired outcome for group projects. Time management allows for stress or conflict management among group members and makes sure that work is done on time. It goes had in hand with prioritising tasks so that the more important topics are dealt with. Avoiding conflict is not the goal, when it does arise then it is important to confront the conflict but it is impotent to put measures in place s more time can be spent on the work and not infighting. Motivating team member and working with the strengths of each team member improves performance and produces quality work that everyone can be proud of and happy with, which I believe is the goal or any group project.

Week 12: Core Domain: Health Policy ❏ How do policies come into existence? Who develops them? Whose interests do they represent? What factors influence the types of policies that come into existence in your home and family? Formal public policy, as developed by governments, is intended to influence the many actors working within a sector or system and the procedures and processes built into it, in ways that guide them to work together to achieve common goals and purposes. In general, public policies seek to generate ‘public value’; that is, they seek to produce things of value to the public at large in any country and to build public institutions, such as hospitals and clinics, that operate in ways that the public judges as fair and accountable. The policy process is a highly dynamic, interrelated and contextually sensitive one, which absorbs a wide variety of influences, including, social, political, economic, environmental, industrial and other factors. This is often a fluid process, as policy-makers respond to the multifaceted nature of demands. The values that my family holds factors into the types of policies that come into existence. ❏ Why is there often a gap between the intentions of policy and practice? As a result of the multifaceted and complex nature of the policy process, the gaps between policy intentions and practice remain a pertinent concern. As contexts, priorities, research methods and population needs are continuously evolving, the ability to learn, adapt and provide evidenced-based approaches to governance and leadership is paramount to the proposals of Health Policy and Systems Research (HPSR). ❏ What role does research play in informing policy making decisions? Health policy and systems research has evolved considerably over the past two decades, where its sphere of influence has broadened and become more complex. However, its central focus remains to inform and influence health policies and systems, to pursue health goals, with the objectives of equity and quality improvements (Peters, 2018). Health policy and systems-based research, therefore, focus their efforts on a number of factors, including: Research focused on health services as well as the promotion of health. Concerns for global and international issues as the promotion of health. Research on or of policy which addresses the politics of health systems and health systems services. Promotes work that explicitly seeks to influence policy. Competency: Research ❏ What do you think the difference between formal research and simply gathering information is? Formal research is to gather information in order to present it or make an argument. Simply gathering information is for knowledge is for discussions and explanatory purposes. Compared to the informal gathering of information you do daily, formal research concerns many people, processes and systems. In general, all formal research contributes to our collective knowledge and is used and applied practically to find, design and implement solutions. ❏ What role does research play in addressing real- world problems? Research is essentially the process of asking questions and finding answers in pursuit of creating knowledge. When knowledge is acquired then problems can be solved. ❏ What is the relationship between epistemology and ontology in research paradigms? Ontology asks what is reality and how do we know it's real. Epistemology asks what counts as knowledge. History of Medicine ❏ What do you understand by the term social-structural violence? Social-Structural Violence is when the is unrest with government entities, or who ever is in charge, which results in violence from the community in order to bring about change. ❏ Which indicators should we use to show health disparities between different population groups? Indicators related to health. Week 13: Core Domain: Health Policy ❏ How are new policies formed? For policies to be formed, there needs to be a public concern or a set of problems to address. ❏ Who should be involved in creating new policies? The problems that any policy seeks to address often requires on-going engagement with stakeholders affected by the problem. Stakeholders such as health researchers, social scientists, healthcare workforce, and organisations such as WHO, NICD, CDC, DOH etc. can inform policy formation. ❏ What factors should be taken into account when implementing a new policy? Public policy formulation commences after a complete agenda has been established and due consultative processes have been followed, where governments and other relevant agencies have consulted with the identified actors and acquired all the necessary information. In this phase, solutions to the problem are shaped through engagement with the different stakeholders. Stakeholders such as health researchers, social scientists, healthcare workforce, and organisations such as WHO, NICD, CDC, DOH etc. can inform policy formation. Competency: Research ❏ Why do you think that using a technique to focus your research and research writing is