Sham Moodley - Academia.edu (original) (raw)

Papers by Sham Moodley

Research Square (Research Square), Apr 6, 2023

Health Sa Gesondheid, Dec 5, 2022

Background: The coronavirus disease 2019 (COVID-19) pandemic has had dire effects on South Africa... more Background: The coronavirus disease 2019 (COVID-19) pandemic has had dire effects on South Africa. Vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are critical in the fight against COVID-19. This study is necessary to optimise vaccine acceptance. Aim: To determine the knowledge, attitudes and perceptions of a patient population in South Africa on the COVID-19 vaccine rollout. Setting: This study was conducted via a retail pharmacy in Merebank, Wentworth and Bluff (Ward 68), which is in the eThekwini Metropolitan Municipality in the KwaZulu-Natal province. Methods: A quantitative study was conducted using an online self-administered questionnaire between April 2021 to September 2021. There were a total of 430 participants. Data were collected on Google Forms, recorded in Microsoft Excel and analysed using descriptive and inferential statistics. Results: Knowledge of COVID-19 in the population was 81.86%. A total of 65% of participants stated that they would definitely take the COVID-19 vaccine, and 33.7% stated that they were hesitant to receive the vaccine. Reasons for hesitancies included concerns surrounding side effects of the vaccines, its safety and efficacy and the fast-tracking of the vaccine. Conclusion: Education campaigns need to be customised to provide the population with reliable and vetted vaccine information and address specific concerns or hesitancies present. Health care workers and the government need to work with religious leaders to improve public trust and confidence in the vaccine. To reach herd immunity and prevent increased morbidity rates, there needs to be a rise in vaccine acceptance across South Africa and globally. Contribution: With the intention of ensuring a successful COVID-19 vaccine rollout strategy in South Africa, it is of great importance to address the reasons for vaccine hesitancy and to determine the knowledge, attitudes and perceptions of the population on the COVID-19 vaccines. This study will therefore aid in developing strategies aimed at improving vaccine education and awareness, thereby resulting in a greater uptake of the COVID-19 vaccine by the population.

To my dad, NS Moodley (1 June 1929-2 June 2019) who has been a guiding light, my moral compass an... more To my dad, NS Moodley (1 June 1929-2 June 2019) who has been a guiding light, my moral compass and my role model. I dedicate this dissertation in your loving memory. Sadly, you did not live to see me complete it: I love and miss you, dad. v ACKNOWLEDGEMENTS This journey has been a long one, made possible only with the help and advice of many along the way in their contribution to the completion of this PhD. It has allowed me to gain knowledge in new areas of pharmacy, acquire a deeper understanding of science, pay particular attention to detail, and strengthen other aspects of life at a personal level. It has been an honour and privilege to be taken under the wing of my supervisor, Professor Fatima Suleman. She has taught me not only the many techniques of scientific research, but has ensured critical thinking, deep analysis, unbiased discussion, and has enabled me to remain focused on the main objectives of the study.

Journal of Pharmaceutical Policy and Practice, Aug 7, 2020

Background: Following the democratic elections in 1994 the South African private pharmaceutical s... more Background: Following the democratic elections in 1994 the South African private pharmaceutical services were mostly in metropolitan centred with a scattering of pharmacies in less densely populated areas. The Government introduced regulations relating to the ownership and licensing of pharmacies on the 25th of April 2003 to improve access to pharmaceutical services by removing ownership restriction to only pharmacists. Objective: To assess the outcomes of the policy implementation in improving access to pharmacies. Method: The register of pharmacies at the South African Pharmacy Council was analysed from 1994 to 2014. Each registration was assigned GPS coordinates using Q-GIS(V3.6) and mapped per province at a district level, following clean-up and verification of the register. New registrations were also categorised as either corporate or independent pharmacy. Population census was obtained from Statistics South Africa and used to determine the number of pharmacies per 100,000 population. Main outcome measure(s): Number of active pharmacies; Number of independent pharmacies; number of pharmacies in each district. Results: The number of active pharmacies increased from 1624 at the end of 2003 to 3021 by 2014. The closure rate decreased from 137 to 86 pharmacies per year post regulations, a 37.23% reduction with a net gain of approximately 127 pharmacies per year. About 38.30% of all pre-2003 pharmacies (622 of 1624) closed by 2014. The population increase in the study period was approximately 20.66% but the overall growth of pharmacies was only 1.88 pharmacies per 100,000 population (3.55 to 5.43). Following the regulations in 2004, 23.9% of pharmacies active within the system closed between 2004 and 2014, of which, 91.7% of them were independent pharmacies. Conclusion: Opening up of pharmacy ownership in South Africa increased the number of pharmacies in the country but did not result in increased access in previously less populated areas. There was still clustering of pharmacies in a well resourced areas, with a steady growth in corporate pharmacy (35%) ownership.

