Tag: Wits University

Categories : Mental HealthTags :

New Study Highlights How to Improve Mental Health Integration in SA Primary Healthcare

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Photo by Pexels on Pixabay

As we commemorate Mental Illness Awareness Month and Psychosocial Disability Awareness Month, a staggering 92% of South Africans living with mental health conditions are not receiving the treatment they need. Yet, research continues to show that collaborative care—where mental health and primary care providers work together—can significantly improve patient outcomes, service satisfaction, and overall quality of life. People with serious mental illness (SMI) are particularly vulnerable as SMI is associated with marked functional impairment and high levels of stigma. SMIs typically include psychotic disorders, bipolar and related disorders, major depression, and severe anxiety and stress-related disorders.

A new study published in Cambridge Prisms’ Global Mental Health explores how integrating community psychiatric services into primary health care (PHC) clinics improves access for individuals with SMI in South Africa. However, the study also reveals persistent challenges related to limited resources, weak management systems, and fragmented collaboration between health care providers as key setbacks.

Conducted in the Sedibeng District, the research forms part of a broader study series focused on patients’ experiences. It is modelled on global evidence to assess the impact of community-based collaborative care—a model increasingly adopted worldwide to strengthen mental health delivery in PHC settings.

Why Integrated Mental Health Care?

Also known as Integrated Care, this health care model plays a vital role in improving access to mental health services by bringing care closer to communities. It relies on bringing together PHC providers such as physicians, nurses and mental health providers to deliver coordinated, person-centred care.  

Integrated care is believed to yield better health outcomes for individuals living with SMIs, who often have comorbid physical health conditions. Saira Abdulla, the lead researcher in the study and Wits PhD fellow based at Centre for Health Policy says the paper highlights key shortfalls in how collaborative care is implemented in this district. This includes poor communication, unclear roles within multidisciplinary teams, and the absence of case managers to coordinate care, with providers instead coordinating care in an ad-hoc manner.

Infrastructure and Staffing Challenges in Integrating Mental Health into Primary Care in Sedibeng

In the Sedibeng District, community-based psychiatry services have been integrated into select primary healthcare (PHC) clinics through two operational models: co-located and physically integrated services. In co-located settings, psychiatric teams operate from separate spaces adjacent to PHC clinics and use independent systems for clinical records. By contrast, physically integrated services are delivered within the same spaces as PHC clinics, using shared management structures and record-keeping systems.

However, a recent study reveals that PHC facilities in the district are not adequately designed to support the specific requirements of psychiatric care. The lack of private, secure consultation spaces compromises confidentiality, as mental health consultations often take place in shared rooms used by multiple healthcare providers.

Physically integrated clinics were found to be particularly constrained, with concerns ranging from overcrowded waiting areas—often without seating—to general safety risks. These conditions compromise the therapeutic environment essential for effective mental health care and highlight the broader systemic challenges of integrating psychiatric services meaningfully within the PHC framework.

The study also underscores a critical shortage of human resources. Most clinics have only five psychiatric nurses on site, while two to four doctors rotate between clinics, offering adult psychiatric consultations just once a week. With monthly patient volumes ranging from 580 to 910, the current staffing levels severely limit the ability to deliver consistent, high-quality care.

Key findings

·        Integration does not guarantee collaboration

While all the elements of full collaboration were not achieved in either setting, the physically integrated setting provided a better opportunity for communication among staff (due to shared files, physical proximity and good management with mental health interest and experience) However, these advantages were still hindered by poor infrastructure and inadequate resources.

·        Integration Models Matter

The study found that physically integrated clinics (shared space and records) had better communication and collaboration between mental health and PHC providers. Co-located clinics (separate buildings and records) suffered from poor communication and siloed teams.

·        Resource and Infrastructure Constraints

Both clinics faced inadequate space, supplies, and staff, although the physically integrated clinic was the most under-resourced. In both settings, insufficient resources were further exacerbated by high caseloads.

·        Leadership is Critical for Collaboration

The study highlighted the importance of management in fostering teamwork. Stronger leadership qualities were evident in the physically integrated clinic, which led to reduced staff conflict and improved communication. In contrast, the co-located clinic was impacted by poor management and a lack of managerial oversight, leading to conflict among staff members. The failure to appoint a permanent Chief Director at the district level has also led to a lack of strategy, and frustration among clinic staff.