recommended? Research writing should always start with a clear research focus. However, for research to be focused, it needs to be well conceptualised. This conceptualisation involves creating a suitable research problem and selecting an appropriate research methodology and conceptual framework. ❏ What do you think is the best approach for asking and receiving feedback on any piece of research writing? Having it peer reviewed by multiple people. ❏ Would you approach how you collaborate remotely as a team differently for this presentation report after your experiences in the previous module? No History of Medicine ❏ The Bill of Rights in the Constitution of South Africa talks about the progressive realization of the right to access health. What does it mean to progressive realize a right? That the change is happening but at a slow and steady pace. ❏ At the start of South Africa’s democracy, many brilliant policies were created. What factors led to the poor implementation of many of these policies? The destructive policies by the apartheid system for decades makes problems very complex to solve along with the HIV/AIDS epidemic means that good polices were poorly implemented ❏ What role did the Constitution of South Africa play in the fight for Antiretroviral Therapy in South Africa? The Treatment Action Campaign (TAC) emerged from this crisis. Along with several leading HIV doctors, including Dr Ashraf Coovadia, the TAC brought a class-action lawsuit against the government’s position. This was heard by the Constitutional Court, the highest court in South Africa. When the Constitutional Court case was won in 2002, in favour of access to antiretroviral treatment, healthcare professionals responded with alacrity. At this point, a new era of health activism is born. Week 14: Core Domain: Health Policy ❏ How can policies support health systems to generate specific outputs and outcomes? Policy analysis is a useful process that helps policy-makers and analysts identify possible policy solutions to problems or unintended consequences that emerge through the development and implementation of policies. In doing so, decision-makers are able to compare different possible solutions and choose the most cost-effective, efficient, and feasible one. ❏ When a policy is implemented, but shows no improvement, what steps can be taken? A new policy will with solutions t the problems that made the first policy fail. ❏ What are the biggest challenges facing the successful implementation of policies in South African healthcare systems today? Fragmentation, lack of human resources and finances. Competency: Research ❏ Are you managing to collaborate remotely as a team more efficiently compared to the previous module? Yes. ❏ What strategies are you and your team implementing to ensure the successful completion of your Group Report 1? Meting up regularly for at least 2 hours and dividing the work. History of Medicine ❏ Do you feel the District Health Systems works well in South Africa? No, the system is ineffective and inefficient. ❏ What impact has the HIV pandemic had on the health systems, both positive and negative? HIV/AIDS prevents progress towards a more equitable health system because it demands a lot of resources to address. It also helped make it necessary for life saving medicines to be freely available from the government meaning it helped the creation of the district health system. ❏ What lesson can we learn from the history of health systems in South Africa in preparation for National Health Insurance? The health system should focus those who are discriminated the most and experience inequality the most. Overall Module Reflection:

Week 8: Core Domain: Health Information Systems ❏ What is your understanding of the term 'health informatics' and why do you think it is important to collect information about health? Health informatics can be described as the ‘logic of healthcare’, much like physiology means ‘the logic of life’, and pathology the 'logic of disease’. It is the study of how clinical knowledge is created, shaped, shared and applied. It is the rational study of the way we think about and view healthcare. It is the way that treatments are defined, selected and evolved according to research, data management and information gathering. Ultimately, it is the study of how we organise ourselves, as both patients and professionals, to create and run healthcare organisations effectively. With such a pivotal role, the study of informatics is fundamental to the medicinal practice and delivery of healthcare in this century. ❏ What role do models play in making sense of health information? Models are the basis of the way we learn about, and interact with, the physical world. Models can act either as copies of the world like maps, or as templates that serve as the blueprints for constructing physical objects, or processes. Models that copy the world are abstractions of the real world. Models can be used as templates and be instantiated to create objects or processes that are used in the world ❏ What is the difference between data, knowledge, and information? Data are a collection of facts. Knowledge defines relationships between data. Information is obtained by applying knowledge to data. Competency: Scholarship ❏ What do you need to consider when formulating a good search strategy? A search strategyis a well thought out plan to search for information, usually by using a set of key terms to search within particular databases. ❏ Do you feel confident in navigating the wits library and resources for research? No, the library set up is too complicated compare to other databases that can be used. ❏ What strategies do you use to find