South African Medical Journal (SAMJ)
Not a member yet
649 research outputs found
Sort by
The Department of Radiation Medicine, Faculty of Medicine and Health Sciences, Walter Sisulu University
No full textEpidemiology of adult obesity
No full textRECOMMENDATIONS
1. Healthcare providers should recognise and treat obesity as a chronic disease, caused by abnormal or excess body fat accumulation (adiposity) that impairs health, with increased risk of premature morbidity and mortality (Level 2b, Grade B).
2. The development of evidence-informed strategies at the health system and policy level should be directed at managing obesity in adults (Level 2b, Grade B).
3. Continued longitudinal national and regional surveillance of obesity that includes self-reported and measured data (i.e. heights, weights, waist circumferences) should be conducted on a regular basis (Level 2b, Grade B)
SAMA’s principled positioning in upholding global medical ethics
No full textIn October 2025, the South African Medical Association (SAMA) suspended all professional and bilateral relations with the Israeli Medical Association (IMA) and called for its suspension from the World Medical Association, citing the IMA’s failure to uphold medical ethics amid Israel’s ongoing military assault on Gaza’s health system. This decisive action follows similar, though less forceful, motions by other national associations, including the British Medical Association, and reflects SAMA’s commitment to ethical accountability under international humanitarian law. Drawing historical parallels with the medical profession’s complicity during apartheid, this article argues that SAMA’s stance constitutes ethical stewardship rather than politicisation, affirming that neutrality in the face of systematic violations of medical ethics equates to complicity. The piece situates SAMA’s decision within a broader call for global medical solidarity, ethical clarity and adherence to the principles of medical neutrality and human rights
A spatiotemporal analysis of emergency medical services use for palliative situations in Cape Town, South Africa
Get PDFBackground. Approximately 56.8 million people worldwide require palliative care annually, while only 14% receive such care. Within low- to middle-income countries (LMICs), this imbalance is prominent, as these countries contain up to 80% of patients requiring palliative care. To correct this imbalance, palliative care integration with other disciplines has been recommended. One developing area of integration in the South African (SA) LMIC context involves emergency medical services (EMS).
Objectives. To describe the geographical and temporal distribution of the EMS and palliative situation intersection in Cape Town, SA.
Methods. A descriptive, retrospective patient record review was employed at two hospitals in Cape Town. Records of patients who received palliative care at hospitals after EMS transport between 1 January 2020 and 31 December 2020 were included. EMS intersection with palliative situations according to the time of day, working hours, day of the week and month of the year were subjected to χ2 testing for temporal analysis. Geospatial data were investigated using cluster and proximity analyses.
Results. Overall, 494 instances of EMS palliative situation transport were identified. Most occurred in peri-urban areas (78%, n=385), during the daytime (52%, n=257), out of office hours (53%, n=261) and on weekdays (76%, n=375). Statistically significant variation in distribution was found according to time of day (p<0.001), with 38% (n=188) of cases occurring between 13h00 and 19h00, and month of year (p<0.001), with 54% (n=267) occurring from June to October. Proximity analysis revealed a mean driving time of 6.69 minutes and distance of 3.65 km to palliative care facilities.
Conclusion. EMS are frequently used for access to palliative care at any time of the day, week or year, particularly in peri-urban areas. EMS may further improve access through integration with palliative care. This efficient use of constrained resources should be pursued in SA, focusing on areas of increased demand
Ritshidze’s community-led monitoring system as a source of information on health system responsiveness in South Africa
Get PDFRitshidze is a large-scale community-led monitoring (CLM) system in South Africa, which has been conducting quarterly surveys of patient experiences at >400 primary healthcare facilities and community sites since 2019. This in-practice piece examines the data collected and publicly reported by Ritshidze, to highlight its role as an independent, complementary source of information on primary healthcare performance. It argues that CLM has significant potential to enhance health system responsiveness. We provide an overview of the data collection system, involving close to 500 data points organised into seven domains, and then focus on two sets of indicators that illustrate the utility of the monitoring and reporting system. The indicators selected are a set that assesses patient time spent at a facility (as a proxy for waiting times), illustrating both the depth and the breadth of the Ritshidze database; and the length of HIV prescriptions (‘length of medicine refill’), as an indicator of the improvements in responsiveness of the health system to the needs of patients. Integrating CLM data into formal health system monitoring and evaluation frameworks could enhance the responsiveness of the health system to patients and communities, one of the key overall objectives of the district health system
World Immunization Week – world agencies reflect on the gains and challenges of vaccine initiatives
Get PDFThe ethics and law of medical AI in South Africa: Balancing innovation with responsibility
Get PDFThe rapid integration of artificial intelligence (AI) into medical practice presents both transformative opportunities and profound ethical and legal challenges. In South Africa, a country with a dual healthcare system and significant disparities in access to medical services, AI holds the promise of revolutionising healthcare delivery by enhancing diagnostic accuracy, improving patient outcomes, and mitigating resource constraints. However, the deployment of medical AI also raises critical ethical concerns regarding patient autonomy, informed consent, data protection, and accountability. From a legal standpoint, South Africa must navigate a complex regulatory terrain to ensure that AI aligns with constitutional rights and statutory obligations while fostering innovation. This article explores the legal and ethical dimensions of medical AI in South Africa, arguing for a balanced approach that encourages technological advancement without compromising fundamental principles of medical ethics and patient rights
AI in medicine: Hype, hope, and the path forward
Get PDFArtificial intelligence (AI) is rapidly transforming healthcare, with applications ranging from diagnostics and predictive analytics to administrative automation. AI holds immense potential to enhance clinical efficiency and improve patient outcomes; however, its integration into medical practice is not without challenges. Physicians remain divided; some view AI as a powerful tool for augmenting medical decision‐making, while others question its reliability, ethical implications, and impact on the physician‐patient relationship. This article examines the promise and limitations of AI in medicine, addressing critical concerns surrounding bias, liability, regulatory uncertainty, and physician adoption. It explores how AI is currently being used in healthcare, the barriers preventing its seamless integration, and the governance structures needed to ensure its responsible deployment