Nursing And Medicine In South Africa Essay Example

Introduction: South Africa

South Africa, a country that officially bears the name of the Republic of South Africa, has one of the largest economies among the countries on the African continent. However, despite this, the country is still stricken by numerous problems such as poverty, unemployment, disease, and extremely high mortality rates. Because of this seeming contrast (largest economy vs. social problems), which may appear paradoxical if one forgets that South Africa is perhaps “the richest among the poorest,” the country was chosen as an object of analysis for this paper. In this work, some aspects of the country (such as its geography, demographics, government, and economy) will be briefly described, after which information about the healthcare and nursing spheres in this country will be provided and discussed.


South Africa is situated in the southernmost part of Africa, near the coastline of both the Indian and the Atlantic Oceans. The state shares its borders with such countries as Botswana, Zimbabwe, and Namibia to the north, as well as with Swaziland and Mozambique to the east; also, Lesotho is a separate state which is an enclave surrounded by South Africa. The country is mainly situated on a large Central Plateau (the altitude varies approximately from 3,300 to 6,900 feet), the edges of which are called the Great Escarpment; the southwestern part of the country has the Cape Fold mountain belt.


The country’s population is nearly 55 million. The government’s statistical bureau describes the population by using five racial groups. According to the department, approximately 80.5% of the population are African, 8.8% are Colored, 2.5% are Indian or Asian, whereas Whites account for 8.3% of the population; there is also a little percentage of Other/Unspecified representatives of the population (Statistics South Africa, 2016, p. 2). There are somewhat more females than males: 22.574 million females vs. 21.653 million males (Statistics South Africa, 2016, p. 2). It is noteworthy that the country often serves as an asylum for refugees from several other African countries, such as Somalia and Zimbabwe.


The government system of South Africa is a representative democracy that has a parliamentary system. The system includes the Parliament of South Africa, which is comprised of the National Assembly and the National Council of Provinces, and has the legislative power in the state; the President of South Africa, who is simultaneously the head of the State and the Head of the Government, and the main representative of the executive power; and an independent judiciary branch, which includes the Constitutional Court, the High Court, and the Supreme Court of Appeal.

The parliament is chosen in a general election, which takes place not more seldom than every five years; the President is elected by the members of the country’s National Assembly (“Government in South Africa,” 2015).


The economy of South Africa is the second-largest in Africa; the gross domestic product (GDP) of the country accounts for almost a quarter of the total GDP of Africa. Despite this, the population of this country still suffers from a high rate of unemployment and poverty. Interestingly, the informal economy in the country is relatively small, which is uncharacteristic of most countries stricken with poverty. The largest sectors of the country’s economy are finance, business, and real estate services, manufacturing, general services of the government, and wholesale and retail trade together with the hospitality industry (Statistics South Africa, 2013).

State of Health

The overall state of health of the South African population is rather poor. A major concern is the epidemic of HIV/AIDS; approximately 11% of the population is infected with the virus (World Health Organization, 2013). Tuberculosis affected nearly 0.97% of the population (World Health Organization, 2013). There is also an abundance of non-communicable diseases, with cardiovascular diseases responsible for the majority of death cases (Udjo & Lalthapersad-Pillay, 2014); the rates of these diseases are constantly increasing (Fryatt, 2013). Also, another significant problem is malnutrition due to hunger; also, poor quality of food often leads to obesity, including morbid obesity, which makes South Africa a “double-burden country,” stricken by both obesity and hunger (Britnell, 2015).

The violence rates are high, and deaths or injuries due to car accidents occur often (World Health Organization, 2013). There is a significant level of structural, gender-based violence, childhood abuse, and so on, which are related to the patriarchal society and the cult of masculinity, as well as to high levels of unemployment and the lack of social protection (Seedat, van Niekerk, Suffla, & Ratele, 2014).

Apart from significant rates of traffic accidents, there is also a high risk of achieving trauma due to accidents at work, for instance, in the mining industry (van den Honert & Vlok, 2015).

Culture/Traditional Medicine

The culture in South Africa is rather diverse. The country is home to representatives of numerous cultures and has 11 official languages. Many inhabitants of the country live in impoverished rural areas, but among them, the cultural traditions remain the strongest. On the other hand, however, urban dwellers often become westernized and lose their cultural peculiarity.

Traditional medicine is stated to be on the rise in South Africa (McFarlane, 2015). In particular, it is stressed that approximately 200,000 traditional healers can be found in the state and that they provide services for approximately 27 million people, which is more than half of the country’s population. The indigenous medicine in this country is based on the use of minerals, plants, and animals, and is aimed at treating “both spiritual and physical components of personhood” (McFarlane, 2015, p. 61).

It is possible to suspect, however, that this form of healing may be of suboptimal efficacy; for instance, some healers claim they are capable of addressing the disease of AIDS, which is doubtful; also, there is a “dark side” to the traditional medicine, such as the belief that certain body parts may bring healing and good luck, which in certain cases leads to kidnappings and further use of parts of bodies of the kidnapped victims (McFarlane, 2015).