information? PubMed and Google Scholar. Complementary Domain: History of Medicine ❏ What influenced your decision to register as a Bachelor of Health Science student? I wanted to either becomea doctor or epidemiolodist and the BHSc degree that I have chosen enables me to enter either of those fields. ❏ How do we interrogate texts that are biased while evaluating their usefulness? [I don't know] ❏ How do epidemics and pandemics shape and influence healthcare systems? Pandemics and epidemics show weaknesses in health systems that need to be addressed. For example a consequence of the Spanish flu was the creation for the first time of a South African effort towards transforming an uneven health landscape into a centralised system of health administration. Week 9: Core Domain: Health Information Systems ❏ What do you think are the key features of any information system? Data generation Compilation Analysis and synthesis Communication and use ❏ What do we need to consider to ensure that data collected by a health information system is of good quality? A successful and effective HIS would need to capture very specific data at the different levels of a healthcare system. Without this very specific data, decision-making and the processes of data generation, compilation, analysis and synthesis, and finally, communication and use would be inaccurate. It is therefore important to look at the different types of data, and at which level, the data needs to be captured. These include: Individual - Level Data (Electronic Health Records) Health Facility Level Data (Aggregated Data) Public Health Surveillance Data Population-Level Data Competency: Scholarship ❏ How do you know the information you are reading can be trusted? By asking the following questions: Is the academic source written by an expert/s in that field? Is the academic source peer-reviewed? Is there a list of references? Is the publisher reputable? ❏ What are the factors to consider when determining the academic rigour of a source? Currency: Does the source reflect recent research? Relevance: Is the source related to your research topic? Authority: Is it a respected publication? Is the author an expert in their field? Accuracy: Does the source support its arguments and conclusions with evidence? (Ryan, 2022) ❏ What criteria would you use to rank the evidence of research? Sources of Data Quantitative, Qualitative and Mixed-Methods Research Theoretical Background Practical Issues Ethical Considerations History of Medicine ❏ What do you think are the differences between Dutch colonialism and British colonialism? Dutch Colonialism was more focused on the cape and setting up a port for sailing ships and British colonialism was interested in natural resources and is the form of colonialism that began to shape South Africa into what it is today. ❏ What home remedies do you and your family use that you can trace back to the Dutch colonial influence? None that I know of. Week 10: Core Domain: Health Information Systems ❏ What health information systems do you know that are already being used in South Africa? Paper-based patient records. Paper-based facility data registers. Electronic Health Records (EHRs). Different electronic health systems in the Private Sector. Notifiable diseases and surveillance databases, such as the National Institute for Communicable Diseases (NICD). The District Health Information System (DHIS). ❏ What challenges do you think South Africa faces in running and implementing the DHIS? There are currently far too many data elements collected routinely and no convincing evidence that the information collected is being put to good use. Most health facilities at PHC level do not have sufficient capacity to collect all the required data daily without compromising patient care. Most data collection tools are not user-friendly because of the massive data collection requirements, i.e. the number of elements and the detail required. There is at present duplication of data from several services which inevitably causes confusion. There is no attempt in the design of tools/registers to collect the lowest denominator data which could be extracted for different reports. Data element definitions are not always clear, leading to different interpretations and confusion. Data collection tools are changed too frequently, which does not allow staff to get used to the tools, and this also tends to compound the problem of shortages. Health facilities frequently run out of collection tools and have to resort to using unreliable collection methods, such as loose sheets which cannot be properly kept. Sometimes nurse practitioners see patients, but their statistics are not included in the clinic data/statistics. In many clinics, the doctors are not cooperative and refuse to complete data collection forms, and their services are sometimes not documented/recorded in clinic statistics, e.g. headcounts. The reason for non-compliance by doctors could not be properly established from clinic heads. Competency: Scholarship ❏ What questions can you ask yourself while reading academic material to focus your efforts? [I don't know how to answer this question, I don't ask questions, I skim through a text and decide if it's relevant to the research question or topic i have in mid. if not then is don't use it.] ❏ How would you strategise individual and team contributions to a group work project? All team members do the assigned worksheets then we meet up and discuss and combine our work. History of Medicine ❏ What do you think are the most influential events that shaped the healthcare system in South Africa 70 to 100 years ago? (Your great-grandparents were possibly the users of the South African