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The Practice and Provision of Community Health in South Africa

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The Practice and Provision of Community Health in South Africa Social Determinants of Health in South Africa IPBH-3005 (3 Credits / 45 hours) SIT Study Abroad Program: South Africa: Community Health and Social Policy Please Note: This syllabus represents a typical semester. Because courses develop and change over time to take advantage of unique learning opportunities, actual course content varies from semester to semester. Course Description This course examines the social determinants affecting the burden of disease in South Africa. The course explores the pervasive effects of a history of racialized under-development and exploitation, and moves on to analyse the systems and policies that have been applied to redress inequities and improve health outcomes. The course is taught through facilitated engagements with local communities, schools, clinics and non-government organisations, and through lectures by local experts on health, education, gender and law. Learning Outcomes By the end of the course students will be expected to: Explain how social and political processes shape health outcomes especially for lower-income rural and peri-urban communities; Demonstrate a nuanced understanding of the necessity for differentiated community-based and nation-wide intervention strategies; and Recognize the complexities involved in the implementation of a multi-sectoral approach to facilitate the progressive improvement of health outcomes that are substantively linked to social determinants. Language of Instruction This course is taught in English but students will be exposed to vocabulary related to course content through in-South Africa expert lectures and field visits to a wide range of venues and regional locales. Copyright © SIT, a program of World Learning Course Schedule *Please be aware that topics and excursions may vary to take advantage of any emerging events, to accommodate changes in our lecturers’ availability, and to respect any changes that would affect student safety. Students will be notified if this occurs. Module 1 – The Pervasive Effects of Colonialism and Apartheid Sessions The History of South Africa Excursion to Freedom Park, Tshwane The State of the Nation Critical Race Praxis in Public Health Those In between: “Coloured and Indian” Excursion and Homestay in Wentworth Issues affecting the Wentworth Community Social Issues affecting Health in Wentworth Excursion and Homestay in Nzinga Village Thirty Day Homestay in Cato Manor Township Excursion to the Cato Manor Museum Required reading A History of South Africa. (2017). Retrieved from Government of South Africa: http://www.gov.za/about- sa/history Coovadia, H., Jewkes, R., Barron, P., Sanders, D., & McIntyre, D. (2009). The health and health system of South Africa: historical roots of current public health challenges. The Lancet, Published online August 25, 22009, 1-18. Farmer, P. (1999, October). Pathologies of Power: rethinking health and human rights. American Journal of Public Health. , pp. 1486-1496. Ford, C. L., & Airhihenbuwa, C. O. (2010). Critical race theory, race equity, and public health: toward antiracism praxis. American journal of public health, 100(S1), S30-S35. Rispel, L., & Nieuwoudt, S. (2013). Mainstreaming the social determinants of health in South Africa: rhetoric or reality? In A. Padarath, & R. English (Eds.), South African Health Review (pp. 89-101). Durban: Health Systems Trust. Vahed, G., & Desai, A. (2010). Identity and Belonging in Post-Apartheid South Africa: The Case of Indian South Africans. Journal of Social Science 25(1-2-3), 1-12. Recommended reading: Cato Manor Museum (2017) Retrieved from eThekwini Municipality: http://www.durban.gov.za/City_Services/ParksRecreation/museums/Local_History_Museums/Pages/Cato _Manor_Heritage_Centre.aspx Elements of the Freedom Park Museum (2017) Retrieved from Freedom Park Museum: https://www.freedompark.co.za/elements-of-the-park/hapo.html Luescher, T. M., & Klemenčič, M. (2017). Student Power in Twenty-First Century Africa: The Character and Role of Student Organizing. Student Politics and Protests: International Perspectives, 113-127. Mayosi, B. M., Lawn, J. E., van Niekerk, A., Bradshaw, D., Abdool Karim, S. S., & Coovadia, H. M. (2012). Health in South Africa: changes and challenges since 2009. The Lancet (Online November 30, 2012), 5-19. 2 Module 2 – Rights-based Approaches to Addressing Social Determinants of Health International Conferences Addressing the Social Determinants of Health and PHC The South African Constitution Excursion to Constitution Hill Video: Taking HAART Social Activism for Health Excursion: Toxic Tour of South City Basin The Gender Commission: The intersection of Health and Gender Required reading: The South African Bill of Rights (2017) Accessed from Chapter 2 of the Constitution of South Africa. http://www.hsrcpress.ac.za De Vries, H., Eggers, S.M., Jinabhai, C. et al. Arch Sex Behav (2014) Adolescents’ Beliefs About Forced Sex in KwaZulu-Natal, South Africa. 