BMC Health Services Research, Aug 16, 2019

Background: Affordability and availability of quality medicines to all its citizens has been a ke... more Background: Affordability and availability of quality medicines to all its citizens has been a key priority area for South Africa since democracy in 1994. In order to introduce transparency in the private market the government introduced the Single Exit Price (SEP) for medicines in 2004, for all prescription medicines, comprising of a fixed exfactory price with a logistics fee component (and value added tax) for medicines sold to all purchasers other than the State. This is complemented with a provision for an annual regulated maximum percentage increase. The study evaluates the impact of the SEP on a basket of originator medicines, in terms of costs, immediate price reductions and projected price reductions. Method: This is an analytical, quantitative study. A basket of medicines was selected, based on the WHO/HAI list, and adapted to include registered medicines in South Africa. Prices of 50 originator medicines were assessed from 1999 to 2014 in terms of the single exit price and the changes in prices in accordance with legislation using a time series analysis methodology. Results: Of the 50 originator medicines investigated 35 showed a statistically significant change in level. For the Global Core list, the percentage change ranged from 2.45-39.12% (mean = 19.87%, SD = 10.62%, IQR = 10.2%). The range for the Regional Core list was 1.77-42.17% (mean = 23.38%, SD = 12.43%, IQR = 15.65%). The Supplementary list was 11.68-55.86% (mean = 22.97%, SD = 16.26%, IQR = 17.34). This study indicates that the SEP regulation had an impact on medicine pricing in South Africa in both the short and long term. Most medicines investigated showed a smaller yearly increase in price compared to before regulations due to the controlled pricing environment introduced by Government. Conclusion: This study provides evidence of the impact of medicine pricing intervention from a middle-income country, and other developing countries looking at introducing medicine price controls can draw useful lessons.

PLOS ONE, Jul 31, 2019

Background Regulating pharmaceutical markets have become a key strategy by most governments in en... more Background Regulating pharmaceutical markets have become a key strategy by most governments in ensuring the availability and accessibility of quality medicines to its citizens. The South African government, when faced with high medicine prices, implemented the Single Exit Price (SEP) in 2004. This study assessed the impact of the of the Single Exit Price (SEP) regulation introduced in South Africa in 2004 on a basket of generic. Method Private sector price data of a basket of medicines (December 1999 to December 2014) was obtained from various price files (Pharmacy Software Vendors and Community Pharmacy). The price of the medicine was expressed in a single unit dose. The medicines investigated used the WHO/HAI methodology. The Interrupted Time-Series (ITS) model was used to estimate the change in slope and level of medicines investigated (50 originator and its available generics) before and after the policy change. Results Majority of the medicines analysed reflect a substantial decrease in medicine prices immediately after implementation of the pricing regulations as reflected in both the change in level and the change in slope using the interrupted time series analysis. Discussion This study indicates that the SEP regulation had an impact on medicine pricing in South Africa in both the short (immediately on the introduction) and long term (over the study period). Most medicines investigated showed a smaller yearly increase in price compared to before regulations.