health care system in that period). The apartheid regime and the democracy of South Africa being achieved. ❏ Do you think epidemics and pandemics can influence health care systems or are they controlled by health care systems? If the healthcare system is bad, then pandemic and epidemic influence the health care system. If it's good, then it can be either. Week 11: Core Domain: Health Information Systems ❏ How do you think the DHIS can be enhanced in a South African healthcare context? To implement solutions to the challenges faced by the DHIS, South Africa has adopted an eHealth strategy. ❏ What do you know of electronic medical records? The storage of EMRs doesn’t require physical space. Copies and back-ups of electronic data can be easily made. Information retrieval is immediate. Data can be more easily secured electronically. EMRs rely on electricity and technology. Data-entries are not as simple as paper-based entries. ❏ In what ways do you think eHealth systems can address the challenges that health systems currently face? Provide a clear roadmap for achieving a well-functioning National Health Information System. Ensure the exchange of data between the Health Information Exchange (HIE) and the central data repository called the National Health Insurance Research Database (NHIRD). Respond to the White Paper on the National Health Insurance (2015) requiring an effective national electronic patient-based information system. (South African Government, 2020). ❏ Are eHealth systems the future of healthcare? Yes, In 2020, the National Digital Health Strategy was being shaped by COVID-19. As South Africa tackles the pandemic, we are tasked with the imperatives of tracking the disease, treating patients, and monitoring healthcare systems. To monitor the virus and work towards flattening the curve, South Africa was actively involved in the processes of screening, testing, diagnosing, contact-tracing and isolation. Because more than 28 000 healthcare workers have been mobilised to screen, test and track, innovations in mHealth are urgently needed to capture data. Competency: Scholarship ❏ Are you managing to collaborate as a group? Yes, my group is managing to collaborate well. ❏ What strategies can you and your team implement to ensure the successful completion of your Presentation 2? We me up outside of school hours, meaning that we spent a lot of time going through and revising the presentation if the hours are added to the normal allocated time in the HSS 2 course. We divided up the work. History of Medicine ❏ Have your parents or grandparents ever related an incident from the past that reflected the policies of apartheid healthcare? No, my grandparents are Kenyan and don't stay in South Africa. ❏ Have you or anyone you know had a current experience that reflects the impact of apartheid and segregationist policies on our current healthcare in South Africa? Apart from the long waiting times in hospitals, No, I've been very fortunate. Overall Module Reflection:

Week 4: Core Content: Dimensions of Quality ❏ Why is Quality important? Quality is a highly important factor across all aspects of the healthcare delivery system. The standard of quality in one area has a ripple effect on the standard of quality in other areas. Whilst there are costs associated with quality, the costs incurred because of non-conformance to quality can be extensive. As a result, poor quality care can be expensive and have implications for patients, institutions and broader societal and economic conditions. Health institutions may experience unnecessary laboratory tests, overburdened resources and low staff morale. Due to poor quality and poor patient experiences, patients may choose not to adhere to treatment. Poor quality can lead to other factors such as an incorrect diagnosis, which can lead to prescribing ineffective treatment and result in repeated visits to health centres, or a prolonged illness, and even death. ❏ What are the dimensions of quality for health systems? Maxwell's dimensions of quality are outlined as: Access to services Relevance to need Effectiveness Equity Acceptability Efficiency and economy ❏ How do we improve quality in our health system? The quality improvement cycle begins with defining the standards of quality, measuring these standards against indicators, using the information to identify gaps or challenges, applying a root-cause analysis to identify the underlying reasons for an identified challenge, and putting measures in place to address problems. It is important to design interventions that can be implemented within resource constraints and to continuously monitor the process of implementation in order to improve the intervention as it unfolds. At the end of any improvement cycle, the problem needs to be (re)evaluated in order to determine if the issue has been adequately addressed. Very often, improving one aspect within the health system allows for opportunities to address other concerns. Cross-cutting Content: Presentation Skills ❏ What are the characteristics of an engaging presentation? An engaging presentation is one that you want to listen to, absorb and interact with. It has the information that you want to be delivered to you in a manner that is easy for you to digest, that is interesting, and that encourages you to engage with the content. There are three main skills that you need to bring together in delivering an engaging presentation: content creation, visual rhetoric, and delivery (voice production and body language). ❏ What skills do I need to develop to present better? The time, sometimes it can be too long and presenting skill, speaking slower. Complementary Content: History of Medicine ❏ What