·        Resistance from PHC Doctors to Manage Mental Health

PHC physicians and doctors are often reluctant to manage stable psychiatric patients, leading to unnecessary referrals. Some providers did not feel equipped to provide quality care and others felt that collaborating with community psychiatry staff would increase their workload.

As low and middle-income countries move towards integrating mental health into PHC, this paper highlights that the type of integration approach needs to be functional at all levels to enhance the health outcomes of the most vulnerable.

Provided by University of the Witwatersrand

Categories : CancerTags :

South African Study Identifies Two New Breast Cancer Genes in Black Women

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Genetic factors contribute to some 30% of breast cancer cases in SA, necessitating investment in genomic research in African contexts.

Photo by National Cancer Institute

A seminal genetic study published in Nature Communications has discovered two genetic variants linked to breast cancer in black South African women, deepening knowledge about the genetic basis for this disease in African populations.

The genome-wide association study (GWAS) of breast cancer is the first to have been done in African women living on the continent.

A GWAS is a powerful research method that scans the entire DNA of many people to find genetic differences associated with a specific disease or trait.

In this case, the scientists at the Sydney Brenner Institute for Molecular Bioscience (SBIMB) scanned for breast cancer and found consistent genetic patterns in black South African women.

The SBIMB researchers discovered genetic signals around the gene RAB27A, a member of the RAS oncogene family, and USP22, a gene which is highly active in breast cancer cells and associated with a poor health prognosis.

“These genes have not been associated with the disease before, which is an important advance in understanding breast cancer risk and biology in women of African ancestry,” says Dr Mahtaab Hayat, the lead author of the study.

The two new genetic variants were identified in black South African women with breast cancer enrolled in the Johannesburg Cancer Study, compared to women without cancer in the Africa Wits-INDEPTH Partnership for Genomic Research (AWI-Gen) study.

Until now, most breast cancer genetics research has focused on European and Asian populations, with studies of African ancestry limited primarily to African- American women, who largely descend from West African populations.

A tool that estimates lifetime cancer risk based on DNA, the polygenic risk score (PRS), performed poorly in distinguishing South African women with breast cancer from those without.

“This is because most PRSs were developed in European populations, and their inaccuracy in African populations highlights the urgent need for ancestry-specific tools in cancer risk prediction,” says Dr Jean-Tristan Brandenburg, also in the SBIMB and a lead author.

Breast cancer is the second most common cancer in South Africa and the most common cancer in women globally, with genetic factors contributing to about 30% of cases. “Our study makes a compelling case for investing in genomic research rooted in African contexts,” notes Hayat.

The potential for precision medicine

If further studies confirm these findings, the USP22 and RAB27A genes could be specific targets for new drugs. “We could potentially target harmful cancer cells while sparing healthy tissue, which is ideally what we want when administering cancer treatment,” says Distinguished Professor at the SBIMB, Chris Mathew, and a lead project investigator.

Furthermore, if a specific gene is associated with poorer survival, it can be used as a biomarker to identify more aggressive cancers and help predict which patients may need more intensive treatment and monitoring.

Understanding the genetic architecture of complex diseases helps scientists figure out the biological processes leading to these conditions and find drug targets and treatments for groups of individuals with similar disease risk profiles.

Genomic diversity in Africa is unparalleled

African populations have more genetic variation than any other population in the world, but they have been significantly underrepresented in genomic research. This means that the global understanding of disease risk, and the tools and treatment developed from it, is limited.

“The study reveals that more people can benefit from genetic discoveries. It proves that new risk factors are still out there, waiting to be found,” says Hayat.

Source: University of the Witwatersrand

Categories : General InterestTags :

MMBCh Tops Applications as Wits University Welcomes First-year Students for 2025

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Among the 85 000 undergraduate applications for 2025 Wits received for 2025, the single most-applied for degree was for the Bachelor of Medicine and Bachelor of Surgery (MBBCh). Of these applications, the university could only register around 6000 first-year students. These students represent the best of the best, earning their place in one of Africa’s most competitive academic environments, with an average of over five distinctions per student in their matric results.

