ANGESISA SITHOLE - Reflections

Systems thinking reflection.docx

Reason for upload:

I uploaded this reflection on systems thinking because being a systems thinker is a crucial competency for being a doctor. It is important for me to develop this competency as it will help me in my career. Incorporating systems thinking in medicine allows you to make informed decisions, considering all aspects of the decisions. How they affect the patient, not only on their physical health but also their personal lives as well. Being a systems thinker also enhances my critical thinking skills and requires us to incorporate the art and science of medicine.

At the beginning of the sessions, I did not understand systems thinking and its importance in my medical career, as well as not understanding the relationship in between causal loop diagrams and systems thinking. Throughout the sessions, I understood what system thinking means and its importance. I also found out that there are other tools for systems thinking that enable us to do root cause analysis and try to find solutions.

All of the sessions about systems thinking changed the way I think about situations, not only school related studies, but also the decisions that are taken in our daily lives. I believe that system thinking helped me elevate my decision-making skills.

This is an example of a causal loop diagram

References: Goodman, Michael. “Systems Thinking: What, Why, When, Where, and How? - the Systems Thinker.” The Systems Thinker, 16 Aug. 2016, thesystemsthinker.com/systems-thinking-what-why-when-where-and-how/.

Reflection on health systems and public health- W1S3

The fields of public health and health systems science are intertwined, improving healthcare outcomes and addressing issues related to population health. Health systems science studies how healthcare is organized, provided, and managed, whereas public health concentrates on illness prevention, policy creation, and community health education. Having a solid knowledge of these fields may help doctors better serve their patients, navigate difficult healthcare systems, put preventative measures into place, and support laws that improve public health. Through integrating these ideas into clinical practice, doctors may embrace a patient-centered strategy, facilitate advances in population health, and actively engage in molding healthcare systems to better serve the needs of patients and the community.

Reasons for upload:

Initially, I thought doctors only focus on treating diseases and performing surgeries. My perspective was influenced by the way doctors are portrayed on television and the way I defined health. In this week I gained more information about medical doctors, and that is they do not only focus on treating diseases, but they also focus on improving the health of patients. I also discovered that health is not defined as the absence of diseases as I thought it was defined; health is defined as " a dynamic state of well-being characterized by a physical, mental and social potential, which satisfies the demands of life commensurate with age, culture, and personal responsibility". This definition changed my whole perspective and made me realise that health is not only about the absence, but also the balance of life's demands. It also changed how I viewed doctors, that they also take part in contributing to a patient's health and they also need to be empathetic. All of this strongly developed my way of thinking of things systematically and see their interdependence and interconnectedness. Understanding public health changed the the duties of doctors and their purpose. I developed love for being a medical doctor, as one of the reasons I wanted to go into this profession was to work with people and improve their health.

HOW CAN I USE CHATGPT EFFICIENTLY AND ETHICALLY AS A STUDENT

I can use ChatGPT to gain a better understanding of complex topics. While I am permitted to use ChatGPT to help comprehend the subject of an essay I need to write, it is essential to verify that the information provided is accurate and reliable. I recognize that ChatGPT can exhibit biases, and it is crucial to remain aware of this and conduct my own research independently.

Copying and pasting essays from ChatGPT is not allowed. To ensure ethical use, I must not rely solely on ChatGPT to complete my work. Instead, I should use various resources to gather information and avoid directly copying the answers or essays generated by ChatGPT. This approach will help me to develop a more comprehensive understanding and maintain academic integrity. In the future, I will use AI for grammar purposes and when I need to comprehend the subject of an essay, ChatGPT can provide valuable insights.

annotated-Assignment%20AI.docx.pdf

Reflection on Ethical Use of AI in Academic Activities

In this activity, we were tasked with using ChatGPT and evaluating the answers to develop definitions of Health Systems Science and Public Health. I uploaded this activity because it emphasizes the importance of ethical usage of ChatGPT when assigned an academic task. Utilizing ChatGPT ethically as a student is crucial in preventing laziness and overreliance on AI sources, ensuring that I continue to engage in my own work and critical thinking.

As someone who had limited exposure to technology in high school and only became aware of AI during my university years, I recognize the importance of learning how to use AI responsibly. It is essential that we, as students, are educated on the proper use of AI to avoid misuse. The temptation to take shortcuts is strong, and AI can easily lead us into the trap of overdependence if not used correctly.