was the impact of hospital medicine on the teaching and practice of medicine today? Medical schools were designed to train more practically rather than theoretically, and training was done inside the hospital. Importantly, the division between the physician and surgeon fell away as medical students were trained in both medicine and surgery. ❏ What impact did the psychiatric hospital have on our understanding of mental health today? A final legacy of hospital medicine is the development of the asylum, where mental and psychiatric conditions were relegated to mental hospitals. Making mental and psychiatric conditions not accepted and stigmatised. Week 5: Core Content: Structure & Process in Health Care ❏ What does success in a health system look like to you? when healthcare is people-centered and all the components that make up a health system are work together to focus on primary and preventative care compared to treatment only. ❏ What are the differences between structures and processes in a health system? Structure includes all of the factors that affect the context in which care is delivered, such as facilities, equipment, and human resources. Process refers to the sum of all actions that make up healthcare. It relates to the active part of providing healthcare to patients, such as diagnosis, treatment, preventive care, and patient education. It makes use of the facilities provided in healthcare organisations. ❏ How do structures and processes affect the outcomes of the health system? Structure: It refers to the infrastructure and facilities in place to capacitate medical professionals to assist patients. Process: According to Donabedian, the measurement of the process is nearly equivalent to the measurement of quality of care as the process contains all acts of healthcare delivery. Cross-cutting Content: Communication & Presentation Skills ❏ What is a discussant and what is their main role? A discussant is an important member of the audience who actively listens to presentations, and then poses questions and points of discussion to presenters. A discussant should stimulate and elevate a broad and meaningful discussion around the presentation, as well as highlight their strengths and areas of improvement. Additionally, a discussant can offer new insights around a key theme or topic being discussed. ❏ How do you prepare to be a discussant? Read all the papers/presentations that will be presented, if they are made available to you. Beyond the papers, do further research. Spend time conceptualising your game plan. Draft presentation slides. ❏ What strategies do you use to answer questions? I answer with the knowledge that i have, and if itis not sufficient then I say that I am unable to speak more about a topic. ❏ What advice can you provide to presenters to improve their presentations? Interact with you audience and link what you are saying to what previous speakers have mentioned. Complementary Content: History of Medicine ❏ What light does the history of public health shed on structures and processes in health systems? Foundational concepts and basic principles of public health focus on maintaining health standards, containing diseases, promoting health and preventing disease. ❏ How did the events of the past necessitate the development of structures and processes? It caused the development of isolation and quarantine and also emphasized the need for sanitary environments. ❏ What structures and processes were inherited from the past, that do not address contemporary challenges? [I don't know how to answer this] Week 6: Core Domain: Structure & Process in Health Care ❏ What are the factors in an individual's environment that affect their development? Individuals are situated within a set of nested social systems where the interactions between levels within a system can influence the individual’s development and behaviour. ❏ How does the individual's environment shape their experiences of the world? Social constructs such as race, gender, and class shapes the way social systems position an individual. In their life course, individuals move through a series of transitions, which are facilitated or hampered by the micro, meso or macro systems in which they are embedded. ❏ How can the fluid nature of the dynamic relationships between systems promote patient-centred healthcare? Patient-centered health services is an approach to care that consciously adopts the perspectives of individuals, families and communities, and sees them as participants as well as beneficiaries of trusted health systems that respond to their needs and preferences in humane and holistic ways. Competency: Communication & Presentation Skills ❏ How can your group prepare for an upcoming presentation? Carefully reading the brief and reading the assigned pages of Bynum's 'A History of Medicine'. Revising the history sessions that are relevant to your topic. Revising the notes your team made on effective and engaging presentations. Reflecting on the kinds of roles you naturally play in teams; and Preparing, mentally, to play a constructive role in ensuring the whole team succeeds. ❏ What strategies do you use to pose/ answer questions? Use them as rhetorical question to the audience then answer as the presentation happens. ❏ What tools, applications or resources will you need for your presentation? Laptop, Bynum book and an app to make slides. History of Medicine ❏ How did the events of the past lead to new inventions, discoveries and new areas of specialisation? Robert Koch was of a younger generation than Pasteur. However, he was more thorough in his research techniques. He introduced the importance of sterilising equipment and made use of the Petri