Recent Publications

The National COVID-19 Epi Model (NCEM): Estimating cases, admissions and deaths for the first wave of COVID-19 in South Africa

In March 2020 the South African COVID-19 Modelling Consortium was formed to support government planning for COVID-19 cases and related healthcare. Models were developed jointly by local disease modelling groups to estimate cases, resource needs and deaths due to COVID-19. The National COVID-19 Epi Model (NCEM) while initially developed as a deterministic compartmental model of SARS-Cov-2 transmission in the nine provinces of South Africa, was adapted several times over the course of the first 

Differential in-hospital mortality and intensive care treatment over time: Informing hospital pathways for modelling COVID-19 in South Africa

There are limited published data within sub-Saharan Africa describing hospital pathways of COVID-19 patients hospitalized. These data are crucial for the parameterisation of epidemiological and cost models, and for planning purposes for the region. We evaluated COVID19 hospital admissions from the South African national hospital surveillance system (DATCOV) during the first three COVID-19 waves between May 2020 and August 2021. We describe probabilities and admission into intensive care units 

Attrition from HIV treatment after enrollment in a differentiated service delivery model: A cohort analysis of routine care in Zambia

Abstract Background Many sub-Saharan Africa countries are scaling up differentiated service delivery (DSD) models for HIV treatment to increase access and remove barriers to care. We assessed factors associated with attrition after DSD model enrollment in Zambia, focusing on patient-level characteristics. Methods We conducted a retrospective record review using electronic medical records (EMR) of adults (≥15 years) initiated on antiretroviral (ART) between 01 January 2018 and 30 

HE²RO 2022 ANNUAL REPORT

RESEARCH HIGHLIGHTS As the COVID-19 pandemic abated in 2022, the Health Economics and Epidemiology Research Office (HE²RO) continued to expand its research and evaluation projects in South Africa and its neighbouring countries. A follow on to the AMBIT (Alternative Models of ART Delivery) study was awarded, along with a supplementary budget to augment the AMBIT 2.0 study which is running in South Africa, Malawi and Zambia. Under this project implementation of the multi-country SENTINEL 

Religious and Medical Pluralism Among Traditional Healers in Johannesburg, South Africa

Abstract Religion and spirituality are powerful social forces in contemporary South Africa. Traditional Health Practitioners (THPs) are commonly consulted for both spiritual and medical ailments as a first line of care. Many studies have assessed African traditional health seeking behaviors but few have examined beliefs, practices, and behaviors of THPs themselves. This study sought to explore spiritual worldviews among South African THPs. Semi-structured in-depth interviews were conducted 

Perspectives of healthcare workers on the novel electronic technology of wearable tags

Background Time and motion studies involve measuring the productivity of employees by directly observing how long it takes to complete required tasks. The purpose of this measurement is to assess efficiency, effectiveness and improve systems. This study examined the perspectives of healthcare workers on the novel electronic technology of wearable tags in order to determine the impact of visit length on the cost and quality of providing TB and HIVservices. These wearable tags are attached 

Qualitative study exploring the feasibility of using medication monitors and a differentiated care approach to support adherence among people receiving TB treatment in South Africa

The tuberculosis (TB) MATE study evaluated whether a differentiated care approach (DCA) based on tablet-taking data from Wisepill evriMED digital adherence technology could improve TB treatment adherence. The DCA entailed a stepwise increase in adherence support starting from short message service (SMS) to phone calls, followed by home visits and motivational counselling. We explored feasibility of this approach with providers in implementing 

Association of maternal age with utilization of antenatal care services and knowledge of child development in rural Limpopo, South Africa

Early pregnancy access to prenatal care is essential. Research has linked a lack of antenatal services to a risk of maternal mortality. Younger women typically share traits such as low socioeconomic position, lack of spousal support, work obligations, and unexpected pregnancies. In South Africa more than a third of births occur in young mothers aged <24 years. The influence of early maternal age and caregiving knowledge on pregnancy, birth, and early childhood outcomes is 

Impact of a Community Health Worker Home Visit Intervention on Child Development in South Africa: A Cluster-Randomized Controlled Trial

A strong body of evidence demonstrates that the negative impacts of early adversity on child development in low- and middle-income countries (LMICs) can be mitigated through appropriate early-life interventions. Regular home visits by trained staff who support and counsel caregivers on a diversity of topics, including child health, nutrition, and play-based stimulation, have been shown to be particularly effective. However, important questions remain around how to effectively integrate 

“I used to feel like a parcel, and now I feel like a human again”. The implementation of the Common Element Treatment Approach in Gauteng South Africa: Lessons learned so far

One barrier to ART treatment adherence in South Africa is intimate partner violence (IPV), which can also affect mental health. The Common Elements Treatment Approach (CETA) is an evidence-based intervention that addresses multiple mental health problems simultaneously including IPV. While the intervention has been successful in improving mental health outcomes it has yet to be tested at improving HIV 

Association of maternal age with utilization of antenatal care services and knowledge of child development in rural Limpopo, South Africa

Early pregnancy access to prenatal care is essential Research has linked a lack of antenatal services to a  risk of maternal mortality Younger women typically share traits such as low socioeconomic position, lack of spousal support, work obligations, and unexpected pregnancies During focused group discussions (FGD) with CHWs they stated that young women had poorer