This activity challenged my understanding of AI and taught me how to use it responsibly. It highlighted the need to avoid unethical practices, such as copying AI-generated content without critical evaluation or understanding. By learning to use ChatGPT ethically, I am better equipped to incorporate AI as a tool for enhancing my learning rather than replacing my efforts.

In conclusion, this exercise has been instrumental in my growth as a student. It has reinforced the importance of maintaining academic integrity while leveraging AI technology. Understanding how to use AI without falling into the trap of dependency ensures that I continue to develop my knowledge and skills effectively, contributing positively to my academic journey and future professional endeavors.

W3- THE SOUTH AFRICAN HEALTHCARE SYSTEM

In this week, we learned about the South African Healthcare System which is divided into the public sector and the private sector. There is a huge difference between the public sector and private sector, one is free and one is costly. While the private sector is costly, it also offers superior quality, access to advanced access to technology, and shorter waiting times than the public sector. The public sector has its challenges such as staff shortages, strained facilities, and insufficient funding which leads to less advanced technology.

We also learned about the primary healthcare system and the universal health coverage. The primary healthcare system is a whole of society approach that brings equitable distribution by mainly focusing on people's needs and promoting health by empowering them to take charge of their own health. Primary healthcare facilities are what we know as clinics, which are closer to communities, increasing access to healthcare. Primary healthcare services are mostly provided to people through the district health service. The universal healthcare coverage means giving people access to quality health services they need, where they need them, without financial difficulties. The primary health system and universal health coverage are connected because the primary healthcare system is a crucial approach to achieving universal health coverage and ensuring the highest possible level of health and well-being for all individuals.

Reason for upload:

It has deepened my understanding of the structure and functioning of the South African Healthcare System, highlighting the critical issues faced by both the public and private sectors. Analyzing the differences between the two sectors and understanding the role of primary healthcare in achieving universal health coverage has enhanced my critical thinking and analytical skills.

Learning about the challenges faced by the public sector, such as staff shortages and insufficient funding, has increased my empathy and awareness of the struggles faced by healthcare providers and patients in these settings. Understanding the interconnectedness of primary healthcare and universal health coverage has provided me with a holistic perspective on healthcare delivery and the importance of equitable access to quality health services. This knowledge is essential for my future healthcare career, as it equips me with the insights needed to navigate and contribute positively to the healthcare system.

By reflecting on and documenting this learning experience, I can continuously build on my knowledge and apply these insights to future academic and professional endeavors. This activity serves as a testament to my commitment to understanding and addressing the complexities of healthcare systems, ultimately contributing to my growth and development as a student and future healthcare professional.

Three dimensions to consider when moving towards UHC.

Determinants of health and health inequalities in South Africa

Social determinants of health and plan

Social determinants of health are the conditions that people are born, live and work in. The conditions within society significantly influence health outcomes, contributing to around 30-50% or even more of the overall health status of the population.

The social determinants of health include:

•Social and Community Networks (support)

•Living and Working Conditions (structural factors)

•Working environment

•Education

•Agriculture and food production

•Unemployment

•Water and sanitation

•Healthcare services

•Housing

General socioeconomic, cultural, and environmental conditions

Reasons for upload:

By gaining insight and understanding these determinants of health we gain insight more about the patient and approach healthcare holistically as future medical doctors. We also have the opportunity to advocate against health inequalities and social inequalities. For example, if people coming from a certain area visit the hospital frequently with cases of diarrhoea and cholera, doctors can raise the issue to people in higher places so that they investigate the cause of the outbreaks. Maybe they don't have good water supply and it is affecting their health, then implementation of good water and sanitation can happen in hat area. I also noticed how lifestyle choices can influence health. For example, an unhealthy diet and lack of physical activity can lead to obesity. It's important to understand that lots of things affecting health are not controlled by healthcare alone. This shows that we need to look at health issues in a wider way, working together across different areas is key to dealing with these big problems effectively.

Understanding the social determinants increased my system thinking skills, developing systems thinking by showing how various factors like income, education, and environment interact to shape people's well-being. Instead of looking at health issues in isolation, it encourages us to see the bigger picture, understanding how different parts of society are connected. This perspective allows us to identify the root causes of health disparities and design more effective, long-lasting solutions. By considering the complex web of influences on health outcomes, we can work collaboratively across sectors to address underlying inequalities and create healthier communities for everyone.

References

Govender, R.2024. Social Determinants of Health, 4 March 2024. Johannesburg: Geosciences Building, University of the Witwatersrand.