From KZN, Glenwood High School’s Brydyn Le’Jean Barnabas, who was offered a place to study MBBCh, says, “I’ve been hearing from friends and family that this is such a prestigious university. It’s not only backed by impressive statistics but also has a rich culture and heritage, having been around for decades. Compared to other universities, it’s truly a privilege to be here. When I received my acceptance letter, my heart dropped – not just with joy but with  gratitude for this opportunity.”

Bachelor of Pharmacy was also a popular degree, coming in at the fifth most applied-for.

Recent enrolment trend assessments indicate that the majority of students offered a place at Wits have achieved an Admission Point Score (APS) exceeding 30, with most scoring 34 or higher. The minimum APS required for degree programmes at Wits is 30, making entry into the university a significant accomplishment.

Wits continues to uphold its reputation as a hub for academic excellence and innovation, attracting top-performing students from across the country and the continent. The university remains committed to nurturing the next generation of leaders, thinkers, and innovators.

For more information about the experiences of first-year students and why they chose Wits, read more here: Wits News.

Categories : Hospitals PaediatricsTags :

Refurbished School for Paediatric Patients Bridges Critical Learning Gaps

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Photo by Mary Taylor on Pexels

April 16 2024 – The Chris Hani Baragwanath Hospital School officially opened in its new location today, marking a key milestone in the partnership between Wits University and the academic hospital. The school caters for all learners in need of longer-term and chronic treatment for various paediatric conditions. Learners between Grades R and 12 are taught.  

“Sick children have multiple needs, and it’s our duty to ensure that they don’t miss out on any schooling. Everyone deserves the right to be educated and to contribute meaningfully to their communities as adults,” said Professor Shabir Madhi, Dean of the Wits Faculty of Health Sciences. 

Professor Madhi noted that the previous school building will be used as a campus for medical students and to grow the university’s teaching and learning footprint at Chris Hani Baragwanath Academic Hospital.  

The school district representative for Johannesburg Central, Ronica Ramdath, said that often sick children forfeit their education, which can be mitigated through the correct teaching approach and through supportive facilities. “When I first came to the school some years back, I was amazed at the teachers’ dedication. I remember seeing a teacher load all their educational resources in a bag and walk to the paediatric ward to teach sick children. Today, these children all benefit from such support,” she said.  

The Wits Faculty of Health Sciences heads of schools were present, together with hospital and teaching representatives.  

Meanwhile, Professor Madhi said that the university’s wifi is available at Chris Hani Baragwanath Hospital, underpinning Wits’ commitment to invest in a world-class academic hospital facility. “We are very proud of our footprint at the hospital and hope to continue to add value through research and clinical work,” he said. 

Source: University of the Witwatersrand – Faculty of Health Sciences

Categories : COVID General InterestTags :

World-renowned Vaccinologist Shabir Madhi Awarded CBE

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Professor Shabir Madhi has been appointed as an honorary Commander of the Most Excellent Order of the British Empire (CBE) by King Charles III.

Wits Professor of  Vaccinology Shabir Madhi led the Oxford University sponsored Oxford/AstraZeneca Covid-19 vaccine clinical trials in South Africa

Wits University and the University of Oxford contributed scientifically to informing the public health response to the Covid-19 pandemic in South Africa and globally.

Madhi receives the Order in recognition of his services to science and public health in a global pandemic.

Madhi led South Africa and the continent’s first Covid-19 vaccine trials in 2020/2021 as founder and Director of the South African Medical Research Council (SAMRC) Wits Vaccines and Infectious Diseases Analytics (Wits VIDA) Research Unit.

An internationally recognised leader in his field, the National Research Foundation A-rated scientist was involved in multiple clinical and serology epidemiology studies on Covid-19, in addition to his research on vaccines against other life-threatening diseases.

The first of (subsequently two) Wits University-led South African Covid-19 vaccine trials, Madhi led the Oxford/AstraZeneca Covid-19 vaccine clinical trials in South Africa, in association with the University of Oxford.

Professor Sir Andrew Pollard, Director of the Oxford Vaccine Group, University of Oxford, and Madhi’s UK counterpart in these Covid-19 vaccine trials, says of Madhi’s CBE appointment: “I am delighted that Professor Shabir Madhi CBE has been honoured by King Charles for his remarkable contributions to global public health and particularly for his extraordinary leadership in the midst of a global pandemic. It has been a huge privilege for me to work alongside him and his team on the development of the globally impactful Oxford-AstraZeneca vaccine.”

