Climate change, biodiversity loss and large-scale environmental degradation are widely recognized 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. Therefore, we conducted a convergent mixed-methods study to investigate South African healthcare professionals’ knowledge, attitudes, practices, and barriers to environmental sustainability. Healthcare professionals participated in a cross-sectional questionnaire (n = 100) and in-depth semi-structured focus group discussions (n = 18). Data were analyzed using descriptive statistics and thematic analysis, respectively, and integrated to provide holistic findings. Our results confirm overwhelmingly positive attitudes and a high degree of interest in education, implementation, and taking on more corresponding responsibility, but a lack of substantial knowledge of the subject matter, and only tentative implementation of practices. Identified barriers include a lack of knowledge, resources, and policies. Further research, education, and policy development on overcoming these barriers is required. This will facilitate harnessing the extant enthusiasm and advance environmental sustainability in South Africa’s healthcare practice.

Background: As the South African government re-engineers primary healthcare (PHC), the need for additional information on stakeholders involved in the process has emerged. Of these are community health workers (CHWs), who have been identified as central to PHC success. Objectives: To profile the current CHWs within KwaDabeka and Clermont in KwaZulu-Natal, to describe their roles and to explore the barriers and enablers influencing their service delivery. Method: A convergent mixed methods design was employed with a sample of CHWs with the use of a survey (n = 53) and two focus groups (n = 10) and semi-structured interviews with four ward councillors (n = 4). Data were analysed statistically and thematically. Results: The profile of CHWs reflected only women with a mixed age range and a majority of 59% who had not completed formal schooling. General work experience as a CHW varied. There were diverse opinions expressed towards the CHW role which related to their job title and identity, supervision, remuneration, growth pathways and psychological and emotional issues. Whilst the National Community Health Worker Profile Framework was established for the CHW programme, there are several factors lacking in the current CHW programme such as a formal growth pathway or formal training to align the CHWs with the National Qualifications Framework. Conclusion: The study findings are essential for the monitoring and evaluation as well as development and refinement of policies that will assist in ensuring adequate rollout of PHC with CHWs.

Among the many actions required to avert further intensification of today’s social, ecological and health crises is also the improvement of healthcare’s environmental sustainability, including in countries particularly vulnerable to such crises. The present study aimed to identify Namibian healthcare professionals’ knowledge, attitudes and practices, along with barriers and educational needs, as a foundation for context-relevant interventions. The study used a non-experimental, descriptive quantitative research design with an existing validated cross-sectional questionnaire as its data collection tool. Both purposive and snowball sampling were used to select healthcare professionals (n = 71) to participate in the quantitative online questionnaire. R (version 4.2.1) software was used to analyse the data from the completed questionnaires. The results showed that the Namibian healthcare professionals participating in this study have basic knowledge of and positive attitudes toward environmental sustainability in healthcare. However, various barriers to implementing strategies towards environmental sustainability exist that currently prevent the implementation of relevant practices. These should be overcome by the Namibian health system by providing the necessary frameworks, policies, measures and resources to drive improvements in environmental sustainability. Additionally, future and current healthcare professionals must receive training across all professional education levels to enable implementation in practice and effective advocacy and planetary health promotion.

Background. Food security is a significant challenge in South Africa, especially for persons with disabilities. This topic is therefore important for educators in the health sciences. Nevertheless, little is known about educators’ awareness of the relationship between food security and people with disabilities, or to what extent the topic is included in their curricula or what their attitudes are regarding this topic. Objectives. We explored the knowledge and attitudes of educators pertaining to food security and people with disabilities. We assessed the current teaching practice associated with the food security of people with disabilities in the School of Health Sciences, University of KwaZulu-Natal. Methods. Thirty-five participants completed a cross-sectional online survey. The participants represented diverse disciplines including audiology, occupational therapy, optometry, physiotherapy, speech-language pathology and sports science. Quantitative data were analysed using descriptive statistics and qualitative data were analysed thematically. Results. The participants had limited self-reported knowledge about the definition of food security. Fewer than 60% of the participants reported a relationship between three of the dimensions of food security and disability, and 80% for one of the dimensions (food utilisation). Of the participants, 88% did not teach food security and disability theoretically, and 80% did not teach it practically. According to the participants, students were not equipped to assess if their clients with disability had food security problems, and were unsure of appropriate interventions. Conclusion. Despite a lack of knowledge, participants had positive attitudes towards including food security into their teaching, although limited teaching existed at the time of the study.