Framework that outlines the social determinants of health

The initial level pertains to individual behaviors and lifestyles that can either enhance or impair health, for instance, the decision to smoke or refrain from smoking. Individuals are influenced by the social dynamics of their friendships and the prevailing norms within their community.
The subsequent level involves social and community influences, which offer mutual support to community members during challenging circumstances. However, they can also fall short in providing adequate support or may even have a negative impact.
The third level encompasses structural elements like housing quality, working conditions, accessibility to services, and the availability of essential facilities.
Lastly, the fourth level encompasses broader factors such as political, cultural, and environmental conditions, within which all these other factors operate.

Inequality and equity of healthcare

Although the terms inequity and inequality may sound similar, they have different meanings. According to McCartney et al. (2019) Inequity of health is defined as unfair imbalances in cases involving social injustices, while health inequalities refer to disparities, discrepancies, and differences in each person's and group's health successes. Between these two concepts, health inequity is the one that interested me the most. This is due to the fact that the socioeconomic health determinants of health and health inequities influence each other. Understanding health inequities and the social determinants of health fueled my drive of being an activist and advocate about them. Health inequities faced in South Africa are poor clean water and sanitation supply, food insecurity leading to malnutrition, lack of healthcare facilities in deep rural areas etc. I am aware that these issues are broad and are related to poverty, I am also aware that there is not much a medical doctor can do when advocating as there are strict conducts that doctors have to follow when advocating; but I believe that unity in doctors and other health professionals can make a difference.

For example I came across a video on YouTube that narrates the story of Mrs. X, woman who tragically passed away during childbirth while eight months pregnant. The narrative highlights the circumstances surrounding her death, attributing it to complications arising from a shortage of blood supply at the hospital due to placental issues. Mrs. X's case is not unique, as it reflects a broader pattern of maternal mortality. Subsequently, healthcare professionals conduct a retrospective analysis, examining cases like Mrs. X's to understand the underlying causes. Initially, they focus on the medical aspects of her death before delving into her socioeconomic background. They find that Mrs. X, like many others in her community, faced challenges due to her role as a homemaker, limited education, and lack of access to healthcare. This prompts efforts to improve healthcare infrastructure and address systemic issues contributing to maternal mortality, such as increasing staffing levels and blood supply. Additionally, advocacy for policy changes aimed at improving educational opportunities and promoting community health literacy ensues.

This is the way I would say healthcare professionals can advocate for such inequities. This video educated me a lot on what doctors can do and collaboration with other people can improve health inequalities and inequities.

References

Goldner, E. (2012). Why Did Mrs X Die, Retold. [online] www.youtube.com. Available at: https://youtu.be/gS7fCvCIe1k.

Reflection on health law: Why do I have to consider Health Law?

Before attending lectures on health law, I was largely unaware of its significance. I assumed that doctors rarely encounter legal issues and that there was little they could do in their professional capacity to fall afoul of the law. However, reflecting on various instances of medical malpractice, such as hospitals facing lawsuits due to surgical negligence, shifted my perspective. A poignant example is a woman from my community who recently passed away due to post-surgery complications. She had undergone an appendectomy, during which the operating surgeon accidentally severed another internal organ. This mistake led to her prolonged suffering and eventual death, prompting her family to consider suing the hospital for negligence. This incident made me contemplate the broader implications for the hospital and the surgeon involved. What if, in the future, I find myself in a similar situation as that surgeon?

Studying health legislation has sparked significant interest and critical thinking within me. For instance, Section 5 of the National Health Act No. 61 of 2003 states, "A health care provider, health worker, or health establishment may not refuse a person emergency treatment." This provision raised several questions in my mind. What if there are insufficient resources to provide emergency treatment to everyone in need? How do we define what constitutes emergency treatment?

These questions highlight the complexities and ethical dilemmas inherent in medical practice. Understanding health law is crucial for navigating these challenges and ensuring that healthcare providers uphold their legal and ethical responsibilities. The intersection of medicine and law is a critical area that requires careful consideration and adherence to ensure the safety and well-being of patients, as well as the legal protection of healthcare professionals and institutions.

In conclusion, my newfound awareness of health law has profoundly influenced my perception of medical practice. It is clear that healthcare professionals must possess a thorough understanding of legal principles to mitigate risks and uphold standards of care. This knowledge not only protects patients but also shields practitioners from potential legal repercussions. As I progress in my medical career, I am committed to integrating legal awareness into my practice, recognizing that excellence in healthcare extends beyond clinical expertise to include a deep respect for the laws and regulations governing the field. This holistic approach will enable me to provide the highest quality of care while safeguarding the rights and well-being of my patients.