43: 1087. doi:10.1007/s10508-014-0280-8 Lewis, J. (Director). (2011, July). TAC - Taking Haart [Video file]. Retrieved July 1, 2017, from https://www.youtube.com/watch?v=eGwvv0z7--Y Scott, D., & Barnett, C. (2009). Something in the air: civic science and contentious environmental politics in post-apartheid South Africa. Geoforum, 40(3), 373-382. WHO. (1991). Sundsvall Statement on Supportive Environments for Health. Retrieved June 17, 2016, from http://www.who.int/healthpromotion/milestones_ch3_20090916_en.pdf WHO. (2011). Rio political declaration on social determinants of health. Geneva: World Health Organization. Module 3 – Multi-sectoral Approaches to addressing Social Determinants of Health Education and the Life Orientation Curriculum Excursion to Special Needs Schools Disability in South Africa The National Health Insurance Plan Social Welfare Sanitation Social Conditions affecting the spread of Tuberculosis Concluding Session: The balance between preventative and curative interventions Required reading Fusheini, A., & Eyles, J. (2016). Achieving universal health coverage in South Africa through a district health system approach: conflicting ideologies of health care provision. BMC Health Services Research, 16(1), 558. Motshekga, A. (2016). Keynote Address by the Minister of Basic Education, Mrs Angie Motshekga, MP, at the Basic Education Sector Lekgotla held at the Saint George Hotel, Pretoria, 20 January 2016 Accessed 18 February 2016 from http://www.education.gov.za/Newsroom/Speeches/tabid/298/ctl/Details/mid/3618/ItemID/3651/Default.as px Mulopo, C., and O. Akintola. "Water, sanitation and hygiene in community based care: implications for wellbeing for people living with HIV/AIDS/TB in Durban, South Africa." Journal of Science and Technology (Ghana) 36.1 (2016): 22-28. Schiel, R., Leibbrandt, M., & Lam, D. (2016). Assessing the impact of social grants on inequality: A South African case study. In Contemporary Issues in Development Economics (pp. 112-135). Palgrave Macmillan UK. 3 Sherry, K. (2015). Disability and rehabilitation: essential considerations for equitable, accessible and poverty-reducing health care in South Africa. In A. Padarath, J. King, & R. English (Eds.), South African Health Review 2014/15 (pp. 89-99). Durban: Health Systems Trust. Readings Students are responsible for all the readings, and should be prepared to bring them to bear on discussions in class. The readings will place the classes and excursions in their contexts, enabling students to challenge and engage lecturers, to generate questions for class discussions and to deepen knowledge of particular aspects discussed in class. Supplementary reading materials, not mentioned on the list, will sometimes be assigned and made available. PLEASE NOTE: COURSE CONTENTS, LECTURERS AND READINGS MAY BE MODIFIED AS NEEDED. SHOULD ANY CHANGE OF CLASS TOPICS OR LECTURERS BE NECESSARY, STUDENTS WILL BE PROMPTLY NOTIFIED. Evaluation and Grading Criteria Assignments Timely completion of all seminar assignments is expected. Unless otherwise stated, all assignments and papers must be turned in on the due date, by 4 pm. 1. Pre-assigned Reading Essay on Health and Human Rights 10% In a short essay of 500 to 750 words, outline the major points contained in Paul Farmer’s article on Rethinking Health and Human Rights. (Download from https://www.ncbi.nlm.nih.gov/pubmed/10511828 ) Use formal academic writing conventions and include a bibliography. 2. Quiz on Essential Understandings from SA History 10% 3. Living Conditions in Nzinga Village Related to Social Determinants of Tuberculosis 30% During your stay in Nzinga Village, take careful note of social conditions that may be rendering members of the community more vulnerable to contracting tuberculosis. Describe the social conditions in thick detail and note where families are already taking steps to improve their health outcomes. Use formal academic writing conventions and include a bibliography. (500 to 750 words) 4. A Multidimensional Approach to Addressing the Social Determinants of Health in SA 50% In an essay of 1500 to 2000 words, analyse how a specific disease that you choose might be tackled using a multi-dimensional approach. Conclude your essay by speaking to the essential balance between treating those already ill and preventing others from becoming infected, providing reasoned arguments to justify where the emphases should lie. Use formal academic writing conventions and include a bibliography. Grading Scale: 94-100% A 90-93% A- 87-89% B+ 84-86% B 4 80-83% B- 77-79% C+ 74-76% C 70-73% C- 67-69% D+ 64-66% D below 64% F Expectations and Policies
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