dish, as we know it today. In the early 19th century, numerous theories were developed that suggested that the whole organism (Plants and Animals) were composed of microscopic units termed cells. One drawback of the earlier microscopes was that the biologists often mistook particles of dust, pollen or other particles for cells. In 1830 a major improvement to the Microscope was made by Joseph Lister (building on the work of Charles Hall) which resolved this problem. ❏ What impact did the discovery of the microscope have on scientific research? Since then the microscope has improved allowing scientists to study molecular and biological specimens in great detail. In the 19th century, the microscope became the symbol of identity for a scientist, much like the stethoscope for a doctor. ❏ How did the discovery of biomolecular cells revolutionise medical practices? As cells are the building blocks of life, understanding how they work was instrumental in laying the foundation for Modern Scientific Medicine. Molecular biology (the study of the composition, and structure of cells as well as the interactions of cellular molecules) has since developed into the foundation for understanding the dynamics of the disease process. Week 7: Core Domain: Structure & Process in Health Care ❏ What are the differences between medical malpractice and professional negligence? Professional negligence is when a health professional fails to exercise the degree of skill and care of a reasonably skilled practitioner in their field. Medical malpractice refers to the negligent or intentional unlawful conduct by a health professional that causes injury or damage to a patient or the patient’s proprietary rights. ❏ What is the role of the HPCSA for the medical profession? The Health Professions Council of South Africa's is mandated in terms of the Health Professions Act 56 of 1974 to guide the professions and protect the public. The HPCSA is responsible for setting standards of professional conduct for health professionals and ensuring that healthcare practitioners are fit to practice their profession free from any impairment which may prevent them from practicing their profession or which may cause harm to a patient. The Health Professions Council of South Africa sets the legal and ethical guidelines for the practice of health professions in South Africa. ❏ How does the law regulate medical practices? Health professionals are obliged by law to be registered with their professional council, to ensure that their personal details are updated and that their professional skills are kept up to date, for the benefit of their patients, their colleagues and the health institutions where they work. ❏ What are a doctors ethical obligations to patients and society? The manner in which the profession is practiced is connected to diagnosis, treatment or prevention of physical or mental defects, illnesses or deficiencies. ❏ When does vicarious liability become applicable? “Vicarious liability, sometimes referred to as “imputed liability,” is a legal concept that assigns liability to an individual who did not actually cause the harm, but who has a specific superior legal relationship to the person who did cause the harm. Vicarious liability most commonly comes into play when an employee has acted in a negligent manner for which the employer will be held responsible.” Competency: Communication & Presentation Skills ❏ How do you identify signs of anxiety when you present? When faced with a situation that makes you anxious, you will typically have thoughts that may allow you to perceive unreasonable challenges and hamper your ability to cope well. These thoughts may Illicit irrational behavioural responses that would not typically be the case when you are not anxious, such as avoiding the situation or being over-precautious. Your mood will be different to your normal self. You may experience a certain set of physical symptoms before and during an anxious situation including shortness of breath, increased heart rate, a dry mouth, sweating, shaking, dizziness, stomach problems including nausea, frequent urination, restlessness, muscle tension, and even difficulty swallowing. Having a fast heart rate, stuttering and forgetfulness. ❏ How can you overcome anxiety? One way to counter performance anxiety is to reframe the presentation as an opportunity to communicate instead of simply presenting. View your presentation as your tool to communicate your ideas. There may be a correct way to act or perform, but there is no single correct way to communicate. Breathing exercises. ❏ How does the environment and audience impact your presentation? With less and familiar people it is not as frightening. ❏ How can you contribute effectively as a discussant? Spend time visualising your audience, the setup, and how you will be presenting. Ensure that before you present that you rest, exercise, eat well, drink enough, and limit caffeine intake. Taking the time to dress properly and smartly also helps deal with anxiety in the build-up to your presentation. History of Medicine ❏ How did the events of history lead to the systematisation of health systems and medical practices today? Medical research has evolved over centuries but has often been impacted by how much funding is made available for research. In the Western world, there is strong support and funding available for extensive research, which has rapidly increased the discovery of disease prevention and cure. ❏ What impact does the systematisation of health delivery have on the various levels of costs? [I don't know] ❏ How can the epistemological disposition of modern medicine be described? [I don't know] Overall Module 2 Reflection: