Bonitas - Parenting Hub

Movember – it’s not just about prostate health

November or Movember is traditionally when men around the world grow a moustache to raise awareness and funds for men’s health – specifically prostate cancer. And, although the campaign is synonymous with prostate cancer, it’s also about testicular cancer, mental health and suicide prevention. The clinical team at Bonitas Medical Fund take us through some of the essential health checks and screenings for men. These are tests to check for diseases and health conditions, even before you have any symptoms. By detecting diseases early, they are often easier to treat. Prostate cancer Prostate cancer is one of the most common types of cancer in men. It occurs in the small walnut-shaped gland that produces the seminal fluid that nourishes and transports sperm. The growth is normally slow, and it is the one type of cancer from which you have the best chances of recovery. However, while some types of prostate cancer grow slowly and may need minimal or even no treatment, other types are aggressive and can spread quickly. Most men with prostate cancer are older than 65 years and, with the correct treatment, have good outcomes. Men from the age of 50 (40 – 45 for those at high risk, with a family history of prostate cancer) should have an annual prostate examination. Checking for prostate cancer? Your doctor will recommend a blood test to check the levels of Prostate Specific Antigen (PSA) in your blood. PSA can be elevated in men who have prostate cancer. This must be supported by a rectal examination. For 2024, Bonitas has introduced the Be Better Benefit, paid from risk for a range of screening tests and benefits to allow for early detection. This includes an annual PSA screening test on all plans except BonCap. Factors that affect prostate health include Lifestyle: A healthy lifestyle that includes maintaining a balanced diet rich in fruits and vegetables, regular exercise and avoiding excessive consumption of alcohol and tobacco can contribute to prostate health Hydration: Staying well-hydrated is important for overall health. Drinking plenty of water can help flush out toxins and maintain prostate function. Medications and Supplements: Some medications and supplements, like alpha-blockers, 5-alpha-reductase inhibitors and saw palmetto, may be used to manage prostate conditions. However, it’s important to consult a healthcare professional before using any of these. In summary, maintaining prostate health and being aware of the risk factors and symptoms are essential aspects of men’s health. Regular check-ups, self-examinations and a healthy lifestyle can go a long way in preventing and managing these conditions. It’s crucial to consult with a healthcare professional for personalised guidance and early detection. Testicular Cancer Testicular cancer is relatively rare and typically affects young and middle-aged men. Here are some key points about testicular cancer: Regular self-examination of the testicles is essential. This involves gently feeling the testicles for any lumps, changes in size or unusual sensations. If any abnormalities are detected, it’s important to seek medical attention promptly. Common symptoms include a painless lump or swelling in the testicles, a feeling of heaviness in the scrotum and discomfort or pain. The main treatment is surgery to remove the affected testicle. Depending on the type and stage of cancer, additional treatments such as chemotherapy or radiation therapy may be necessary. The prognosis for testicular cancer is generally quite good, especially when detected early While the exact causes of testicular cancer are not well-understood, certain risk factors include a family history of the disease, undescended testicles and a personal history of testicular cancer Mental Health in men Mental health is of critical concern in South Africa, and it affects both men and women. Men, however, may face specific challenges and stigmas related to mental health. The clinical team at Bonitas stress that, ‘Mental illness is not a character defect, it is a health problem just like arthritis, diabetes or cancer. Fear and misunderstanding often lead to prejudice against people with mental illness and addiction which is a serious barrier to diagnosis and treatment.’ The economic uncertainty, political instability and poor socio-economic conditions in SA have also added to the burden of mental health issues. ‘We have seen a 25% increase in the number of mental health hospital admissions, indicating a need for additional support,’ says Lee Callakoppen, Principal Officer of Bonitas. ‘This need is particularly high in the 18 to 44 age groups. We have further noted that mental health was a key driver for absenteeism in corporate groups.’ Anxiety disorders and depression are the most common mental health problems but others include eating disorders, post-traumatic stress disorder (PTSD), obsessive compulsive disorder (OCD), bipolar mood disorder as well as psychotic disorders such as schizophrenia and personality disorders. Substance abuse, such as drugs and alcohol, is also classified under mental illness. Here are some important points regarding mental health: South African men, like men in other parts of the world, may face societal pressures to conform to traditional notions of masculinity, which can make it difficult to express emotions or seek help for mental health issues. Mental health conditions may be underreported and untreated due to the stigma associated with them. Access to mental healthcare services can be limited in certain areas of South Africa, particularly in rural regions. This can create barriers to seeking help for mental health issues Substance abuse issues are often intertwined with mental health problems. Turning to alcohol or drugs will just exacerbate mental health challenges. In response to what is rapidly becoming a mental health crisis, medical schemes are stepping up. Bonitas, for example, has a Mental Health Programme (MHP) which is part of the Scheme’s Managed Care initiatives. The programme, which is primarily education driven, is aimed at improving quality of life and empowering people with mental health issues to manage their condition. In addition, Bonitas was the first medical scheme to offer it members Panda, a mental wellness app. Panda provides scientifically validated assessment tools to enable users to measure their mental wellbeing objectively. It also enables members to book one-on-one

November 1, 2023

Breast Cancer – different screening tools

Radiologists from the SCP Radiology practice and Dr Lizanne Langenhoven, who specialises in the treatment of breast cancer, talk about the different kinds of screening for breast cancer. Dr Langenhoven says, ‘When you consider that around 90% of women find their own breast lumps, it is a very important part of the screening process. Although 80 percent of these lumps are not malignant, there are cases where women owe their lives to their own self-examination.’ A guide to self-examination: Lying down or in the shower: Place your right hand behind your head. Using the pads of the fingers on your left hand, feel for changes in your entire breast in a circular. Do the same above and below and in your armpit area. In front of a mirror: Check for any dimpling, puckering or changes in either nipple. See your doctor or clinic if you have any of these symptoms. Have regular screenings at your doctor or clinic. The different screenings include: Mammogram: Is breast imaging using low-dose X-rays to form a 2D image. The advantage is it often reveals abnormalities undetected in a clinical breast examination. Four images are taken, two of each breast. The breast is lightly compressed for less than 1 minute during the examination to improve diagnostic accuracy. Tomosynthesis: This is a form of 3D mammography and uses X-rays as well as sophisticated software to create a 3D image of the breast. It is considered better at detecting cancer and reducing false positives in dense breast tissue. It is invaluable in problem-solving and is used in combination with 2D mammography. Breast Ultrasound: Ultrasound is a supplementary investigation used to further evaluate morphology, blood flow, and consistency of masses and lymph nodes that are abnormal mammography. It uses no radiation but rather real-time imaging, using sound waves to create an image. It’s a slightly longer process and is also valuable in problem-solving. It is used in combination with a mammogram not in place of it. MRI: The digital MR image is created using strong magnetic fields and radio waves but no radiation. You will receive an intravenous injection and then lie on your stomach, in an MRI ‘tunnel’ for around 45 minutes. An MRI for breast screening is usually used for problem-solving, high-risk screening and for women who have breast implants. Biopsy: A breast biopsy may be recommended when a suspicious area is found in your breast, like a breast lump or other signs and symptoms of breast cancer. It is also used to investigate unusual findings on a mammogram, ultrasound, or other breast examination. Thermography: Thermography is a test that uses an infrared camera to detect heat patterns and blood flow in body tissues. Digital infrared thermal imaging (DTI) is the type of thermography that can be used to show these patterns and flow in the breasts.

October 23, 2023

Beating heatstroke

Bonitas Medical Fund offers some advice about heatstroke. What the symptoms are, how to avoid it and what to do if someone, child or adult, develops heatstroke.

October 20, 2023

Q and A – why are some women reluctant to go for a mammogram

The World Health Organization creates awareness around breast cancer in October. First initiated in October 1985, Breast Cancer Month has grown exponentially globally and this year is no exception. According to the Cancer Association of South Africa (CANSA), it’s far better to have an early-stage diagnosis, as it results in better breast cancer treatment and long-term survival. CANSA recommends monthly breast self-examination, annual medical check-ups, and screening. Radiologists from the SCP Radiologist Practice and Dr Lizanne Langenhoven, who specialises in the treatment of breast cancer, address some of the concerns around breast cancer screening. If early detection is recommended and provides the best outcome, why are women reluctant to screen for breast cancer? An informal survey amongst women, who are hesitant to go, even though they have the means to go, shows that the top reasons include the following: It’s going to be too painful Many women still rely on their mother’s experience with early mammograms which were painful. Mammography machines have progressed exponentially since the early days, so the level of discomfort experienced during the procedure is now significantly reduced. Modern technology and digital equipment allow us to use less compression and still obtain quality imaging. Also, the amount of pressure is different for each individual, depending on the breast size and composition. Pressure is often manually adjusted so speak to your mammographer if you experience any discomfort. Fear of exposure to radiation A mammogram uses relatively low-dose radiation. The total dose is approximately 0.5 mSv (2D mammogram). To put it into perspective, we are exposed to 3.0 mSv of background radiation from our natural surroundings per year. Radiologists also strictly follow what’s known as the ALARA principle – to always apply radiation “as low as reasonably achievable”. The benefits of mammography thus far outweigh the risks from this low dose radiation. Fear of finding out you have breast cancer Dr Langehoven says, ‘The good news is that our understanding of the different subtypes of breast cancer has improved significantly over the past few years! We no-longer follow a one-type-fits-all approach and many women may even safely be spared chemotherapy in a curative setting. ‘As with everything else in life, it is easier to address a ‘small’ or ‘early’ problem than it is to address a much larger problem! I’ve seen breast cancer diagnosed at a size of 2mm on mammogram – meaning that treatment is tailored to a very low risk situation. In short, the earlier we become aware of an existing problem, the sooner it can be addressed and with much less invasive treatment.’ I don’t go for mammograms, I only go for thermography At present, thermography cannot substitute mammography but may be used as complementary screening. Dr Langenhoven cautions that thermography is not all it is cut out to be. In order for the cancer to give off heat signals, it has to be significant in size. Mammography on the other hand can detect changes in the breast before they progress to cancer. A mammogram therefore picks up the disease course much sooner than thermography. Why mammography instead of ultrasound, which doesn’t use radiation? Mammography is our workhorse. We look for masses, calcifications, and architectural distortion. Ultrasound is a supplementary investigation used to further evaluate morphology, blood flow, consistency of masses, and lymph nodes that are abnormal on a mammogram. Tomosynthesis is also supplementary, used to further evaluate architectural distortion seen on a mammogram. They all work together. With denser breasts mammography is less sensitive, which is when we add the supplementary investigations to improve the sensitivity of detection. If am diagnosed with breast cancer I am going to die anyway, so I would rather not find out This statement is not true in the current day and age where 90% of women with early breast cancer can be cured of their disease, says Dr Langenhoven. ‘In the same way we don’t drive cars from the 50’s, our treatment is no longer ancient either!’ The side-effect profiles of our new drugs are aimed at improving quality of life during treatment, and the fact that we now identify and treat 4 distinct subtypes of breast cancer means that we can target the specific growth-pattern at play and avoid unnecessary treatment. Previously, because we didn’t know which women had aggressive breast cancers and who didn’t, all women were treated more or less the same up to a few years ago. This meant that women feared finding out they had breast cancer for fear of the radical and toxic treatment they would be subjected to. This has really changed over the past 10 or 15 years and our approach has changed to be specific and conservative when we advise treatment. It is tailored to the specific characteristics of each women’s disease. Surgical outcomes are so much better and very few women would ever be offered a ‘flat’ mastectomy as part of their treatment plan. We no longer approach breast cancer surgery without consideration of the cosmetic outcomes and quality of life of the woman behind the cancer. The notion that cancer means suffering and death comes from a bygone time and we should do all we can to change this outdated perception. The survival rate of breast cancer depends on a number of factors including the type of cancer, the immune receptors, the grade, and the speed at which it is growing – these all determine the survival rate. A big tumour that is slow growing and has a low grade has a more favourable outcome after treatment, than a small tumour that is high grade and fast growing. However, if a cancer is found early and the grade is established earlier, then tailored treatment can begin earlier which may slow down or limit the progress. An early diagnosis will improve treatment outcome. The advantage of screening is early detection for better treatment outcomes and prognosis. Dr Langenhoven adds that early detection really counts when it comes to treatment related side-effects and cost of treatment. An early cancer may very

October 16, 2023

DEALING WITH KIDS AND PREGNANCY

Dealing with pregnancy can be tricky on its own, but when you have a toddler or young kids to look after things can become more difficult. If this is your second pregnancy, you may be struggling with morning sickness, fatigue and a tired achy body and still having to look after another young child. You’re probably wondering how to manage, so we’ve put together some useful tips to help you the second time around. Be patient with them and yourself It’s important that you’re patient with your child. Initially, they may not understand the pregnancy which can make them act out in confusion. Getting them involved and feeling like a big sibling can help them to feel excited about the new addition to the family. That being said you should also be patient with yourself. You may be feeling unwell due to your pregnancy, and with looking after another child you may find things falling by the wayside. It’s likely that only you will notice these things, so don’t be too hard on yourself. Playtime for you and them You might not always be feeling up to playtime with your little one, so this is a good time to encourage them to play independently. This way you free up a little bit more time for yourself while keeping them entertained. As your pregnancy progresses, play in ways that you can manage. Instead of running around, focus on board games, drawing and puzzles. Allowing a little bit of screen time (even together) is another way you can easily entertain your kids. Help and schedules Don’t be afraid to ask for help. If you have a partner, they are the obvious person to lend a hand, but if you are by yourself, either reach out to close family or consider getting paid help for part of the day. Another way to find some time for yourself is to nap when your toddler naps. Syncing up your sleep schedules may mean that you find yourself a little bit more rest time for when you’re feeling tired or nauseous.

October 6, 2023

Bonitas balancing increases with value and sustainability

onitas Medical Fund, one of the leading medical schemes in South Africa, announced its 2024 product line up today. Lee Callakoppen, Principal Officer of Bonitas says, ‘We appreciate that many of our members and South Africans in general, are faced with increasing financial pressures. We have therefore taken great care to balance our benefit enhancements to provide value to our members, while still ensuring that contributions remain affordable. ‘The percentage increase required is methodically worked out by our team of actuaries who determine the minimum increase against ensuring the financial sustainability of the scheme while meeting the regulatory guidelines and requirements. It’s a delicate balancing act,’ says Callakoppen. ‘For 2024, the weighted increase is 6.9% with the average increase across nine of our plans at 6%. This means that over 227 000 members – around 65% of our membership – will experience an increase below CPI.’ How we did this We conducted in depth research over the last year, which included stakeholder engagement, actuarial analysis and projections to look at how to enhance our benefits. In addition, we analysed feedback from over 10 000 member surveys, researched international healthcare protocols, trends and disease burden rates in South Africa. The result: We have stayed true to our ultimate commitment of giving more value to our members, by reducing out-of-pocket expenses, enhancing benefits and providing additional preventative and managed care. Our fiscal health The Scheme is financially sound, including financial indicators to claim’s paying ability and strong solvency levels. And, despite investing over R1.4 billion back to members in 2021 and 2022, we saw our reserves increase to R8.8 billion last year. A feat matched by no other open scheme. We have noted an erratic claims’ catch up emerge over the past 12 months and, it is for this reason that it’s essential to take a well-rounded approach and apply a modicum of conservativeness to our approach. This, to remain sustainable for our members, regardless of increased claim patterns. We also applied prudent investment management strategies that enabled solid returns for the members. Membership growth Membership grew by 62 000 principal members, 80% through organic growth – in a declining industry. New members are 13 years younger than the average, which means we have succeeded in attracting a younger, healthier profile which is coveted across our industry. We attribute this to offering a diversified product range from hospital plans to network options and Edge plans – driven by innovation and technology. So, what’s new? Our research identified various healthcare trends and needs and we have ensured these are met in our plan benefits and enhancements. Our solution to unregulated healthcare costs In South Africa, providers are free to charge patients any tariff they see fit. However, with the economic pressures faced by consumers, funding is usually in short supply. Through engagement and collaboration with healthcare providers we have found solutions to these challenges. We implemented networks at the most favourable tariffs for our members so that they can avoid out-of-pocket expenses and get more value from their medical aid. This applies to GPs, medication, dentistry, optical, specialists and hospitals. Not only do we direct members to the most efficient hospitals, with the best healthcare options but the discounted tariffs reduce co-payments or eliminate them. Specialist’s costs For 2024, we considered the input from specialists, regarding the cost of services and enhanced our specialist reimbursement rates. This allows 85% of our members to have full cover, wallet-free specialist visits. Our specialist network ensures members are covered with the top 15 speciality types contracted into the network. We have introduced three tiers of network specialist rates, based on experience and proximity. The key focus is on specialty types with high claim volumes and major medical costs such as gynaecologists, physicians and cardiologists. Managed Care enhancements Over the years the prevalence of non-communicable diseases, such as diabetes and hypertension, has increased year-on-year. This is further compounded by the increased burden of mental health which is an added risk factor. Mental health One of the key insights noted was that mental health prevalence is at an all-time high. This is exacerbated by factors such as an increased economic burden and increased psycho-social challenges, such as loadshedding. We have seen a 25% increase in the number of mental health hospital admissions, indicating a need for additional support. This need is particularly high in the 18 to 44 age groups. We further noted that mental health was a key driver for absenteeism in corporate groups. For this reason, we have included the Bonitas Mental Healthcare Programme across all plans for 2024 and included depression as a chronic condition. We also offer access to Panda, a digital platform available through the Bonitas app, giving members easy access to expert help, mental health information and community support. Back and neck programme We recognised that not all members have access to the DBC back and neck facilities so, in addition to adding a digital version of the programme, we have established a network of physiotherapists so members can access the benefits of the programme in more remote areas. Preventative screening A key trend across the healthcare industry has been the decline of preventative screening, including wellness checks and health risks assessments. We have taken up the challenge and have intensified our drive to increase screening uptake. Introducing the Bonitas Be Better Benefit! Funded completely from risk, this unique benefit provides a range of screening tests and benefits to ensure members have access to the necessary screenings, to allow for early detection and to be put onto a path to wellness. The Be Better Benefit is available on all options, except BonCap. This benefit is paid for from risk – helping families to get the best possible healthcare. As an added bonus for 2024, childhood immunisations following the State Vaccine Schedule will be added to six of our plans. HPV vaccine We’ve also taken great care to expand our preventative care benefits by including the Human Papilloma (HPV) vaccine on all

September 28, 2023

Bonitas Medical Fund: 2024 Product Launch round up

At a glance: 353 763 Principal members 727 041 Total beneficiaries 62 000 new principal members added last year 18.7% chronic profile Average age of beneficiary: 35.5 Average age of new members is 13 years younger than existing members R8.8 billion in reserves 41.3% solvency ratio AA+ Credit rating Plans Bonitas offers a wide range of plans that are simple and easy to understand. There are 15 options in five categories: Savings, traditional, hospital, Edge (virtual) and income-based. Increases The average increase, across all plans, is 6.9% The risk contribution on Primary, Primary Select, BonSave, BonFit Select, BonEssential, BonEssential Select, BonStart, BonStart Plus and BonCap is 6% These options contribute to over 70% of new business 227 000 members will experience an increase below CPI – approximately 65% of our membership Plan increases range from 2.7% to 9.6% Increased savings, for BonSave it’s an increase of 25% Note: Contributions from January 2024 Name of plan Type of plan Main member Adult member Child member % increase BonComprehensive Savings R9 853 R9 292 R2 006 9.6% BonClassic Savings R6 732 R5 780 R1 662 9.6% BonComplete Savings R5 359 R4 293 R1 455 9.6% BonSave Savings R3 447 R2 671 R1 032 6.8% BonFit Select Savings R2 295 R1 719 R 772 2.7% BonStart Edge R1 378 R1 378 R1 378 3% BonStart Plus Edge R1 754 R1 668 R 773 3% Standard Traditional R4 922 R4 267 R1 444 8.4% Standard Select Traditional R4 448 R3 849 R1 302 8.4% Primary Traditional R2 993 R2 341 R 952 7.2% Primary Select Traditional R2 619 R2 048 R 832 7.2% Hospital Standard Hospital R2 964 R2 497 R1 127 8.4% BonEssential Hospital R2 287 R1 690 R 739 7.1% BonEssential Select Hospital R1 998 R1 464 R 659 6.7% BonCap New and revised income bands Income-based 5.5% R0 to R10 680 R1 430 R1 430 R 673 R10 681 to R17 330 R1 745 R1 745 R 802 R17 331 to R22 541 R2 813 R2 813 R1 064 R22 542+ R3 453 R3 453 R1 310 What’s new? Mental Health: Due to a 25% increase in the number of mental health hospital admissions, the mental health programme has been included on all plans for 2024. Depression has also been added as a chronic condition on 11 plans The mental health app – Panda – is a free to download mental health and wellness mobile app available to all members Hearing: As part of the audiology programme, free online hearing screenings have been introduced DBC Back and neck programme: A physiotherapy network has been established Oncology: Increased specialised drug benefit on BonClassic, BonComprehensive, Standard and Standard Select International bone marrow searches allowed Introduction of a Be Better Benefit, paid from risk for a range of screening tests and benefits to allow for early detection (all plans except BonCap) An annual wellness screening (blood pressure, blood glucose, BMI, cholesterol) Flu vaccines HIV Lipograms Mammograms Pap smears Prostate screening Pneumococcal vaccine Whooping cough boosters HPV vaccines Stool tests for colon cancer Dental fissure sealants Online hearing screening Contraceptives Pharmacy network: Over 4 000 pharmacies to choose from including all Clicks, Dischem and Medirite branches HPV vaccine has been extended to all plans. 2 doses for females aged 9 to 14 years and 3 doses for females aged 15 to 26 years per lifetime HIV+ members: An annual test for HIV+ members who had a positive cytology test, as well as a choice between the 3-yearly basic cytology test or a 5-yearly HPV PCR test The Benefit Booster has been adjusted according to utilisation (10% monetary increase on 8 plans). The only benefit in the market which provides members with access to an additional amount to use for out-of-hospital expenses at no extra cost – effectively giving savings and day-to-day benefits a healthy boost Covers everything from additional GP consultations to acute medicine. Increased the child dependant age to 24 years, not just for students Partnered with What’s Up Doc: An innovative patient-driven WhatsApp service that allows doctors on the BonCap network to engage with members more easily – sharing prescriptions, blood test results, specialist referrals, etc – it’ll improve care coordination

September 28, 2023

Webinar – Dealing with blocked noses in babies & toddlers

In this antenatal class, Sr Talia, explains how to treat block noses in Babies and Toddlers. Knowing when to go to the doctor and what to do at home.

September 22, 2023

Webinar – Cracked nipples during breastfeeding

Sr Talia talks about cracked nipples during breastfeeding, why they are caused and how to treat them.

September 15, 2023

Webinar – breastfeeding positions

Sr Ingrid Groenewald explains the different breastfeeding positions that you can try to have a successful Breastfeeding journey, as well as the latch baby, should have.

September 8, 2023

Dealing with diabetes

South Africa is the most obese nation in sub-Saharan Africa*. It’s not surprising then that we also have the highest rate of Type 2 diabetes. The danger is that most people are unaware of the risk until they are diagnosed as pre-diabetic or Type 2 diabetics. Diabetes is the third most significant risk factor for disability and early death in South Africa. While 4.5 million South Africans are currently diagnosed with the condition, what’s more alarming is it’s estimated that 61% of diabetics remain undiagnosed. The concern about the number of diabetics is not restricted to our country though. The International Diabetes Foundation predicts that by the year 2040, over 642 million people worldwide will be diagnosed with the disease. Lee Callakoppen, Principal Officer at Bonitas Medical Fund, together with the Scheme’s clinical team talks about diabetes and why a proactive and holistic approach to management of the disease is essential. What is diabetes? It is a disease that occurs when your blood glucose, also called blood sugar, is too high. Insulin – a hormone made by the pancreas – helps glucose from food get into your cells to be used for energy. An overview Type 1 diabetes. Results from the body’s failure to produce insulin, the hormone that unlocks the cells of the body, allowing glucose to enter and fuel them Type 2 diabetes. With Type 2 diabetes, the more common type, your body does not make or use insulin well Pre-diabetes. This means that your blood sugar is higher than normal but not high enough to be called diabetes. If you are at risk for Type 2 diabetes, you may be able to delay or prevent developing it by making some lifestyle changes Gestational diabetes. Is diabetes diagnosed, for the first time, during pregnancy (gestation) 10 early signs of diabetes The symptoms of diabetes are usually so mild that they can easily go unnoticed. This results in many diabetics being unaware of their condition until they are diagnosed with Type 2 diabetes. Fortunately, diabetes is a manageable condition, especially if diagnosed early. Here are 10 early signs you can look out for: #1 Frequent urination When your blood sugar is elevated, the kidneys can’t keep up with the amount of glucose in your system, allowing some of it to go into your urine. This results in you having to urinate more often than usual. #2 Increased hunger and thirst Diabetics usually don’t get enough energy from their food, which leads to a craving for more food. The frequent urination is also likely to cause dehydration and lead to you feeling thirstier than normal. #3 Pain and numbness If you have Type 2 diabetes, you might experience numbness in your hands and feet. This is usually a sign of nerve damage or diabetic neuropathy and is usually after years of living with diabetes. #4 Dry Mouth A dry mouth is one of the most common symptoms of diabetes. Symptoms may include: Trouble chewing, swallowing or speaking, dry, cracked lips, sores or infections in the mouth or a furry, dry tongue. #5 Blurred vision High sugar levels in the blood can damage the tiny blood vessels in the eyes, causing fluid to seep into the lens of the eye, potentially causing blurry vision. #6 Yeast infections Yeast feeds on glucose, so having plenty of glucose around makes it thrive. Yeast infections usually grow in warm, moist areas of skin, like between fingers and toes, under breasts and in or around sex organs. #7 Slow healing cuts and wounds Over time, high blood sugar levels narrow your blood vessels, slowing blood circulation and restricting much needed nutrients and oxygen from getting to the wounds. As a result, even small cuts and wounds may take weeks or months to heal. #8 Skin discolouration Insulin resistance can cause patches of darker skin to form on creases of the neck, armpits, groin area or over the knuckles. This condition, known as acanthosis nigricans, can be a result of diabetes. The skin in the affected area also becomes thickened. #9 Fatigue Diabetes-related fatigue is caused by fluctuating blood glucose levels resulting in not enough glucose for the body’s energy supply. #10 Weight loss Losing weight without trying to, can be a warning sign of diabetes. When your body can’t get energy from your food, it will start burning muscle and fat for energy instead, resulting in weight loss even though you haven’t changed your eating habits. Holistic treatment and management of diabetes critical Over the past few years, the Council for Medical Schemes (CMS) cited an increased prevalence of chronic conditions, diabetes in particular, as one of the key contributors to a rising disease burden and escalating healthcare costs. ’To offset this growing disease burden and proactively empower patients with diabetes to take control of their health, Bonitas has developed an integrated, holistic programme that is based on the specific needs of members with diabetes,’ says Callakoppen. Diabetic co-morbidities – a higher risk Individuals with diabetes often have other chronic conditions (co-morbidities) – such as high blood pressure, high cholesterol, heart disease and depression. This fact greatly increases the risk of diabetics developing complications such as nerve damage, eye problems, kidney damage as well as problems in pregnancy. To manage diabetes effectively, all the other conditions and complications must be managed as well. A key feature of the Bonitas diabetes programme is that it manages each individual’s unique mix of disease and lifestyle factors, rather than a standard approach to managing a specific disease. Diabetes Management Complications of diabetes must be prevented by ensuring access to proper treatment such as specialised diabetes’ doctors, paediatricians, podiatrists, diabetic educators to help manage the diabetes. Diabetics need to understand their condition and be empowered to make the right decisions to stay healthy. Containing the risk ‘We believe the way forward is an increased focus on prevention, lifestyle changes, coordination of care by doctors and the utilisation of evidence-based disease management interventions,’ says Callakoppen. ‘The Bonitas clinical team uses an innovative Emerging Risk predictive model and screening algorithms

September 1, 2023

Breastfeeding Webinar – How to know if baby is full

Sr Ingrid Groenewald explains more about breastfeeding and how to know if baby is full or still hungry.

August 18, 2023

Webinar – Vaginal Infections during Pregnancy

Sr Talia discusses different vaginal infections that you can experience during pregnancy

August 11, 2023

Webinar – Baby Milestones

Sr Ingrid Groenewald explains the milestones that you can experience in your baby’s first year.

August 2, 2023

Webinar – Gestational Diabetes

In this antenatal class, Sr Talia explains what Gestational Diabetes is, what the symptoms are and how to manage it.

July 28, 2023

Webinar – Caesarean Birth and Recovery

In this webinar, Sr Ingrid Groenewald explains the process of a Caesarean Birth and the recovery process thereafter.

July 21, 2023

Webinar – Post Birth Care for Moms

In today’s webinar, Sr Ingrid reminds Mom’s that’s it’s important to look after yourself post birth. What you can experience post birth and how to deal with the body changes, bleeding and uterus contractions.

July 14, 2023

Bonitas 2022: Annual results show steady growth and industry-leading financials

Bonitas Medical Fund, in its 42nd year, announced its 2022 financial results today. The medical aid for South Africa, achieved a net surplus supported by positive membership growth, boosted reserves, an increased solvency ratio and a strong investment performance. ‘We know affordability pressures facing South Africans are overwhelming, which is why we strive to find the right balance between value for our members and long-term sustainability,’ says Luke Woodhouse, Chief Financial Officer. ‘To this end, we are pleased to report a record high R8,8 billion in member reserves at year end 2022. We are also thrilled to confirm that we have exceeded industry benchmarks, particularly for value creation, achieving a R1.78 return for each R1.00 spent on administration and managed care – 12% higher than the industry average of R1.59. ‘Bonitas outperformed all expectations in 2022, in terms of all key indicators and we are poised to continue on this positive trajectory. This performance speaks to the strategy we’ve put in place as well as the Scheme’s overarching aim to make quality healthcare more affordable and more accessible.’ Increases One of the key cost drivers in medical aid contributions is healthcare inflation, typically around 4% higher than CPI. Rising consumer price inflation (which impacts healthcare inflation) has exacerbated the ongoing challenge of medical schemes to remain affordable. We addressed healthcare inflation through two pillars of our strategy: Strategic purchasing and integration of the value chain. We were able to restrict the average increase in membership contributions for 2023 to 4.8%, compared to CPI of 7.2% as of December 2022. To demonstrate our commitment, we introduced our first contribution increase freeze, with increases only applied from April 1, 2023, to create some financial respite for our members. The number of principal members has exceeded 353 763, with 727 041 beneficiaries at an average age of 35.5. In a time when it is a challenge for schemes to acquire new members, Bonitas had a net membership growth of 4% with 47 446 gross membership acquisitions. This excludes the 14 585 acquired from the Nedgroup Medical Aid Scheme (NMAS) amalgamation – highlighting the attractiveness of the Bonitas offering and product range for corporates. We pride ourselves in providing one-on-one assistance to members and their beneficiaries, as well as access to care of the highest quality. To do so, we have partnered with best-in-class service providers. Testimony to this is being awarded a Titanium Award from the Board of Healthcare Funders (BHF) for ‘Operational Performance’ in May 2023 for the second year running. The award benchmarks industry excellence and rewards medical schemes, administrators and managed care organisations which provide best value and service to their members. Earlier this year, Bonitas was also named ‘Medical Scheme of the Year’ at the News24 Business inaugural awards. The Scheme was also voted South Africa’s number 1 medical aid in the Ask Afrika 2021/2022 Orange Index. Investment We achieved a 7.2% return on investment for member’s funds during a year which was marked by high volatility and uncertainty in the markets, both domestically and abroad. The investment portfolio value for 2022 reached R9.97 billion. As a medical scheme we don’t have shareholders or investors who receive dividends, we exist and spend our funds purely for the benefit of our members. Cost-saving initiatives The Scheme’s approach to realigning Managed Care initiatives, with a particular focus on hospital negotiations, resulted in a projected negotiated savings of R260 million. Strategic purchasing yielded a value of at least R441 million for our members. Optimising and aligning networks is a key strategy to managing costs. We regularly evaluate the quality of all service providers to ensure there is a reduced healthcare risk for Bonitas (and for our members). Amalgamations Our Board managed the successful amalgamation with NMAS which required close scrutiny of our governance and compliance. Fraud, Waste and Abuse (FWA) In 2022, Bonitas spent R49 million on its FWA programme with Medscheme and, for the first time we banked recoveries in excess of R55 million. Banked recoveries represent a small portion of the actual savings emanating from successful FWA detection and preventions, as service providers who engage in FWA are likely to continue doing so if they are not held to account. We estimate a saving of R1.1 billion from changed behaviour since the commencement of our FWA programme in 2016. Solvency levels Our solvency levels reached an all-time high of 41.3% – 16% above the legislated 25%. Our objective is to sustain solvency levels above 30% and to use our bolstered reserves to benefit our members. Hospital costs Hospital costs again dominated claims, reaching R6.9 billion (2021: R6.45 billion). Managed Care Active Disease Risk Management (ADRM) focusses on improving clinical outcomes, reducing admissions, readmissions and improving medicine adherence. The estimated value realisation of these interventions achieved savings in excess of R14 million. Value for money above industry average Deloitte conducted a Transactional and Relational Governance Review of years 2020 and 2021 with the results received in November 2022. The Review found that Bonitas obtained significant value for money from its primary contracted service providers. For every R1.00 spent on administration and Managed Care, Bonitas derived R1.78 for 2021, an increase of 19%, demonstrating substantial improvement year on year. Outlook for 2023 Our agile approach to the execution of our strategy is likely to stand us in good stead in 2023, as we expect further volatility in local and international markets and an increase in disease burden such as mental health. For our members, affordability and quality remains top of mind. Private medical aid shifted from being a grudge purchase to a necessary monthly budget item during COVID-19. However, Bonitas remains committed to deliver benefit enrichment for members, which we can do through our value-added offerings, healthy reserves and high solvency level. In terms of the NHI draft Bill, we have done extensive scenario planning to consider both best- and worst-case scenarios for Bonitas. We remain unequivocally in support of the principle of universal healthcare but believe that a collaborative and cohesive approach, between the