These questions - extracted from a lecture presentation- made me think critically about health law. They made me question about my knowledge of health law.

References

Khan,S. 2024. Introduction to law: Health and the Law, 8 April 2024. Johannesburg: Wits Geosciences Building, University of the Witwatersrand.

Reflection on our mapping assignment and the WHO building blocks

mapping reflection.docx

Reasons for upload:

Working on this map has been a highly enlightening experience for me. Not only did it require me to consider the South African Health System in its entirety and its various sub-divisions, but it also provided an opportunity to develop my collaborative skills, as this was a group assignment.

Engaging with my group was a bittersweet experience, primarily because I suffer from social anxiety. Working with others often makes me nervous and shy. In such situations, I tend to underestimate my abilities and mistakenly believe that my contributions will not be significant. This is a classic example of "Imposter Syndrome," which involves persistent feelings of self-doubt and personal incompetence despite one's education, experience, and accomplishments. Initially, I was reticent and contributed little, but as the assignment progressed, I became more open and actively engaged.

One of the challenges we faced as a group was effective communication. There were instances where a member would add elements to the map without consulting the rest of us, which created some confusion and disorganization.

Presenting the map to the class was particularly daunting for me, as public speaking is not my forte. Throughout high school, I struggled with public speaking, which deterred me from pursuing any leadership positions due to my anxiety. However, my group was very understanding and empathetic towards my situation.

Reflecting on this experience, I realize the necessity of improving my public speaking skills, especially since we have been informed that there will be many more presentations in the future, and my chosen career path requires strong communication abilities. To address this, I plan on enhancing my skills by watching YouTube videos that offer guidance on improving communication skills.

In conclusion, this group assignment has not only deepened my understanding of the South African Health System but also highlighted areas for personal growth, particularly in overcoming social anxiety and improving public speaking. This experience has been invaluable in preparing me for future academic and professional challenges.

Our map outlines the Health System's distinct components that are aligned with the WHO building blocks.

This is the first video that I watched to improve my public speaking skills. I still have a long way to go but I believe taking this first step will get me where I want to be.

References

Lyon, A. (2018). Public Speaking For Beginners. [online] www.youtube.com. Available at: https://youtu.be/i5mYphUoOCs.

Recommendations Report Reflection

Recommendations report.docx

Working on this report was daunting as we also had to prepare for a block 2 test. Multi-tasking can be really stressful sometimes but we made it a success. My communication skills were really tested in this report assignment, and I believe that I am getting better at improving them.

Self Reflection

When I think about the public health of South Africa.docx

In February, at the beginning of the course, we were assigned an activity to write about our thoughts on the public health of South Africa. Reflecting on my initial response, I realize how much my understanding has evolved since then. Initially, I did not grasp the concept of public health and was unaware of the distinction between clinical medicine and public health. With my newfound knowledge, I recognized that I had conflated clinical medicine with public health.

Public health is a comprehensive approach aimed at preventing diseases, prolonging life, and promoting health through collective societal efforts. The primary distinction between public health and clinical medicine lies in their focus: clinical medicine is centered on treating individual patients using clinical skills, whereas public health is concerned with both healing individuals and preventing disease recurrence within the community.

The public health system in South Africa is not without its flaws, but there are programs in place that significantly benefit communities. For instance, in my community, there are initiatives that assist elderly individuals in obtaining their medications from clinics. Nurses visit the homes of chronic patients on their scheduled check-up dates, rather than requiring patients to travel to the clinics. Additionally, during the 2020 quarantine, programs were implemented to distribute food to impoverished communities. Although I still believe there is substantial room for improvement in our public health system, it is not as deficient as I initially perceived.

Learning about public health and health systems science in this course has inspired me to pursue a major in public health for my future career. The subject has been immensely interesting, and my eagerness to become a medical professional has only grown through my studies.

This video helped me a lot in understanding about the difference between public health and clinical medicine.

References

www.youtube.com. (2017). What is Public Health?? [online] Available at: https://youtu.be/t_eWESXTnic.

