Karen Hofman
Dados Biográficos
| ID | 1735650 |
|---|---|
| NOME | Karen Hofman |
| PRENOMES | Karen |
| SOBRENOME | Hofman |
| ASSINATURA | HOFMAN K |
| AFILIAÇÕES | South African Medical Research Council |
| ORCID | 0000-0001-9512-7220 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 72 |
| TOTAL DE CITAÇÕES | 20 |
| TOTAL COMO AUTOR | 72 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1993 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2025 |
| ÍNDICE H | 3 |
Changes in the provision and utilisation of health care services for chronic health conditions during the Covid-19 pandemic in rural northeast South Africa
Background: The COVID-19 pandemic has impacted the provision and utilisation of health care services with varying magnitude across settings due to spatial temporal variation in the burden of COVID-19 cases and the roll-out of local COVID-19 response policies. This study assesses changes in the provision and utilisation of health care services for three major chronic health conditions (HIV/AIDS, hypertension, and diabetes) over the pre-COVID-19 an…
A cost-effectiveness analysis of a South African pregnancy support grant
Poverty among expectant mothers often results in sub-optimal maternal nutrition and inadequate antenatal care, with negative consequences on child health outcomes. South Africa has a child support grant that is available from birth to those in need. This study aims to determine whether a pregnancy support grant, administered through the extension of the child support grant, would be cost-effective compared to the existing child support grant alon…
Moving towards social inclusion
BACKGROUND: Achieving universal health coverage (UHC) in the context of limited resources will require prioritising the most vulnerable and ensuring health policies and services are responsive to their needs. One way of addressing this is through the engagement of marginalised voices in the priority setting process. Public engagement approaches that enable group level deliberation as well as individual level preference capturing might be valuable…
Extended cost-effectiveness analysis of interventions to improve uptake of diabetes services in South Africa
The rising prevalence of diabetes in South Africa (SA), coupled with significant levels of unmet need for diagnosis and treatment, results in high rates of diabetes-associated complications. Income status is a determinant of utilization of diagnosis and treatment services, with transport costs and loss of wages being key barriers to care. A conditional cash transfer (CCT) programme, targeted to compensate for such costs, may improve service utili…
Addressing unmet social needs for improved maternal and child nutrition
Maternal and child malnutrition persists globally, despite existing healthcare and social protection systems. Socio-economic disadvantages contribute to high malnutrition rates, particularly in poor urban communities where many disadvantaged mothers cannot fully benefit from services. To address these disparities, a novel social needs framework has been proposed, emphasising the importance of addressing individuals' unmet needs to enhance the ben…
Identifying pregnant and postpartum women’s priorities for enhancing nutrition support through social needs programmes in a resource-constrained urban community in South Africa
Women expressed strong views about which programmes should be prioritised to support mothers and pregnant women in addressing their social needs and improving nutrition. Key areas included providing support with job searching and entrepreneurship, accessing childcare and the healthy foods recommended at clinics, as well as finding information on available community and government services. Leveraging multisectoral collaboration, aligned policy ob…
Defining and conceptualising the commercial determinants of health
Investing in school systems
Public policies often aim to improve welfare, economic injustice and reduce inequality, particularly in the social protection, labour, health and education sectors. While these policies frequently operate in silos, the education sphere can operate as a cross-sectoral link. Schools represent a unique locus, with globally hundreds of millions of children attending class every day. A high-profile policy example is school feeding, with over 400 milli…
Investing in human development and building state resilience in fragile contexts
Maternal and early malnutrition have negative health and developmental impacts over the life-course. Consequently, early nutrition support can provide significant benefits into later life, provided the later life contexts allow. This study examines the limits of siloed investments in nutrition and illustrates how ignoring life-course contextual constraints limits human development benefits and exacerbates inequality, particularly in fragile conte…
Indirect effects of Covid-19 on maternal and child health in South Africa
BACKGROUND: The unfinished burden of poor maternal and child health contributes to the quadruple burden of disease in South Africa with the direct and indirect effects of the COVID-19 pandemic yet to be fully documented. OBJECTIVE: To investigate the indirect effects of COVID-19 on maternal and child health in different geographical regions and relative wealth quintiles. METHODS: We estimated the effects of COVID-19 on maternal and child health f…
Stakeholder arguments during the adoption of a sugar sweetened beverage tax in South Africa and their influence