Healthcare System and Delivery

Governmental Health-Related Agencies and Health Regulatory Organizations

The state healthcare system in South Africa is controlled by the governmental Department of Health; the latter has the responsibility for controlling the public sector of the healthcare industry in this state (South African Government, 2015).

Only nearly 16% of South African inhabitants are covered by healthcare schemes, whereas the rest of the country’s dwellers are forced to “payout of pocket” or utilize the services of private medical services providers. However, it is stated that “South Africa is in the process of introducing an innovative system of healthcare financing with far-reaching consequences on the health of South Africans,” which is supposed to be fully implemented over 14 years (South African Government, 2015, para. 36-37).

Healthcare Personnel and Hospitals

According to World Health Organization (2011), the total number of physicians in South Africa in years 2000-2010 equaled 34,829, whereas the corresponding number of nurses and midwifery personnel was 184,459 (p. 122). Simultaneously, in 2000-2010, the number of doctors per 100,000 population was 77, whereas the number of nursing and midwifery personnel was 408 per 100,000 population (World Health Organization, 2011, p. 122).

Approximately 200 private and 400 public hospitals are to be found in the Republic of South Africa. It is important to note that the Department of Health conducts direct administration of 10 large teaching hospitals in the state. Also, the third-largest hospital in the world, the Chris Hani Baragwanath Hospital, can be found in this state, in the city of Johannesburg; the hospital is public.

Nursing Education System and Accrediting Organizations

In South Africa, nurses are trained at universities and public nursing colleges. In 2009-2011, universities have trained nearly 1,900 and 6,700 nurses (Department of Health, 2013, p. 18). As for nursing education, the following is stated:

Nursing education takes place in a complex environment, which includes 20 out of 23 public universities, 12 public-sector nursing colleges (with numerous satellite training campuses) that are the responsibility of the nine provincial health departments, a nursing college run by the defense force, private nursing colleges run by the three major private hospital groups in South Africa, and private nursing schools that are run for profit. (Armstrong & Rispel, 2015, para. 7)

There exist national standards about nurse accreditation, regulation, as well as their vocational qualifications, which are overseen by the South African Government (Armstrong & Rispel, 2015).

Nursing Associations

There exist several nursing associations in South Africa. These include the South African Nursing Council, Democratic Nursing Organization of South Africa (DENOSA), Allied Nursing Association of South Africa (ANASA), South African Democratic Nurses’ Union (SADNU), and some others.

Health Priorities

From the information provided above, it is possible to see that, even though the country of South Africa is one of the wealthiest countries on the African continent, it still suffers from several serious health problems. In this country, it is paramount to dedicate attention to the epidemic of HIV/AIDS, which is unimaginably large; as was stressed, 11% of the population is infected with the virus. The high rates of tuberculosis also need to be addressed. Also, the government should provide the population with a satisfactory number of jobs and/or social aid, to address the problem of child malnourishment. It is also important to emphasize that the country lacks medics; the training and, importantly, employment opportunities for physicians and nurses require to be provided.

Conclusion: Nursing Implications

Therefore, it should be stressed that, despite the privileged position of South Africa on the African continent, the population of this country suffers from numerous social problems, as well as from disease and poor medical service. These problems should be addressed if the quality of life of the country’s dwellers is to be improved. To help handle these issues, local nurses might take part in public life.

In particular, it might be recommended to conduct political activism aimed at creating workplaces for nurses and other medical personnel, for the country experiences a significant dearth of medics; the working conditions and wages of medics should also be paid attention to. It is also possible to demand more places in local colleges and universities for nurses, as well as for other healthcare professionals. The issues of lack of medical insurance among the population should also not escape the nurses’ attention.


Armstrong, S. J., & Rispel, L. C. (2015). Social accountability and nursing education in South Africa. Web.

Britnell, M. (2015). In search of the perfect health system. London, UK: Palgrave.

Department of Health. (2013). The national strategic plan for nurse education, training and practice 2012/13-2016/17. Web.

Fryatt, R. (2013). Screening for chronic diseases in South Africa. South African Medical Journal (Suid-Afrikaanse Tydskrif Vir Geneeskunde), 103(5), 289.

Government in South Africa. (2015). Web.

McFarlane, C. (2015). South Africa: The rise of traditional medicine. Insight on Africa, 7(1), 60-70. Web.

Seedat, M., van Niekerk, A., Suffla, S., & Ratele, K. (2014). Psychological research and South Africa’s violence prevention responses. South African Journal of Psychology, 44(2), 136-144. Web.

South African Government. (2015). Health. Web.

Statistics South Africa. (2013). Gross domestic product: First quarter 2013.

Statistics South Africa. (2016). Mid-year population estimates.

Udjo, E. O., & Lalthapersad-Pillay, P. (2014). Mortality from non-communicable diseases in South Africa, 1997-2009. Etude De La Population Africaine, 28(1), 601-609. Web.

Van den Honert, A. F., & Vlok, P. J. (2015). Estimating the continuous risk of accidents occurring in the mining industry in South Africa. South African Journal of Industrial Engineering, 26(3), 71-85.

World Health Organization. (2011). World health statistics 2011. Web.