African Journal of Emergency Medicine, Jun 1, 2021

Fever is one of the most common reasons for unwell children presenting to pharmacists and primary... more Fever is one of the most common reasons for unwell children presenting to pharmacists and primary healthcare practitioners. Currently there are no guidelines for assessment and management of fever specifically for community and primary healthcare workers in the sub-Saharan Africa region. This multidisciplinary consensus guide was developed to assist pharmacists and primary healthcare workers in sub-Saharan Africa to risk stratify and manage children who present with fever, decide when to refer, and how to advise parents and caregivers. Fever is defined as body temperature ≥ 37.5 • C and is a normal physiological response to illness that facilitates and accelerates recovery. Although it is often associated with self-limiting illness, it causes significant concern to both parents and attending healthcare workers. Clinical signs may be used by pharmacy staff and primary healthcare workers to determine level of distress and to distinguish between a child with fever who is at high risk of serious illness and who requires specific treatment, hospitalisation or specialist care, and those at low risk who could be managed conservatively at home. In children with warning signs, serious causes of fever that may need to be excluded include infections (including malaria), non-infective inflammatory conditions and malignancy. Simple febrile convulsions are not in themselves harmful, and are not necessarily indicative of serious infection. In the absence of illness requiring specific treatment, relief from distress is the primary indication for prescribing pharmacotherapy, and antipyretics should not be administered with the sole intention of reducing body temperature. Care must be taken not to overdose medications and clear instructions should be given to parents/ caregivers on managing the child at home and when to seek further medical care. African relevance • Countries in sub-Saharan Africa face healthcare challenges unlike those in Western countries. • Currently there are no guidelines for assessment and management of fever specifically for community and primary healthcare workers in the sub-Saharan Africa region. • Available published fever guidelines have been written for middleupper income and/or Western countries. • This multidisciplinary consensus guide was developed to assist pharmacists and primary healthcare workers in sub-Saharan Africa to risk stratify and manage children who present with fever, decide when to refer, and how to advise parents and caregivers.

Health SA Gesondheid

Background Since the severe acute respiratory syndrome coronavirus (SARS-CoV-2) in China emerged,... more Background Since the severe acute respiratory syndrome coronavirus (SARS-CoV-2) in China emerged, millions have been affected. Due to the spread of the virus, and the increasing number of cases and deaths, the crisis has been declared a global pandemic. There have been several suitable vaccines and South Africa (SA) commenced its rollout in February 2021. The pharmacists have played a vital role through the Coronavirus Disease 2019 (COVID-19) pandemic as they are the first point of care for many. It is equally necessary to explore their perceptions towards the vaccine and vaccine rollout. In this study, the Theory of Planned Behaviour is utilized to explore pharmacists’ behaviour based on their perceptions towards the COVID-19 vaccine and the rollout. Method This study used a qualitative approach to gain depth on the topic and purposive sampling was used. Thereafter, more participants were recruited via a snowballing technique. All participants were community pharmacists in Durban, ...

INQUIRY: The Journal of Health Care Organization, Provision, and Financing

The implementation of universal health coverage (UHC) in South Africa has focused on promoting eq... more The implementation of universal health coverage (UHC) in South Africa has focused on promoting equitable health care services to all citizens. In this regard, pharmacists are expected to expand their professional capabilities to promote primary healthcare system functionality. The new medicine service (NMS) has proven to be beneficial in medicine optimization and adherence. The aim of the NMS is to assist and advise patients on their newly diagnosed conditions and to promote the safe and rational use of medicines. This study explores the provision of NMS within the UHC primary healthcare service package and the opportunity for enhancing pharmacist practice. This pilot reports on the implementation of NMS in a low-middle income country. Data was obtained using convenience sampling and an interview-based approach. Findings were evaluated, analyzed, and reported using qualitative techniques. This study was conducted at an independent community pharmacy in Durban, South Africa. Fifty-fo...

Additional file 1. Active pharmacies in the eastern cape: registered pre-regulation.

Journal of Pharmaceutical Policy and Practice, 2020

Background Following the democratic elections in 1994 the South African private pharmaceutical se... more Background Following the democratic elections in 1994 the South African private pharmaceutical services were mostly in metropolitan centred with a scattering of pharmacies in less densely populated areas. The Government introduced regulations relating to the ownership and licensing of pharmacies on the 25th of April 2003 to improve access to pharmaceutical services by removing ownership restriction to only pharmacists. Objective To assess the outcomes of the policy implementation in improving access to pharmacies. Method The register of pharmacies at the South African Pharmacy Council was analysed from 1994 to 2014. Each registration was assigned GPS coordinates using Q-GIS(V3.6) and mapped per province at a district level, following clean-up and verification of the register. New registrations were also categorised as either corporate or independent pharmacy. Population census was obtained from Statistics South Africa and used to determine the number of pharmacies per 100,000 popula...