BACKGROUND: Sugar-sweetened beverage (SSB) taxes are recognised as an effective intervention to prevent obesity. More countries are adopting SSB taxes, but the process of the adoption is politically complex. OBJECTIVE: This study aimed to analyse how public participation processes influenced the South African tax. METHODS: We conducted a content analysis of documents associated with the process of adopting the tax. Records were identified utilisi…
The passage and implementation of a Health Promotion Levy in South Africa as a case study of fair financing procedures
Procedural fairness is an accepted requirement for health decision-making. Fair procedures promote the acceptability and quality of health decisions while simultaneously advancing broader goals of participatory democracy. We conducted a case study of the Sugary Beverage Tax in South Africa known as the Health Promotion Levy (HPL), which was legislated in 2018. The case study examines the process around the adoption of the HPL from the perspective…
Participatory prioritisation of interventions to improve primary school food environments in Gauteng, South Africa
Prioritising evidence-based, feasible and important interventions underpinned by behaviour change theories is an important step towards enhanced policy making and resource allocation to tackle South Africa's childhood obesity epidemic effectively
What values drive communities’ nutrition priorities in a resource constrained urban area in South Africa
Our study demonstrates how public engagement can facilitate the incorporation of community values and programmatic preferences into nutrition priority setting, enabling a responsive approach to local community needs, especially in resource constrained contexts. Findings could guide policy makers to facilitate more appropriate decisions and to improve nutrition in the first 1000 days of life
Essential health services delivery in South Africa during Covid-19
Background: Between May 2020 and February 2022, South Africa's health system bore strain as it battled mitigating the coronavirus pandemic. The country's pandemic response was scrutinized. This period also brought into focus pre-existing shortcomings in the healthcare system and its governing bodies. Contextually, there is a paucity in literature on the experiences of healthcare providers and users. This study aimed to contribute information on C…
The effectiveness of virtual vs real-life marine tourism experiences in encouraging conservation behaviour
Nature-based tourism experiences have the potential to inspire visitors to adopt conservation behaviours that protect natural environments; however, to have global effect on environmentally sensitive areas such as the Great Barrier Reef, we may need to expand this influence to beyond just visitors. One way to reach large audiences is through digital technology. Virtual reality is becoming increasingly popular due to its ability to replicate reali…
Estimating the healthcare cost of overweight and obesity in South Africa
BACKGROUND: Overweight and obesity are major risk factors for noncommunicable diseases. This presents a major burden to health systems and to society in South Africa. Collectively, these conditions are overwhelming public healthcare. This is happening when the country has embarked on a journey to universal health coverage, hence the need to estimate the cost of overweight and obesity. OBJECTIVE: Our objective was to estimate the healthcare cost a…
We Were Afraid”
The impacts of pandemics are recognized to go beyond infection, physical suffering, and socio-economic disruptions. Other consequences include psychological responses. Using a mental wellbeing lens, we analyzed COVID-19-related stressors in healthcare workers (HCWs) and community members who provided and regularly accessed health services in South Africa, respectively. From February to September 2021, during the second COVID-19 wave we conducted …
Towards unified and impactful policies to reduce ultra-processed food consumption and promote healthier eating
Realising the potential human development returns to investing in early and maternal nutrition
The benefits of interventions which improve early nutrition are well recognised. These benefits, however, only accrue to the extent that later life circumstances allow. Consequently, in adverse contexts many of the benefits will never be realised, particularly for the most vulnerable, exacerbating inequality. Returns to investment in early nutrition could be improved if we identified contextual factors constraining their realisation and intervent…
Barriers to, and facilitators of, the adoption of a sugar sweetened beverage tax to prevent non-communicable diseases in Namibia
The Government of Namibia has taken positive steps and the policy environment is friendly towards an SSB tax. The proximity of trade and the competitive nature of the Namibian drinks industry with South Africa suggest that a regional perspective to advocacy would be of value
Nutrition-related non-communicable disease and sugar-sweetened beverage policies
Background: The burden of undernutrition is significant in Kenya. Obesity and related non-communicable diseases are also on the increase. Government action to prevent non-communicable diseases is critical. Taxation of sugar-sweetened beverages has been identified as an effective mechanism to address nutrition-related non-communicable diseases, although Kenya is not yet committed to this.Objective: To assess the policy and stakeholder landscape re…
Strengthening prevention of nutrition-related non-communicable diseases through sugar-sweetened beverages tax in Rwanda
Background: Food and beverages high in sugar are recognized to be among the major risk factors for nutrition-related non-communicable diseases. The growing presence of ultra-processed food producers has resulted in shifts to diets that are associated with non-communicable diseases and which include sugar-sweetened beverages. Sugar-sweetened beverage taxation presents an opportunity to prevent non-communicable diseases but it comes with challenges…
The data availability landscape in seven sub-Saharan African countries and its role in strengthening sugar-sweetened beverage taxation
Timely, easily understood, concise, and locally relevant evidence is needed in order to inform policy development on SSBs. The relevant data are drawn from multiple sectors. Cross- sector collaboration is therefore needed. Indicators for SSBs should be developed and included in current data collection tools to ensure monitoring and evaluation for SSB taxation
Nutrition related non-communicable diseases and sugar sweetened beverage policies
Background: Taxation on unhealthy products is recommended as a cost-effective intervention to address the global burden of non-communicable diseases. Taxation of sugar-sweetened beverages dis-incentivize consumption of unhealthy products. Implementation of such policies is difficult in Sub-Saharan African countries, which are targets for global corporate expansion by the sugar-sweetened beverages industry.Objective: To identify opportunities to s…
Improving response rates through incentive and follow-up
OBJECTIVES. This study assessed efforts to increase response rates to a mailed physician survey and examined whether, as a result, nonresponse bias was reduced. METHODS. Randomly selected physicians and geneticists were mailed a questionnaire concerning genetics knowledge and attitudes. In the final but not the pilot survey, a $25 incentive and intensive follow-up were used to increase the response rate. RESULTS. The response rate from physicians…
Sugar-based beverage taxes and beverage prices
Protecting the Great Barrier Reef
Nature-based tourism experiences have the potential to change the environmental knowledge, attitudes and behavior of visitors; but such experiences may be beyond the physical and/or financial reach of many people. To influence the conservation behavior of populations world-wide, a more accessible yet equally effective strategy is required. Using an experimental design, this study explored whether a conservation documentary about Australian marine…
Impact of supplemental immunisation activity (SIA) campaigns on health systems
BACKGROUND: Supplemental immunisation activity (SIA) campaigns provide children with an additional dose of measles vaccine and deliver other child health interventions including vitamin A supplements, deworming medications and oral polio vaccines. They also require the mobilisation of a large health workforce. We assess the impact of the implementation of SIA campaigns on selected routine child and maternal health services in South Africa (SA). M…
Addressing the Growing Burden of Trauma and Injury in Low- and Middle-Income Countries
Low- and middle-income countries suffer disproportionately from reduced life expectancy and quality of life. Injuries are overlooked as contributors to global inequities in health, yet the long-term disabilities they frequently produce represent a significant burden. The Fogarty International Center of the National Institutes of Health convened a panel of experts in trauma and injury from the United States and low- and middle-income nations to id…
Bringing Attention to Problem Solving and Meaningfulness at Work
A local division of a multinational manufacturer was experiencing declining enagagement and perceptions of leadership (measured in employee satisfaction surveys). In anticipation of coming waves of organizational change, they asked the research team to explore how "nostalgia" may be contributing to these issues and how they might define the unique culture of the division.Combining ethnographic observations with other qualitative methods, across a…
Improving response rates through incentive and follow-up
OBJECTIVES. This study assessed efforts to increase response rates to a mailed physician survey and examined whether, as a result, nonresponse bias was reduced. METHODS. Randomly selected physicians and geneticists were mailed a questionnaire concerning genetics knowledge and attitudes. In the final but not the pilot survey, a $25 incentive and intensive follow-up were used to increase the response rate. RESULTS. The response rate from physicians…
The Global Burden of Chronic Diseases
Chronic diseases are the largest cause of death in the world. In 2002, the leading chronic diseases--cardiovascular disease, cancer, chronic respiratory disease, and diabetes--caused 29 million deaths worldwide. Despite growing evidence of epidemiological and economic impact, the global response to the problem remains inadequate. Stakeholders include governments, the World Health Organization and other United Nations bodies, academic and research…
Addressing the Growing Burden of Trauma and Injury in Low- and Middle-Income Countries
Low- and middle-income countries suffer disproportionately from reduced life expectancy and quality of life. Injuries are overlooked as contributors to global inequities in health, yet the long-term disabilities they frequently produce represent a significant burden. The Fogarty International Center of the National Institutes of Health convened a panel of experts in trauma and injury from the United States and low- and middle-income nations to id…
Evidence that a tax on sugar sweetened beverages reduces the obesity rate
Supplementary immunization activities (SIAs) in South Africa
BACKGROUND: Supplementary immunization activity (SIA) campaigns provide children with an additional dose of measles vaccine and deliver other interventions, including vitamin A supplements, deworming medications, and oral polio vaccines. OBJECTIVE: To assess the cost-effectiveness of the full SIA delivery platform in South Africa (SA). DESIGN: We used an epidemiologic cost model to estimate the cost-effectiveness of the 2010 SIA campaign. We used…
The non-fatal disease burden caused by type 2 diabetes in South Africa, 2009
BACKGROUND: Increasing urbanisation and rising unhealthy lifestyle risk factors are contributing to a growing diabetes epidemic in South Africa. In 2000, a study estimated diabetes prevalence to be 5.5% in those aged over 30. Accurate, up-to-date information on the epidemiology and burden of disease due to diabetes and its sequelae is essential in the planning of health services for diabetes management. OBJECTIVE: To calculate the non-fatal burde…
Addressing research capacity for health equity and the social determinants of health in three African countries
BACKGROUND: The importance of tackling economic, social and health-related inequities is increasingly accepted as a core concern for the post-Millennium Development Goal framework. However, there is a global dearth of high-quality, policy-relevant and actionable data on inequities within populations, which means that development solutions seldom focus on the people who need them most. INTREC (INDEPTH Training and Research Centres of Excellence) w…
Cost-effectiveness analysis of infant feeding strategies to prevent mother-to-child transmission of HIV in South Africa
Despite increasing availability of perinatal interventions to prevent mother-to-child transmission (MTCT) of HIV in South Africa, MTCT remains high due to breastfeeding. To inform policy decisions in the country, cost-effectiveness of alternative infant-feeding interventions was conducted. Mathematical modelling was used to simulate post-natal transmission and mortality due to infant feeding in a hypothetical cohort of 1 000 HIV-exposed infants. …
Impact of supplemental immunisation activity (SIA) campaigns on health systems
BACKGROUND: Supplemental immunisation activity (SIA) campaigns provide children with an additional dose of measles vaccine and deliver other child health interventions including vitamin A supplements, deworming medications and oral polio vaccines. They also require the mobilisation of a large health workforce. We assess the impact of the implementation of SIA campaigns on selected routine child and maternal health services in South Africa (SA). M…
Closing the mental health treatment gap in South Africa
BACKGROUND: Nearly one in three South Africans will suffer from a mental disorder in his or her lifetime, a higher prevalence than many low- and middle-income countries. Understanding the economic costs and consequences of prevention and packages of care is essential, particularly as South Africa considers scaling-up mental health services and works towards universal health coverage. Economic evaluations can inform how priorities are set in syste…
Hypertension education and adherence in South Africa
Additional training for CHWs on hypertension management could be a cost-effective strategy for CVD in South Africa and a very good purchase according to World Health Organization (WHO) standards. The intervention could also lead to reduced visits at the health centres freeing up more time for new patients or reducing the burden of an overworked staff at many facilities
The cost of injury and trauma care in low- and middle-income countries
INTRODUCTION: Injuries are a significant cause of mortality and morbidity, of which more than 90% occur in low- and middle-income countries (LMICs). Given the extent of this burden being confronted by LMICs, there is need to place injury prevention at the forefront of public health initiatives and to understand the costs associated with injury. The aim of this article is to describe the extent to which injury-related costing studies have been con…
Nutrition labelling
BACKGROUND: To identify peer-reviewed research on consumers' usage and attitudes towards the nutrition label and the food industry's response to labelling regulations outside Europe, North America, and Australia and to determine knowledge gaps for future research. DESIGN: Narrative review. RESULTS: This review identified nutrition labelling research from 20 countries in Asia, Africa, the Middle East, and Latin America. Consumers prefer that pre-p…
Human resources for research
BACKGROUND: The collaboration of scientists between the developed and the developing world is an opportunity to reverse the 'brain drain' and to enable 'brain circulation'. OBJECTIVE: Attracting alumni from the Diaspora to strengthen the development of talented scientists will strengthen research in Africa. DESIGN: In 2010, the Faculty of Health Sciences at the University of the Witwatersrand, South Africa (SA), created an Alumni Diaspora Program…
Cost and impact of scaling up interventions to save lives of mothers and children