World Health Organization. (2013). Country cooperation strategy at a glance: South Africa. Web.

Grant Proposal: Writing Requirements

Writing a grant proposal is a challenging task. To win, the applicant should consider multiple factors. Establishment of a budget for the project and provision of an eloquent rationale supporting it are among the most important things one must take into account. In her post, Tylisha says that these areas are associated with the greatest difficulties for her. I think it may be the case with many applicants because not everyone has a clear vision of the scope of an endeavor, of what is to be done exactly and at what cost. At the same time, the budgets and significance of the grant project are usually firstly evaluated by the committee. Thus, having a clear vision of what one wants to achieve is important.

Vandenbroek (2010) suggests starting writing the proposal by visualizing the desired results of the project realization. The applicant should demonstrate the committee what impact the work has on the social environment, etc., and these effects must be significant and valuable. At the same time, one should remain realistic. Vandenbroek (2010) also recommends evaluating personal/organizational strengths and weaknesses to develop a plan which will be possible to realize.

When you have a vision of what you want to achieve, it becomes easier to identify the budget. However, the research of the background, needs, and suppliers, etc. is still required. As stated by Ward (2012), “the budget should include brief explanations of each item, including the basis for the cost listed” (p. 15). It means that the applicant’s choice should be justified and correlated with the overall mission of the project.

Overall, I consider that a winning research proposal is exclusive of any inaccuracies, i.e., in calculations, language use, and contents. The applicants thus should check the forms multiple times because errors may give a reason to think that the person/organization will be as sloppy when implementing the grant funds.


Vandenbroek, A. (2010). Grant writing without blowing a gasket. Library Media Connection, 28(6), 28-30.

Ward, D. (2012). Writing grant proposals that win. Burlington, MA: Jones & Bartlett Learning.

Chronic Patient Education Intervention And Treatment

Clinical Question

The clinical question can be explicitly stated with the help of PICOT format. Thus, for this research, PICOT will be stated as follows: “In elderly patients with chronic diseases (P), does patient education intervention in addition to medication treatments (I), compared with only medication treatments (C), increase their health knowledge and improve their health status (O) in a period of 6 months (T)?” The research will apply an educational intervention to answer this clinical question.

There are some studies dedicated to the problem of patient education and its outcomes. For example, Peter et al. (2015) conducted an investigation of core-measure education with the use of teach-back questions among patients with heart failure. However, not many studies disclose the issue of patient education efficiency among elderly patients with chronic diseases. Thus, an educational intervention aimed specifically at elderly patients will be designed. It will make possible answering the clinical question formulated above.

Type of Study

The research has aims to compare the influence of patient education intervention applied together with medication treatment and only medication treatments on the increase of health knowledge in elderly patients with chronic diseases. Consequently, it needs two groups of participants to answer the clinical question. The purpose of the research predetermines the choice of the study type. Thus, for this research, the experimental design is suitable.

This type of qualitative study presupposes some experiments intervention. Its characteristic features include manipulation (patients will experience education intervention); control (the patients’ outcomes of control and experimental groups will be recorded and analyzed); and randomization (patients will be randomly included in control or experimental groups) (Polit & Beck, 2013). The use of the experimental design of the study allows avoiding “systematic bias in the groups” (Polit & Beck, 2013, p. 226). Quasi-experiment is not suitable for this research since it lacks randomization.

Theoretical Framework

The issue of patient education is complex. Thus, different nursing theories and models can be applied to provide a deeper understanding of the problem. First of all, the theoretical framework for the research can include Self-Care Deficit Theory by Dorothea Orem (Alligood, 2014). Self-care depends on some factors, which include the patient’s age, gender, health condition, family factors, external environmental factors, availability of resources, etc. (Alligood, 2014).

Patient education can be considered one of the resources which empower self-care. The ability of patients to take care of themselves according to the demands of their disease depends on the level of their knowledge of the health problem. It is particularly important for elderly patients with chronic diseases because of their ability to self-care influences the quality of their daily life.

Another theory that can be applied to this research is Bandura’s Self-Efficiency Theory (Alligood, 2014). It can be used to stimulate changes in patient’s health behavior. The same effect is expected from patient education. Patients with chronic diseases are going to become more self-efficient with patient education intervention in addition to medication treatments if compared with only medication treatments.

A nursing model which should be regarded within this research is Trajectory Model developed by Straus and Corbin (Alligood, 2014). It focuses on the chronic diseases and the notion of “trajectory” is used to determine the course of a chronic disease. This trajectory consists of several phases. Each of them needs specific interventions. Patient education can be one of such interventions.


Alligood, M.R. (2014). Nursing theory: Utilization and application (5th ed.). St.Luuis, MS: Elsevier Mosby.

Peter, D., Robinson, P., Jordan, K., Lawrence, S., Casey, K.J., & Salaa-Lopez, D. (2015). Reducing readmissions using teach-back: Enhancing patient and family education. The Journal of Nursing Administration, 45(1), 35-42. Web.

Polit, D.F., & Beck, C.T. (2013). Essentials of nursing research: Appraising evidence for nursing practice (8th ed.). Philadelphia, PA: Wolters Kluwer Health.