July 13, 2023

Load shedding – healthcare and chronic meds

Load shedding in South Africa has significant effects on both private and public healthcare. These are far-reaching and can have severe consequences for patients, medical facilities and healthcare professionals. So just what is the impact of load shedding on healthcare in South Africa? In the realm of healthcare, load shedding exacerbates the existing challenges faced by hospitals and clinics. Load shedding further strains infrastructure and compounds existing shortages, compromising patient care. New regulations allow larger public hospitals exemption from load shedding however, Eskom has warned that it would be technically impossible to isolate and exclude most healthcare facilities from load shedding. Dr Morgan Mkhatshwa, Clinical Executive of Bonitas Medical Fund says, ‘prolonged or frequent loss of basic services, including the lack of electricity, has been shown to have financial, psychological and physical implications.’ The importance of private healthcare was highlighted during the Covid-19 pandemic. ‘Medical aid changed from being a grudge purchase to an absolute necessity and, once again, this is being reinforced by the electricity crisis and load shedding,’ says Dr Mkhatshwa. ‘Apart from having access to private hospitals, which are predominately well equipped with generator banks and/or inverters, medical aids take every precaution to ensure other services are available at optimum levels and the highest quality.’ He says, ‘To ensure the delivery of cost-effective healthcare, we have a network of hospitals and clinicians with whom we have negotiated favourable rates to minimise co-payments for our members. All of these hospitals and clinician practices have put effective contingency plans in place to ensure they are able to generate sufficient back-up power for uninterrupted patient care.’ Provision of pharmaceuticals These include vaccines, insulin and certain antibiotics, which are sensitive to temperature fluctuations and require refrigeration/strict maintenance of the cold chain. During power outages, the lack of electricity can compromise the integrity and efficacy of these medications, rendering them ineffective or potentially harmful. This does not only pose a risk to patient health but also leads to financial losses as medications and vaccines may need to be discarded, due to compromised storage conditions. He says the provision of chronic medications is essential to ensure members are able to adhere to their medicine regime. The Fund ensures their Designated Service Providers are proactive in developing contingency plans to ensure an uninterrupted medicine supply to its members. This includes having generators and backups, double dispensing of medication to ensure chronic medication deliveries are doubled up and developing communication tools to inform and educate members about medication supply. ‘More than 80% of South Africans are reliant on public healthcare services at the approximately 420 state-run hospitals and more than 3 000 state-run clinics. While private facilities, secondary- and tertiary-level public hospitals appear to be well equipped with generator banks, smaller healthcare facilities including primary healthcare clinics, are often left in the dark,’ says Dr Mkhatshwa. ‘The cost of alternative sources of power can be substantial, with a private hospital group recently reporting an average monthly expenditure of R800k to run its generators. ‘The situation is not only unsustainable but is also putting the healthcare of our citizens at risk and, once again, it is the most vulnerable who are compromised the most.’ The original study by the University of the Witwatersrand’s Department of Emergency Medicine, Faculty of Health Sciences in 2019. http://www.scielo.org.za/scielo.php?script=sci_arttext&pid=S0256-95742019001200003

July 12, 2023

Asthma – avoiding triggers

Asthma is one of the most common chronic illnesses, affecting over 300 million people worldwide. Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund, talks about the causes of asthma, preventative steps to reduce the chances of an attack and treatment. What is asthma? Asthma is a long-term condition affecting children and adults. The air passages in the lungs become narrow due to inflammation, production of extra mucus and tightening of the muscles around the small airways. This causes asthma symptoms such as coughing, wheezing, shortness of breath and chest tightness. These symptoms can be intermittent, are often worse at night and can be triggered by exercise. It affects approximately one in 10 children and one in 20 adults and can occur for the first time at any age, even in adulthood, although asthma usually begins before the age of five. A few children affected will ‘outgrow’ it during their teenage years but it usually persists if contracted in adulthood. Asthma tends to run in families. Signs and symptoms Asthma is often under-diagnosed and under-treated and this can lead to disturbed sleep, tiredness during the day and poor concentration. If you fail to recognise and avoid triggers that lead to your tightened airways, you may have an asthma attack, feel respiratory distress or experience a life-threatening situation. It’s important to avoid the triggers and recognise the signs of this condition to enjoy a better quality of life. What causes asthma? There are various types of asthma including allergy-induced asthma. Research shows that the risk factors include a combination of genetic predisposition and environmental exposure, to inhaled substances and particles that may cause allergic reactions or irritate the airways. These include indoor allergens – such as dust mites, particles of cockroach waste and pet dander and outdoor allergens – such as seasonal pollen, mould as well as tobacco smoke and air pollution. Smoke and strong soaps and perfume can also be triggers. Other triggers for asthma can include cold and dry air, physical activity, stress, certain medications, such as aspirin and other non-steroid anti-inflammatory drugs and beta-blockers (which are used to treat high blood pressure, heart conditions and migraine) viral infections and occupational asthma, triggered by workplace irritants such as chemical fumes, gases or dust. Factors associated with asthma prevalence or disease severity in South African children include the adoption of an urban lifestyle, atopy (a genetic predisposition to having allergies), obesity, respiratory infection or exposure to industrial pollution or tobacco smoke. Treating asthma Asthma can be life threatening when left untreated and cannot be cured but, with the right treatment most asthmatics will lead completely normal, active lives. The aim of treatment should be to make the lungs and breathing tubes as normal as possible so that there are minimal symptoms and as little disruption to ordinary life as possible. People with asthma may need an inhaler. Their treatment will depend on the frequency and severity of symptoms and the different types of inhalers available. There are two main types of inhalers: Bronchodilators that open the air passages and relieve symptoms Steroids that reduce inflammation in the air passages. This improves asthma symptoms and reduces the risk of severe asthma attacks and death It can sometimes be difficult to coordinate breathing using an inhaler, especially for children and during emergency situations. Using a spacer device makes it easier and helps the medicine to reach the lungs more effectively. A spacer is a plastic container with a mouthpiece or mask at one end and a hole for the inhaler in the other. A homemade spacer, made from a 500ml plastic bottle, can be as effective as a commercially manufactured inhaler. Reduce your exposure to allergy triggers The best way to reduce your exposure to seasonal allergy triggers is to avoid them. Avoid activity in the early morning when pollen levels are at their highest Stay indoors on dry, windy days as the pollen counts surge in these conditions The best time to go outside is after a good rain, rain washes pollen away but beware, pollen counts can also soar after rainfall Delegate gardening chores like mowing the lawn to others Wear a pollen-filtering mask if you must do chores outside. When back indoors, shower to rinse pollen from your skin and hair and put on clean clothes Keep windows shut or use an air conditioner if you know that pollen counts are going to be high Clean floors often with a vacuum cleaner Wash your bedding in hot water at least once a week Don’t hang laundry outside during this time as pollen can stick to sheets and towels Cover your bedding and pillows with allergen-proof covers Remove stuffed toys from your children’s bedrooms Dr Mkhatshwa says, ‘If you are experiencing asthma symptoms or think you might have asthma, it is important for you to talk to your GP. This will help you establish if your symptoms are linked to asthma or whether something else is causing them.’

June 14, 2023

Free hearing screening (online) for all

Hearing loss is an under-diagnosed medical condition that significantly impacts the physical and mental health of those who have any degree of hearing difficulty. Disabling hearing loss is being called the ‘invisible epidemic.’ It affects more than three million South Africans and over 1.5 billion people globally. The World Health Organization (WHO) estimates that in just two more decades, this number will exceed 2.5 billion. To help create more awareness, Bonitas Medical Fund is offering free online hearing screening for all South Africans. One of the biggest concerns associated with hearing loss when it is not treated properly is the long-term impact it has on the quality of life. Prevention and early detection are important, after all, hearing is the foundation for speech and language development, as well as learning and communication. Which is why Bonitas Medical Fund has introduced an online hearing screener on its website www.bonitas.co.za. ‘We have partnered with hearConnect to make this functionality available to all South Africans,’ says Lee Callakoppen, Principal Officer of Bonitas. The online, validated speech-in-noise hearing test uses the latest in audiological technology. This is combined with the highest standards of clinical expertise and available on the website. In just two minutes you can test your hearing status. All you need is access to a computer or your mobile, headphones or ear plugs, a quiet area and then you’re all set to take the test. If the screening test indicates you are experiencing hearing loss, hearConnect is available to guide you through the next steps. ‘Our partnership with hearConnect includes a full audiology benefit management programme for our members. This includes a follow up with ongoing treatment steps if hearing loss is detected.’ The introduction of this programme has also improved audiology benefits for Bonitas members – offering full cover all consultations, tests and treatment needs without any unwanted co-payments. This is subject to the use of an audiologist on the hearConnect Audiology Network, hearConnect treatment protocols and clinical pathways. There are many challenges associated with hearing loss. These include language development that impacts our ability to read, write, spell and concentrate. It affects social skills resulting in isolation, depression, loneliness, cognitive impairment, unemployment and an increased risk of dementia. Hearing loss also has a direct impact on healthcare costs. ‘As a medical scheme we know that patients with untreated hearing loss experience more inpatient stays compared to those without hearing loss,’ says Callakoppen. This has a direct impact on healthcare utilisation costs. There is a 17% increased risk of emergency department visits, readmissions and rate of hospitalisation as well as longer hospital stays.’ What causes hearing loss Hearing loss can come about as you age or as a result of loud noises, illnesses and disease, genetics and trauma (contact sport) can also cause hearing loss. Other factors, such as too much earwax, also reduce your ability to hear. Don’t blast your eardrums Overexposure to loud music – or any loud noises – can be harmful. Research indicates that hearing loss results from a combination of sounds being too loud, listening to loud sounds over an extended period and the frequency of exposure. A BMJ Global Health review recently reported that pumping tunes, listened to via ear buds or even live, could be placing up to 1.35 billion young people at risk of hearing loss worldwide. The gift of hearing ‘Our new ABM programme, with hearConnect, supports our initiative with Gift of the Givers and sponsorship to test over 15 000 learners this year. The learners are from Grade R to Grade 12 at schools in in six areas within KZN,’ explains Callakoppen. ‘This project uses a South African manufactured portable audiometer, called the Kuduwave. It’s a state-of-the-art, medically certified device that has revolutionised the testing and diagnosis of auditory related deficiencies. It combines a headset, audiometer and sound booth into a single, lightweight device, which can be used in just about any location. ‘The combination of the online testing through hearConnect and the Kuduwave means we are able to offer a comprehensive hearing testing solution in South Africa,’ says Callakoppen.

