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Introduction: The healthcare system in South Africa is based on the district health system through a primary healthcare approach. Although many vision and mission statements in the public healthcare sector in South Africa state that the service aspires to be holistic, it is times unclear what exactly is meant by such an aspiration. The term ‘holism’ was coined in the 1920s and describes the phenomenon of the whole being greater than the sum of the parts. Over the past two decades the term has entered into many academic disciplines as well as popular culture. Also within public healthcare services, despite predominantly biomedical approaches, there is the aspiration to offer a more holistic service. As part of a larger research study, the limitations to working holistically in the public sector in a rural sub-district in South Africa were explored.
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Methodology: The study used a participatory action research design that allowed participants a large degree of influence over the direction of the study. The research group consisted of four primary healthcare nurses and one medical doctor, all working in the public sector in a rural sub-district. The research group took part in the process of design and data gathering phases, as well as analysing and making meaning of the data generated. After a thematic analysis of the transcribed meetings, interviews and field notes, the themes were shared with the participants, who arranged them into a graphic representation showing the interrelationships of the themes.
Results: From analysis of the data it was clear that there were significant limitations to practicing holistically in the public sector of the rural sub-district in which the study took place. The limitations were grouped into those arising from within the public healthcare system and those outside the healthcare system. Within the healthcare system, the main factors limiting holistic care were: limited resources; poor training in and knowledge of holistic care; poor supervision; distance from the community; the referral system, intersectoral work and bureaucracy. Outside the healthcare sector the following factors challenged the provision of holistic care: poverty; poor nutrition; HIV/AIDS; and the cultural context. All the limitations were found to contribute to the danger of burnout among healthcare workers who wanted to work holistically. The limitations were also found to have a negative impact on the healthcare worker-patient relationship, thereby further challenging holistic care.
Conclusion: A number of aspects of the healthcare provision system that contributed to limiting the provision of holistic care could be changed quite readily, if there was a will to do so. Many of the issues seemed to plague the healthcare system generally, not only in relation to the provision of holistic care (such as supervision or a response to poverty). The close relationship between difficulty in providing a holistic healthcare service and burnout was an important finding that deserves further exploration.
The first prescription antidepressants were introduced to the American people in the 1950s. Back then, very few Americans were diagnosed with or treated for depression.
But times have changed, and today, roughly 13% of the American population takes antidepressants on a daily basis. And as more people are prescribed these drugs, more research is done on them, and a different picture is coming into focus. Antidepressants may not be the safe and effective treatment that so many pharmaceutical marketers want us to believe they are.
In fact, a study conducted Zurich University of Applied Sciences in Switzerland, found antidepressants to be largely ineffective and potentially harmful. Lead researcher Michael P. Hengartner had this to say after their findings:
“Due to several flaws such as publication and reporting bias, unblinding of outcome assessors, concealment and recoding of serious adverse events, the efficacy of antidepressants is systematically overestimated, and harm is systematically underestimated.”
Socrates said in the 4th century B.C., “the part can never be well unless the whole is well.” This is the basic premise of holistic medicine, which has been practiced for thousands of years in Traditional Chinese Medicine (TCM) and Ayurveda.
Since the 1970s, the holistic health movement has infiltrated modern medicine, and it is common nowadays to have someone see a regular doctor while also incorporating herbal medicines and acupuncture into their treatment plan.
But it is only fairly recently that people have begun to take a holistic approach to treating mental health issues such as depression and anxiety. And, as in physical health, there are pros and cons of holistic therapy for depression and anxiety.
On the positive side, holistic therapy for mental health can be self-directed, affordable, and does not require the use of prescription medications that come with harmful side effects. Holistic treatments also focus on balancing the relationship between the mind and the body toàn thân.
Holistic therapy encourages positive thoughts as a means to help bring the mind and body toàn thân into balance. It is common for counseling and psychotherapy to be a part of holistic therapy for depression. These modalities focus on developing coping skills rather than using prescription medications.
On the negative side, holistic therapies are typically not supported by medical doctors and many people question the effectiveness of treatments. But when you understand that the efficacy of prescription medications are also being called into question, you recognize that treatment for mental illness is a complex thing.
If you suffer from depression or anxiety, you must choose the path to wellness that feels right for you. And if you’d like to discuss therapy options please get in touch with me. I’d be more than happy to discuss how I may be able to help you get better.
Roberts, Terry (2012) Benefits and disadvantages of using a holistic development approach vs streamlined rural electrification programme in using renewable energy to tư vấn social development objectives in the Himalayan context. Masters by Coursework thesis, Murdoch University.
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Based on review of available literature, comparison was made between two programmes (RIDSNepal and ADB-Bhutan rural electrification programme) targeted improving quality of life for Himalayan communities, in order to see how their different approaches to achieving these improvements worked towards meeting similar objectives within similar target audiences.
It was found that each programme approach was well suited to its context of delivery; the ADBBhutan streamlined electrification approach is deemed highly appropriate given the context of strong, able government tư vấn, and the objective for delivering equity to all populace of Bhutan as rapidly as possible, while the RIDS-Nepal holistic approach delivers amazing results given its overall limitations of resourcing and attendant challenges in delivery. Both were found to have significant impact on their target audience, towards achieving their high level objectives of improving quality of life.
The comparison revealed that the RIDS-Nepal programme had managed to achieve significantly greater relative impact on its target audience in regards to reducing levels of fuelwood consumption, and associated health, social and environmental benefits than the streamlined rural electrification approach. It had achieved this through greater focus on end benefits in programme design and delivery, and through being forced to innovate and consider achievement of high level objectives holistically, given its lower resource base.
The ADB-Bhutan electrification programmes could learn from the RIDS-Nepal experience, particularly in regard to deploying complimentary policy and technology in conjunction, or shortly after electrification. Specifically, greater focus on energy efficiency and tư vấn of other options for improving energy services are required in order to make steeper in-roads into reducing fuelwood consumption, and attendant benefits to preventative health, labour burden and the environment.
Examples of this include focus on a wider array of smokeless metal stove/heating options, and tư vấn to establish community based bathing facilities, and development of lower cost, safe bulk hot water heating devices. The opportunity to establish internal cottage industries to develop these options may also provide economic advantages.
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