BACKGROUND: South Africa has made substantial progress on child and maternal mortality, yet many avoidable deaths of mothers and children still occur. This analysis identifies priority interventions to be scaled up nationally and projects the potential maternal and child lives saved. DESIGN: We modelled the impact of maternal, newborn and child interventions using the Lives Saved Tools Projections to 2015 and used realistic coverage increases bas…
Sugar and health in South Africa
A growing body of evidence indicates that excessive sugar consumption is driving epidemics of obesity and related non-communicable diseases (NCDs) around the world. South Africa (SA), a major consumer of sugar, is also the third most obese country in Africa, and 40% of all deaths in the country result from NCDs. A number of fiscal, regulatory, and legislative levers could reduce sugar consumption in SA. This paper focuses on a sugar-sweetened bev…
Reducing diarrhoea deaths in South Africa
Diarrhoea is one of the leading causes of morbidity and mortality in South African children, accounting for approximately 20% of under-five deaths. Though progress has been made in scaling up multiple interventions to reduce diarrhoea in the last decade, challenges still remain. In this paper, we model the cost and impact of scaling up 13 interventions to prevent and treat childhood diarrhoea in South Africa. Modelling was done using the Lives Sa…
Strategic planning for saving the lives of mothers, newborns and children and preventing stillbirths in KwaZulu-Natal province South Africa
Focused attention on a set of key interventions could have a significant impact on averting stillbirths and maternal and neonatal mortality in KwaZulu-Natal. Concerted effort to prioritize family planning will save more lives overall and has the potential to decrease costs in other areas of maternal and child care
Bibliometric trends of health economic evaluation in Sub-Saharan Africa
BACKGROUND: Collaboration between Sub-Saharan African researchers is important for the generation and transfer of health technology assessment (HTA) evidence, in order to support priority-setting in health. The objective of this analysis was to evaluate collaboration patterns between countries. METHODS: We conducted a rapid evidence assessment that included a random sample of health economic evaluations carried out in 20 countries (Angola, Botswa…
Informing road traffic intervention choices in South Africa
INTRODUCTION: Given the burden of road traffic injuries (RTIs) in South Africa, economic evaluations of prevention interventions are necessary for informing and prioritising public health planning and policy with regard to road safety. METHODS: In view of the dearth of RTI cost analysis, and in order to understand the extent to which RTI-related costs in South Africa compare with those in other low- and middle-income countries (LMICs), we reviewe…
Modelling the potential impact of a sugar-sweetened beverage tax on stroke mortality, costs and health-adjusted life years in South Africa
Fiscal policy has the potential, as part of a multi-faceted approach, to mitigate the growing burden of stroke in South Africa and contribute to the achievement of the target set by the Department of Health to reduce relative premature mortality (less than 60 years) from non-communicable diseases by the year 2020
Cost of inaction on sugar-sweetened beverage consumption
Objective To estimate the effect of increased sugar-sweetened beverage (SSB) consumption on future adult obesity prevalence in South Africa in the absence of preventive measures. Design A model was constructed to simulate the effect of a 2·4 % annual increase in SSB consumption on obesity prevalence. The model computed the change in energy intake assuming a compounding increase in SSB consumption. The population distribution of BMI by age and sex…
Strengthening expertise for health technology assessment and priority-setting in Africa
BACKGROUND: Achieving sustainable universal health coverage depends partly on fair priority-setting processes that ensure countries spend scarce resources wisely. While general health economics capacity-strengthening initiatives exist in Africa, less attention has been paid to developing the capacity of individuals, institutions and networks to apply economic evaluation in support of health technology assessment and effective priority-setting. OB…
‘First 1000 days’ health interventions in low- and middle-income countries
BACKGROUND: In South Africa (SA), despite adoption of international strategies and approaches, maternal, neonatal and child (MNC) morbidity and mortality rates have not sufficiently declined. OBJECTIVES: To conduct an umbrella review (UR) that identifies interventions in low- and middle-income countries, with a high-quality evidence base, that improve MNC morbidity and mortality outcomes within the first 1000 days of life; and to assess the incor…
Protecting the Great Barrier Reef
Nature-based tourism experiences have the potential to change the environmental knowledge, attitudes and behavior of visitors; but such experiences may be beyond the physical and/or financial reach of many people. To influence the conservation behavior of populations world-wide, a more accessible yet equally effective strategy is required. Using an experimental design, this study explored whether a conservation documentary about Australian marine…
Medicine (58 obras) · Environmental health (46 obras) · Economic growth (43 obras) · Economics (42 obras) · Business (37 obras) · Political science (31 obras) · Geography (27 obras) · Global Public Health Policies and Epidemiology (27 obras) · Obesity, Physical Activity, Diet (25 obras) · Nursing (24 obras)