My feelings toward the ever-changing landscape in medicine

One crucial attribute of a robust healthcare system is its resilience and capacity for evolution. The dynamic nature of healthcare necessitates that we, as future healthcare professionals, hone the core skills essential for optimizing healthcare delivery. A significant change currently being implemented in healthcare is the integration of artificial intelligence (AI). Critics argue that AI could negatively impact healthcare and the economy by causing unemployment among healthcare workers and introducing systematic errors. While these concerns are valid, I contend that the integration of AI can enhance our healthcare system.

AI has the potential to revolutionize many aspects of healthcare. For instance, AI can assist in diagnosing diseases with greater accuracy and speed than human practitioners alone. This can lead to earlier interventions and better patient outcomes. Additionally, AI can streamline administrative tasks, reducing the burden on healthcare professionals and allowing them to focus more on patient care. Furthermore, AI-driven data analysis can provide valuable insights into patient care and treatment outcomes, fostering a more evidence-based approach to medicine.

Change within our health system is inevitable, and it is imperative for us as future health professionals to adapt rather than resist these changes. Embracing AI does not mean replacing human healthcare providers but rather augmenting their capabilities. AI can handle routine and repetitive tasks, while human professionals can focus on complex decision-making, emotional support, and ethical considerations that AI cannot replicate.

Fear of risks associated with new technologies is understandable; however, it is important to recognize that all advancements come with inherent risks. Rather than rejecting these changes, we should approach them with an open mind, aiming to mitigate potential risks. For instance, implementing robust training programs for healthcare workers on how to effectively use AI can reduce errors and improve integration. Establishing clear guidelines and ethical standards for AI use in healthcare can also address concerns about safety and unemployment.

By adopting a proactive and thoughtful approach to AI integration, we can harness its potential to improve healthcare delivery. This will require continuous learning, adaptation, and a commitment to ethical practices. As future healthcare professionals, our role is not just to provide care but to be innovators and leaders in the evolving landscape of healthcare.

In conclusion, resilience and adaptability are key to a strong healthcare system. Embracing AI and other technological advancements with a balanced and informed perspective will enable us to enhance patient care and optimize healthcare delivery. By doing so, we can contribute to the continued improvement and evolution of the healthcare system, ensuring it remains responsive and effective in meeting the needs of all patients.

Overall Reflection of the course

The course has been an enriching and transformative experience, significantly contributing to my understanding and perspective as a medical student. Through this course, I have gained valuable insights and knowledge that will undoubtedly shape my future career in healthcare. I also developed love for it and made me realize what I wanted to major in when I am done with med school.

One of the most profound gains from this course is a comprehensive understanding of public health. I have learned about the various determinants of health, including social, economic, and environmental factors, and how they interplay to influence population health outcomes. This holistic view of health determinants has highlighted the importance of addressing not just individual health issues, but also the broader societal factors that contribute to health disparities.

The exploration of health systems science has provided me with a detailed understanding of how health systems function, including the organizational structures, processes, and policies that govern healthcare delivery. Learning about the World Health Organization’s building blocks of health systems has been particularly enlightening. It has helped me appreciate the complexities of health systems and the critical role each component plays in ensuring effective healthcare delivery.

The course has deepened my understanding of primary healthcare and its pivotal role in achieving universal health coverage. I have gained insights into how primary healthcare serves as the foundation for equitable health systems, focusing on accessibility, community-based services, and preventive care. Understanding the principles of universal health coverage has underscored the importance of providing comprehensive, quality health services to all individuals without financial hardship.

Another significant aspect of the course was the emphasis on ethical decision-making and health law. I have learned about the ethical principles that guide healthcare practice and the legal frameworks that ensure patient rights and provider responsibilities. This knowledge is crucial for navigating the ethical dilemmas and legal challenges that arise in clinical practice, ensuring that I can uphold the highest standards of professional integrity.

The course introduced me to the systems thinking approach, which is essential for analyzing and addressing complex health issues. This approach has equipped me with the skills to think critically about the interconnections within health systems and to develop holistic solutions that consider the broader context of health problems.

On a personal level, this course has been instrumental in my growth as a student. It has enhanced my critical thinking skills, enabling me to analyze health issues from multiple perspectives. The collaborative assignments have improved my teamwork abilities, while the presentations have helped me overcome my fear of public speaking.

Overall, the Foundations of Public Health and Health Systems Science course has provided me with a robust foundation of knowledge and skills that are essential for my future career in healthcare. It has broadened my understanding of the multifaceted nature of health and healthcare systems, preparing me to contribute effectively to the field of public health and to advocate for better health outcomes for all individuals. This course has been a vital step in my journey towards becoming a well-rounded and competent healthcare professional.

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