Over the course of the pandemic (2020-2022), Madhi had been an outspoken, articulate, and ardent advocate of Covid-19 vaccination as well as for increased access to these and other vaccines in Africa.

On his appointment as CBE, Madhi says: “The privilege of being conferred this honour is credit to the tremendous effort of the incredible Wits VIDA research team that I have the privilege of leading at Wits University – before, during and beyond the Covid-19 pandemic. As a collective, and together with colleagues at the University of Oxford and in South Africa, we are proud to have contributed scientifically to informing the public health response to the Covid-19 pandemic in South Africa and globally.”

Source: Wits University

Categories : HospitalsTags :

Wits Opens Advanced Surgical Skills Lab

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Photo by Clodagh da Paixao on Unsplash

To help address the critical shortage of expert medical specialists in the country, including surgeons, Wits University opened the Wits Advanced Surgical Skills Lab. It has been estimated that the country needs double the number of surgeons to meet its needs, a situation worsened by losing many surgical experts to the competitive overseas market due to the lack of sufficient highly specialised facilities, infrastructure, and advanced academic training programmes.

“Wits trains more doctors, surgeons, specialists and sub-specialists than any other university in southern Africa. The new R22-million Wits Advanced Surgical Skills Lab will help to enhance the training of surgeons, across disciplines, in a state-of-the-art environment, with the best equipment available,” said Professor Damon Bizos, Head of Wits Surgical Gastroenterology, and the Clinical Head of Surgery at the Wits Donald Gordon Medical Centre. “We need to replenish these specialised skills and replicate them in adequate measure in order to deliver essential services to South Africans and Africans.”

Located on the ninth floor of the Faculty of Health Sciences building in Parktown, the Wits Advanced Surgical Skills Lab officially opened on Tuesday, 12 October 2021. The state-of-the-art facility is designed in line with international best standards. along with teaching facilities that make the Wits surgical training programme one of the best in the world.

“If we fail to replenish the pool of surgeons in South Africa, both the training of all South African doctors and the delivery of healthcare for all will be compromised. The loss of these skills will result in the loss of services in both the private and public sectors,” said Professor Zeblon Vilakazi, Wits Vice-Chancellor and Principal. “South Africa needs to retain highly skilled and specialised surgeons. By creating opportunities for doctors to undergo highly specialised training locally, rather than abroad, the likelihood of losing these doctors to other countries is lessened.”

The Wits Advanced Surgical Skills Lab will be able to provide the interdisciplinary training needs of surgical disciplines including general surgery; orthopaedics; gynaecology; ear, nose and throat; cardiothoracic; urology; maxillofacial; ophthalmologic; neuro; and plastic surgery. It will also include the training of specialists, doctors, nurses and other allied health practitioners.

“The basic and intermediate courses will help inculcate basic surgical competence and skills development, whilst advanced courses will ensure that experienced practitioners remain at the forefront of advances in the field,” added Prof Bizos. “We will offer access to in-house training as well as industry-sponsored surgical training courses and symposia. Train-the-trainer programmes and research into skills training will also be integral.”

The Wits Advanced Surgical Skills Laboratory boasts a large ‘wet lab’ with eight stations; laparoscopic towers and endoscopy (upper endoscopy and colonoscopy); has facilities available for training on cadavers; lead-lined walls to accommodate imaging; a new lecture room for 35 participants; and full audiovisual and videoconferencing facilities.

“Access to safe, high-quality surgery care remains an ongoing challenge in South Africa and beyond. There is a well-defined unmet need, and the training of surgeons and surgical care providers is an essential component of the strategy to improve surgical care and address the unmet need. Modern day approaches to training require that we must address both the technical competency and non-technical skills of the surgeon. This must be achieved in a standardised and measurable way. To do so has meant that we, as the trainers of the next generation of practitioners, must embrace new technologies and training opportunities,” said Professor Martin Smith, the Head of the Department of Surgery in the Faculty of Health Sciences at Wits University. “We are very grateful that through the support of the University and the contributions of a number of donors we have been able to establish a facility to enhance and improve this training.”

Source: Wits University