South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde
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Editorial Historical Article
Celebrating a quarter-century of the UP School of Health Systems and Public Health (SHSPH).
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Community-led monitoring (CLM) of health services is a mechanism of community participation and accountability that is increasingly advocated across the globe. In South Africa (SA), a large-scale community-led monitoring initiative called Ritshidze ('saving our lives') was established in 2019. ⋯ We also highlight some of the positive changes achieved, and reflect on possible reasons for successes. In doing so, we aim to draw attention to this significant national initiative and its potential as a mechanism of social accountability in SA.
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Hereditary breast cancer is characterised by the presence of a pathogenic sequence variant passed from one generation to the next. These cancers are aggressive, develop early, and account for 5 - 10% of all breast cancer cases. In South Africa (SA), the common variants that predispose to hereditary breast cancer have been well documented among white patients and form part of screening panels during targeted testing. For non-white patients, common variants are not well understood, and as such, all populations are offered the same test optimised for white patients. This carries a risk of misdiagnosis, the consequences of which include recurrence and increased mortality. ⋯ This study highlights unique genetic trends for SA populations and the need for more inclusive targeted tests that are optimal for these populations.
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To fulfil its role, the District Health System (DHS) must enable and lead learning in the South African (SA) health system. Meetings are a core routine that can be leveraged to encourage learning in the DHS. In this article, we draw from existing experiences in SA to present practical steps that can be implemented to transform meetings into spaces of learning.