June 12, 2023

All about cholesterol

High cholesterol levels go hand in hand with a number of other factors which fall under chronic conditions. It is often as a result of lifestyle factors. According to the South African Heart and Stroke Foundation, one in four adults in South Africa has high total cholesterol, while 30% have a high LDL level and 50% have low HDL Levels. What does this mean? Dr Morgan Mkhatshwa, Clinical Executive at Bonitas Medical Fund takes a look at cholesterol: What it is and why it is used, together with other factors like lifestyle and medical conditions, to estimate your risk of cardiovascular disease. And why knowing your LDL and HDL numbers is important in managing your health. What is cholesterol? Cholesterol [kuh·leh·stuh·rol] is a waxy fat-like substance, made in the liver and found in the blood and cells of your body. We all have cholesterol, it is made naturally and helps to form cells, hormones, vitamin D and bile acid (that helps us digest food). What is the difference between bad cholesterol LDL and good cholesterol HDL? LDL is low-density lipoprotein: It is called the ‘bad’ cholesterol because a high LDL level leads to a buildup of cholesterol in your arteries which leads to a greater chance of developing a heart disease HDL is high-density lipoprotein: Is the ‘good’ cholesterol because it carries cholesterol from other parts of your body back to your liver. Your liver then removes the cholesterol from your body. However, if someone has high levels of bad cholesterol it means they have too much of this fatty substance in their blood and, over time, this could cause arteries to block and result in a heart attack or stroke. Unfortunately, unlike most medical conditions, high cholesterol can go unnoticed and often doesn’t present any symptoms, unless it’s serious enough to cause problems. What test is used to determine the levels of cholesterol in your body? Called a fasting lipogram, it measures the exact amount of different types of cholesterol you have. The SA Heart and Stroke Foundation maintain that healthy cholesterol levels should be: Total cholesterol: Less than 5.0 mmol/l (millimoles per litre) LDL cholesterol: Less than 3.0 mmol/l HDL cholesterol: Greater than 2.0 mmol/1 If your triglycerides (fat stored in the body) are higher than 1.7mmol/l, this is also indicative of a possible cholesterol problem Dr Mkhatshwa cautions that these are variables for the optimal LDL(bad cholesterol) count, according to your risk profile. ‘If you are very high-risk or high-risk the LDL-C goal is 1.8 mmol/l and 2.5 mmol/l respectively. Your doctor will explain these to you, what they mean and the steps you need to take to reduce your LDL count,’ he says. ‘You can then begin to play an active role in managing your own health.’ How often should you be tested? Most healthy adults should have their cholesterol checked every four to six years. People who have heart disease, diabetes or a family history of high cholesterol, need to get their cholesterol checked more often. What diseases or conditions result from high cholesterol levels? When you have too much ‘bad’ cholesterol in your blood, it can cause narrowing and blockages of the arteries – the blood vessels that carry blood to your heart muscle and to other parts of your body. In time, this narrowing can lead to a heart attack, while blockages in the arteries of your brain can cause a stroke. What kind of illnesses or diseases can cause elevated levels of LDL? People with high blood pressure (hypertension) and diabetes often have high cholesterol. Some other health conditions that can also cause raised levels of cholesterol include kidney disease and liver disease. What role does genetics play in high cholesterol levels? The medical term for high blood cholesterol is Familial hypercholesterolaemia. It is an inherited condition characterised by higher-than-normal levels of LDL blood cholesterol. It causes up to 10 per cent of early-onset coronary artery disease – heart disease that occurs before the age of 55 years. The cause is a mutation in a gene. Can I lower my genetically high LDL cholesterol? There is no cure for familial hypercholesterolaemia. Treatment aims to reduce the risk of coronary artery disease and heart attack and may include Dietary changes, including reduced intake of saturated fats and cholesterol-rich foods, and increased intake of fibre. Statins are the most common medicine for high cholesterol. They reduce the amount of cholesterol your body makes and you usually need to take them for life. What lifestyle changes can help to lower cholesterol levels? Losing weight Eating a heart-healthy diet: Focus on plant-based foods, including fruits, vegetables and whole grains Exercising regularly Not smoking Did you know? One third of adults have high cholesterol No one can live without cholesterol High cholesterol could be genetic Even children can have high cholesterol Sweating can raise your good cholesterol levels Supplements may work to lower cholesterol — but slowly

June 9, 2023

Dealing with anxiety during pregnancy

Pregnancy can be a very happy and exciting time of your life, however, it can also be a time that is very difficult for some expecting moms. This is often made more difficult by the fact that many family and friends expect you to be thrilled, and conflicting emotions are often surrounded by guilt. Your mental health is important, and you shouldn’t expect yourself to snap out of it, or soldier on alone. What is anxiety during pregnancy? It’s natural for an expecting mom to have worries, this is a new and ever-changing part of your life. However, if your anxiety is ever-present, can’t be controlled easily and impact on your daily life it may be time to seek help. Worrying is part of being human, and if you have struggled to conceive or have lost a baby before, it’s very understandable that you may worry about your baby’s health. You may also worry about whether you’ll be a good parent or how your family dynamic will change, and these are all normal worries. But if you find your heart racing, your breathing shallow, obsessively worrying with racing thoughts, feeling restless or struggling to eat or sleep you may have anxiety. Anxiety in pregnancy is fairly normal, and you’re more likely to experience it if you’ve had anxiety in the past, have a high-risk pregnancy or are dealing with huge life stresses. What can I do about it? If you think you may have anxiety during your pregnancy, know that you are not alone or abnormal, as many expecting moms have experienced this. If you’re struggling, the best way forward is not put up with it, but to seek help. Speaking to a psychologist is a good way to start dealing with why you are suffering from anxiety and how you can deal with it. Medication during pregnancy can be tricky but are an option if they’ll benefit you and your babies well being. Staying active, eating healthy and trying to get enough sleep are also ways in which you can help yourself. Talking to others that have gone through pregnancy, or making sure that you rely on your family and partner for support are also ways in which you cope with your feelings and feel less isolated.

