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K. Mostert1, F. Maric2, H. Lister3, T. Cronje4, S. van der Linde1, E. Van Wyk3, S.-A. Rocher1, R. Laing3, L. Wu1, S. Muller3, A. des Tombe1, T. Kganyago1, N. Zwane1, B. Mphogo1
1University of Pretoria, Department of Physiotherapy, Pretoria, South Africa, 2UiT The Arctic University of Norway, Department of Health and Care Sciences, Tromsø, Norway, 3University of Pretoria, Department of Occupational Therapy, Pretoria, South Africa, 4University of Pretoria, Department of Statistics, Pretoria, South Africa
Background: Climate change, biodiversity loss and large-scale environmental degradation are widely recognised as the biggest health threats of the 21st century, with the African continent already amongst the most severely affected and vulnerable to their further progression. The healthcare system’s contribution to climate change and environmental degradation requires healthcare professionals to address environmental issues urgently. However, the foundation for context-relevant interventions across research, practice, and education is not readily available.
Purpose: To lay the foundation for context-relevant interventions to advance environmental sustainability in South Africa’s healthcare system and services, the aim of this study was to identify certrain South Africa’s healthcare professionals’ KAPs, and barriers regarding environmental sustainability in healthcare.
Methods: A consecutive mixed methods study was carried out with registered healthcare professionals (audiologists, occupational therapists (OTs), physiotherapists (PTs), and speech therapists, from private, non-governmental, public, and academic settings. Purposive and snowball sampling were used to identify individuals willing to participate. Hundred participants completed a cross-sectional questionnaire (n=100) and 18 took part in in-depth focus group discussions (FGD). Data were analysed using descriptive statistics and thematic analysis respectively, andwere then integrated.
Results: The participants in the quantitative phase were OTs (69%), whereas in the qualitative phase, the majority were PTs (11/18 participants). Ninety-one percent agreed that the current state of environmental degradation is concerning, and 50% strongly agreed that environmental degradation has an impact on the health of individuals. The highest percentage felt that the government should take responsibility (92%), followed by healthcare professionals (89%), leadership in communities (84%) and individuals (80%). An overwhelming 97% indicated an interest in implementing relevant strategies, and 93% were interested in corresponding educational input. These findings were matched in the FGDs. Participants recycled in hospitals, departments, practices, and their personal capacity, but also noted inconsistencies in implementation due to barriers. They saw potential for advancing environmental sustainability within the South African context. Beyond mere necessity for survival, participants noted that the natural world has positive effects on human well-being, that need to be safeguarded for future generations. Living in informal settlements, still prevalent in the country, was highlighted as detrimental due to poor environmental conditions.
Conclusions:Results indicated overwhelmingly positive attitudes and a high degree of interest in education, implementation, and taking on more corresponding responsibility. However, a lack of substantial knowledge on the subject matter, and only tentative implementation of practices relevant to recycling, reusing, and reducing waste and resource consumption exist.
Implications:
Our findings point to a pressing need and desire for: (1) healthcare professional education in environmental sustainability and planetary health, (2) factoring environmental sustainability into clinical practice guidelines while ensuring availability of matching equipment and infrastructure, and (3) corresponding policy development. These systemic barriers to implementation—lacking resources (financial, time, and material), policies and infrastructures—must be addressed to harness the extant enthusiasm and advance environmental sustainability in healthcare practice on the African continent. Timely research, development, and implementation across these arenas are essential to advance the implementation of environmental sustainability into South African healthcare systems and daily professional practice.
Funding acknowledgements: None
Keywords:
Environmental sustainability and sustainable health care
Planetary health
Climate change
Environmental sustainability and sustainable health care
Planetary health
Climate change
Topics:
Primary health care
Education: continuing professional development
Globalisation: health systems, policies & strategies
Primary health care
Education: continuing professional development
Globalisation: health systems, policies & strategies
Did this work require ethics approval? Yes
Institution: University of Pretoria
Committee: Faculty of Health Sciences Ethics Committee
Ethics number: 559/2020; 798/2020
All authors, affiliations and abstracts have been published as submitted.