June 8, 2023

7 Vital health checks for women

When it comes to healthcare, the focus has moved to preventative managed care and particularly, health checks and screenings. These include tests carried out by a medical doctor to check for diseases and health conditions, even before you may have any symptoms. By detecting diseases early on they are often easier to treat. Dr Morgan Mkhatshwa, Clinical Executive at Bonitas Medical Fund, talks about the most important check-ups for women. Breast cancer From the age of 18 you should do regular self-examination of your breasts, if you see or feel any changes, consult your doctor immediately. Early detection increases the chance of survival and can save your life. Some doctors recommend having a mammogram every two years from the age of 40 , others believe you only need to start at 50 years of age. A mammogram is a low-dose X-ray which radiologists analyse to look for changes in breast tissue. Although the greatest risk for breast cancer is age, women can get breast cancer from a very early age, genetics also play a role in determining if you are at risk for breast cancer. Having a first-degree relative (mother, sister or daughter) with breast cancer almost doubles a woman’s risk. Having 2 first-degree relatives increases her risk 3-fold. Breast cancer can affect men too, so women with a father or brother who has had breast cancer have a higher risk of breast cancer. Cervical cancer South Africa has a high rate of cervical cancer which has been attributed to the fact that not enough women are screened regularly. Screening can detect early changes in the cervix which can be treated and save your life. These include: Pap test (pap smear) which looks for cell changes (pre-cancers) in the cervix that may progress to cancer if not treated. The Human Papillomavirus (HPV) test. Looks for the virus that causes most cervical cancers It is recommended that between the ages of 21 and 65, women should have a pap smear every two years and, from the age of 30 onwards, a pap smear and HPV test can be done every 5 years. A vaccine has been developed to protect women from getting HPV. It is administered free of charge, annually, to girls between Grade 4 and 7 (9 to 12 years of age) in all government schools. The HPV vaccination can be a cost-effective strategy in lowering the cervical cancer risk among women in South Africa. HIV/AIDS It is a misconception that men predominantly become infected with HIV/AIDS. Studies show that women are getting infected at a faster rate, particularly in developing countries and are both infected more and suffer more, than men. It is advisable for women to have an HIV test annually. Bone Density As you age, your bones become thinner and weaker. Over time this can lead to a condition called osteoporosis. If you’re aged 65 or older a bone density test is recommended, which is covered by Bonitas. Called a DEXA scan, the frequency of this screening varies depending on your bone density and other risk factors. Your doctor may suggest you have this test earlier if you: Broke a bone in the past Have taken steroids for a long time Have rheumatoid arthritis Are underweight Have a parent who has broken a hip after a minor injury Treatment for osteoporosis is readily available, ask your doctor. Colorectal cancer screening These tests look for cancer in the colon or rectum by checking for tissue growths, called polyps. If you don’t have an elevated risk for cancer, then you should start having these tests when you turn 45. A colonoscopy, where the doctor looks at your entire colon, should be done every 3-10 years depending on what is found during your exam. A Faecal Immunochemical Test (FIT) should happen annually. The FIT is also a screening test for colon cancer which tests for hidden blood in the stool, which can be an early sign of cancer. Skin checks Skin cancer is caused by the abnormal growth of skin cells – usually on the skin that has been exposed to the sun but not always. There are three major types of skin cancer: Basal cell carcinoma, squamous cell carcinoma and melanoma. Examine your skin carefully at least once a month and, if you are prone to getting lots of moles, go to a dermatologist and have the moles ‘mapped.’ If skin cancers are found early and treated, they are almost always curable. If you have a history of skin cancer in your family, have your skin checked regularly by a doctor. Non-communicable diseases (NCDs) Known as lifestyle diseases, NCDs pose some of the biggest threats to the health of South Africans. They are a result of the way we live, combined with genetic, physiological, environmental and behavioural factors. The most common are hypertension (or high blood pressure), diabetes, mental health and obesity. It is imperative to have regular or annual checkups as recommended by your doctor. Weight and BMI Almost 70% of women in South Africa are overweight or obese. The Body Mass Indicator (BMI) is used to check if you are a healthy weight. To calculate your BMI: Divide your weight in kilograms (kg) by your height in metres (m) Then divide the answer by your height again Underweight is less than 18.5 and over 30 is considered obese Diabetes With over 4.6 million people in South Africa living with diabetes, it’s important to check your blood glucose. There are two main types of diabetes: Type 1 and Type 2. They are different conditions but are both serious and need to be treated and managed properly. One of the biggest problems with diabetes is when it remains undiagnosed. This can lead to blindness, heart attackstroke, kidney failure, impotence and amputation, so it’s vital to be checked frequently. Blood pressure Hypertension (high blood pressure) is when blood pressure stays elevated over time. It is often referred to as the ‘silent killer’ since nearly 33% of people who have it,

June 1, 2023

Stress and the physical effects on your body

It is common knowledge that an overload of stress is not healthy and can have detrimental effects on your mental and physical health. Dr Morgan Mkhatshwa, Clinical Executive at Bonitas Medical Fund, discusses how too much stress interferes with the optimal functioning of your body and mind and results in an alarming number of health issues. What is stress? Stress is a natural human response to challenges and threats in our lives. It usually happens when we are in a situation that we don’t feel we can manage or control. Medically, stress causes chemical changes in the body that can raise your blood pressure, heart rate and blood sugar levels. So, what happens to your body? Your Sympathetic Nervous System (SNS) is a network of nerves that helps your body activate its ‘fight-or-flight’ response. This system’s activity increases when you’re stressed, in danger or physically active. The body shifts its energy resources toward fighting off a perceived life threat or fleeing from an enemy. The SNS signals the adrenal glands to release hormones called adrenalin (epinephrine) and cortisol. The fight response is your body’s way of facing any perceived threat aggressively Flight means your body urges you to run from danger Freeze is your body’s inability to move or act against a threat Research suggests that stress also can bring on or worsen certain symptoms or diseases. What are the most common physical symptoms in reaction to stress The cortisol and adrenaline hormones released during a stressful situation can cause several changes in your body, including: Increased heart rate and blood pressure: The increased level of hormones can cause your heart to beat faster and your blood vessels to constrict, leading to higher blood pressure. Digestive problems: Stress can affect your digestive system and cause symptoms such as stomach pain, bloating, constipation or diarrhoea. Weakened immune system: Chronic stress can suppress your immune system and make you more susceptible to infections and illnesses. Muscle tension and pain: Stress can cause muscle tension and pain, especially in your neck, shoulders and back. Headaches: Stress can trigger tension headaches, migraines as well as muscular spasms in the neck and shoulders. Sleep problems: Stress can interfere with your sleep, causing difficulty falling asleep, staying asleep or waking up too early. Skin problems: Stress can exacerbate skin conditions such as eczema, psoriasis or acne. Endocrine disorders caused by stress include thyroid hormones leading to hyperthyroidism or hypothyroidism, ghrelin and leptin, the hormones that regulate appetite, increasing hunger, melatonin, resulting in restlessness and insomnia, insulin, contributing to Type 2 diabetes. Mental health issues: Chronic stress can also contribute to the development of mental health disorders such as anxiety, depression and burn-out. How do you monitor your stress levels? To monitor your stress, first identify your stress triggers. What makes you feel angry, tense, worried or irritable? Do you often get headaches or an upset stomach with no medical cause? Is it hard to focus or do you have trouble sleeping at night? Overall, chronic stress can contribute to the development or worsening of chronic conditions such as diabetes, obesity, depression and anxiety. Stress can be a killer. Which is why it’s essential to manage your stress. Do this through healthy coping mechanisms such as exercise, meditation, deep breathing or seeking professional help, if necessary. And remember, your GP should be your first port of call for all your healthcare needs. We believe there needs to be coordination of care and encourage you to see your GP, who can refer you to a specialist or auxiliary provider as and if the need arises.

May 26, 2023

YOUR GUIDE TO A HEALTHY PREGNANCY

Looking after your health is important, but even more so when you are an expectant mom. There are several steps you can take to ensure you have a healthy pregnancy and give your little one the best possible start in life, here are a few tips brought to you by Bonitas Medical Fund. Eating right is vital Eating healthily during pregnancy will help your baby to develop properly. There’s no need to go on a special diet but, it is important to eat a variety of foods every day to get the right balance of nutrients that you and your baby need. Eating healthily often means just changing the the foods you eat so that your diet is varied. Staying active is a must Regular exercise will help you control your weight, improve circulation, boost your mood and help you sleep better. Pilates, yoga, swimming and walking are all great activities for pregnant women. Aim for 30 minutes of exercise most days of the week. Listen to your body though and don’t overdo it. Be sure to check with your doctor first, before starting any exercise programme. Approach chores with caution Chores like scrubbing the bathroom or cleaning up after pets can become risky when you are pregnant. Exposure to toxic chemicals, lifting heavy objects or coming into contact with bacteria can be harmful. So, avoid heavy lifting, climbing on ladders, changing the kitty litter, using harsh chemicals and standing for long periods of time. Take care of your feet Weight gain during pregnancy throws off your centre of gravity, which puts extra pressure on your feet. This can cause painful flattening out of the feet. You may retain fluids too, which can make your feet and ankles swell. To prevent this, wear comfy shoes with good support. Many pregnant moms find they need a larger shoe size even after they give birth, so go a size up if you need to. Benefits for you and your baby Bonitas offers a wide range of maternity benefits as well as benefits for newborns and babies. These are paid for from Risk so they are in addition to your savings and day-to-day benefits. Some are: Maternity benefits Having children is expensive. That’s why Bonitas pays for your maternity benefits in addition to your savings and day-to-day benefits so you can focus on the things that really matter. Contact The Bonitas Maternity Programme today to see all the benefits when you click here. Bonitas is also in the process of establishing a comprehensive mother and baby support programme which will offer pregnant moms a range of benefits including: 24/7 pregnancy care helpline Dedicated Bonitas care advisors Pregnancy education SMSs and emails Online pregnancy education Bonitas pregnancy events with expert speakers on prenatal and postnatal care The full programme has bee available since March 2020 and will ensure there is sufficient support for moms throughout the pregnancy journey. Education and information will be provided to allow for healthier pregnancies which in turn could support higher incidences of natural birth. But there will also be management and support for pregnancy complications including miscarriage and gestational diabetes. In addition, your stay in hospital when your baby arrives will also be covered. Please make sure you pre-authorise your hospital stay after your 24th week of pregnancy. Please note: Your maternity benefits will depend on the medical aid option you have selected. Newborn hearing screening Significant hearing loss is the most common disorder at birth which is why screening all newborns for hearing loss is internationally recommended. We cover two electrophysiological techniques, auditory brainstem responses (ABR) and optoacoustic emissions (OAE) for all babies under 8 weeks old, in or out-of-hospital allowing you to ensure your baby’s hearing is intact or intervene early if necessary. Congenital hypothyroidism screening Cover for TSH tests (to screen for congenital hypothyroidism) is available on all options for children under a month old. Help is just a call away with BabyLine BabyLine (0860 999 121) is the first dedicated children’s health advice line in South Africa. It is available 24 hours a day, 365 days a year. The service is run by paediatric-trained nurses who assist with any queries related to your little one’s health and wellness. The benefit is available to all Bonitas members and is for children under 3 years, it offers: Home care advice Clinic/primary care/GP referral for the same day Clinic/primary care/GP referral for the following day After-hours care within the next six hours Immediate referral to the E

May 22, 2023

All you need to know about your newborn

Newborn Hearing Newborns can hear immediately upon birth and are able to distinguish their mother’s voice above all else. If your baby does not seem to react to your voice or does not startle with a loud noise, be sure to tell your paediatrician. Stimulating your baby’s sensesBelieve it or not your baby will learn a lot in their first year of life. One way you can help them learn is to provide stimulation for them in different forms. This can be done in a variety of ways such as stimulating their vision and hearing or through touch and movement. Remember to spend some time every day working to help your baby explore the world around them. Stimulating your baby’s vision Here are a few ways to help stimulate your baby’s vision: Make eye contact with your baby during times when their eyes are open. Look them right in the eye. They recognize faces very early in life, especially yours!This helps them develop their memory. Use a mirror to let your baby stare at his or herself. They will enjoy looking at “another” baby and watching the movements it makes. Stick out your tongue for your baby or make funny faces. Starting at 2 days old newborns can begin to mimic simple facial movements as they begin to develop problem solving skills. Hold up two pictures for your baby to look at. They should be similar, but with some sort of difference between the two – maybe one has a house and the other doesn’t. Even young babies will look back and forth between the two to try and figure out the difference between them. This can help them develop letter recognition and reading skills later. Stimulate your baby with laughing and singing Laughing and singing are great ways to stimulate your baby and have fun at the same time. Here are a few suggestions: Find ways to get your baby laughing. This can be through methods like gentle tickling, blowing on their arms and tummy, or making funny faces. As they get older you can joke around more too. Laughter is great for babies! Sing song to your baby. Learn as many as you can or make up your own words to songs you already know. Play music to your baby. This can be Bach or Mozart or even the Beatles. Learning music rhythms may help them learn math skills later on. Talk away. In other words, have a silly, fun conversation with your baby. Chat away and pause at places where your baby would speak in the conversation. As your baby grows, they will learn to start chatting to fill in the spaces you leave. Be sure to make eye contact and smile a lot! Play peek-a-boo, it’s great for getting babies to giggle and laugh – it also teaches them that objects can disappear and then come back. Physical activities for your baby As your baby gets older and is more mobile encourage physical activities that can help with motor skills, coordination and problem-solving. Here are a few suggestions: Turn yourself into a playground by lying on the floor and letting your baby crawl all over you. This will help boost their problem-solving skills and coordination. Teach them to move to music. You can teach them to do the twist, twist and shout or even twirl like a ballerina. This helps them develop skills like balance and coordination as well as a sense of rhythm. Create an obstacle course by laying toys, boxes or sofa cushions on the floor and then show your baby how to crawl over and around or under the items. This helps with problem-solving, strength and coordination. Play pick up by allowing them to drop toys or pieces of wadded up paper off their highchair into a bucket or other safe container. This helps them learn and explore the laws of gravity.

May 22, 2023

Mental health and pregnancy – Antenatal depression

Your health during and after your pregnancy is important to both you and your baby. Normally when people think health, assume physical, but your mental health is just as important. If you are struggling with anxiety and depression during your pregnancy, this is known as antenatal depression. You’re probably chalking your mood swings and doubts down to pregnancy hormones, but when should you start to be worried about your mental health during pregnancy? What is antenatal depression? Mood swings during pregnancy are fairly normal, as your body is adjusting to changing hormones. Not only are your body’s hormones changing, but the emotional, physical and psychological changes that you are going through during pregnancy can also be overwhelming. Most antenatal care focuses on physical health, meaning depression and anxiety are often overlooked during pregnancy. Postnatal depression is far more commonly addressed than prenatal, and it is important that both are equally acknowledged – your mental health is always important. Antenatal depression is different from mood swings in the way that it is a persistent feeling of sadness or loss. Many of the symptoms of depression are similar to what can normally be experienced during pregnancy, such as fatigue and changes in sleep patterns. However, when you are struggling to function normally day to day, or your symptoms persist for weeks on end, it may be time to find professional help. What can I do if I think I have antenatal depression? If you are worried that your feelings of frustration or sadness are not just normal pregnancy blues, here is what you can do to help yourself. Talking to a professional is always a good first step as they can guide you in a direction that will work best for you and your baby. You could help yourself feel better by looking after yourself. Eating healthy, exercising and sleeping well are all ways in which you can boost your serotonin levels. Speak to people with similar experiences or open-up to your close friends and family. Building your support network can help you feel less isolated and alone.

May 15, 2023

YOGA AND PILATES FOR PREGNANT MOMS

Staying active during your pregnancy is another important way of staying healthy. Not only is exercise good for you physically, but it helps relieve stress, improve sleep and boost your mood. However, being pregnant, especially later on in your pregnancy, means that you’ll need to consider what exercise you’re doing. Contact and high-risk sports are a no-no, but if you are looking for a way to stay fit, prenatal yoga and pilates could be your answer. Why yoga and pilates? Prenatal yoga and pilates can help you strengthen your body, stop excess weight gain and help prepare your body for childbirth. Both are low impact and can be adjusted to suit you and your growing baby. During your pregnancy, you may experience backache, aching legs and abdominal pain. Providing nothing serious is wrong, yoga and pilates can help alleviate pain through strengthening your body. Prenatal yoga and pilates classes are specifically tailored to expecting moms, so should be completely safe unless you are recommended otherwise. Getting ready for birth Not only can these practices help reduce stress and anxiety, but they can also help you during childbirth. The combo of stretching and strengthening your body should mean that your body is more equipped to deal with the stress of labour and birth. Strong core and pelvic will help support your spine and help you during birth. Joining prenatal yoga and pilates classes will help you connect with other expecting moms and, a professional can guide you through which poses are best for you throughout your pregnancy. Not only can yoga help you physically, but the breathing techniques you’ve learnt can help calm and focus you during labour. Is there anything I should be cautious of or avoid? Although good for you, there are still certain yoga and pilates poses and exercises that you should avoid during your pregnancy. If you are new to yoga and pilates, most studios offer prenatal classes for beginners, and, if you are practising already you can probably continue with most of your practice, just let your instructor know you’re expecting – they can help you modify your routine. Things to be cautious of are hot yoga, full inversions (poses on your head), deep twists and exercises that cause you to crunch your abdominal cavity. Your body is in constant flux as your baby develops, meaning some days you’ll feel energised whereas otherwise will leave you feeling drained. Because of this, it’s important that you are aware of how your body is feeling while practising. If you notice anything unusual or painful it’s best to chat with your doctor.

May 8, 2023

Preterm Labour

Although most moms pregnancies last 40 weeks (your baby will have spent 38 weeks in your uterus) sometimes birth can begin prematurely. If you go into labour anytime between week 20 and 37 is known as preterm labour. A baby delivered before this is known as miscarrige, and anytime after week 37 is considered normal. If you suspect you’re going into labour early it’s critical that you contact your doctor as quickly as possible so that they can assist you. Ideally your baby needs to stay in your uterus until full term, but even if your baby is premature (sometimes called a preemie) they can still go on to lead a healthy life. Here are the signs of preterm labour, how you can try prevent it and what to do if you think that your baby might be coming early. How to decrease your risk of preterm labour There are some things that increase your risk of going into premature labour – however, that being said, just because your risk factors are low, you aren’t guaranteed not to go into preterm labour. Firstly, throughout your pregnancy staying healthy is critical. Smoking, drinking and recreational drug use are all activities that increase your risk of preterm labour (amongst other things). Good nutrition and prenatal care is a key aspect of a healthy pregnancy and baby. Other risk factors include, having more than one baby in your uterus, short intervals between pregnancies and having had another baby preterm. There are certain infections and chronic conditions that can also contribute to preterm labour. Preeclampsia, gestational diabetes, depression, chronic kidney or heart disease or infections can all lead to preterm labour and birth. Signs and symptoms that you may be experiencing preterm labour Controlling what you can, keeping a healthy pregnancy lifestyle and maintaining good prenatal care are not guarantees for your baby’s timely arrival. However, spotting preterm labour early means that you’ll be able to receive treatment as quickly as possible. Backache and pressure in your lower belly (almost as if your baby is pushing down) as well as bell cramps and contractions are all signs of premature labour. These contractions are different to Braxton Hicks contractions as they are regular. Other signs include a change in your vaginal discharge to watery or bloody, or even experiencing a gush of fluid from your vagina. What happens if I go into preterm labour? If you suspect preterm labour let your doctor know right away. Once you have alerted your doctor they’ll give you medication to stop the birth or slow down your labour. How close you are to your due date will impact on how they decide to treat you. You may be given medication to slow or stop your contractions, as well as medication that will help your babies lungs mature and grow, as if they are born preterm they may not work on their own. If your baby is born preterm it is likely they’ll need special care from the hospital as they are at higher risk of health complications. However, even if your baby is preemie they can still go on to live a healthy life.

May 2, 2023

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