Expert Advice from Bonitas Medical Fund
Bonitas – innovation, life stages and quality care

Vaccinations proving to be the best defence

As the fourth wave of Covid spreads, South Africa is seeing a considerable increase in positive cases. Just as the Delta variant became part of our daily vocabulary, the Omicron or BI.I.529 strain has too. Omicron has more than 30 mutations (double those carried by Delta) that may have an impact on how it behaves. This includes how easily it spreads and the severity of the illness it causes. The Omicron variant was found in 74% of the 249 Covid-19 samples that were gene-sequenced in November in SA. It appears with more than double the mutations carried by Delta, Omicron is virulent enough to take over from Delta. Current international data shows that there are far more positive cases, meaning that Omicron appears to be highly transmissible. However, although more people are testing positive, they are presenting with mild symptoms with fewer hospital admissions. Medical professionals believe this is a direct result of the immunity acquired through vaccinations. The first wave of Covid-19 took the world by surprise but globally everyone is better prepared for this new wave. This includes a sustained effort to vaccinate as many people as possible. What the World Health Organization (WHO), the National Institute for Communicable Diseases (NICD) and most people involved in the healthcare sector agree on unanimously, is that the best form of protection from serious disease is vaccination.  Lee Callakoppen, Principal Officer, Bonitas Medical Fund says, “We have been proactive in urging our members and the public to be vaccinated. Our statistics show that, of our members over 60, there are 90% fewer admissions to hospital after full vaccination and 56% fewer after one vaccination. Research across the public healthcare environment has shown the same results. With this information freely available it is disturbing that only 16 944 413 people living in SA have been vaccinated. This is only 35.5% of adults and 23.7% of the total population. ‘The cost of hospital admissions too, especially ICU, are very high. Our figures show that up to November 22, the Bonitas Covid-19 costs totalled R1.75 billion. 80% of this (R1 399 181 922) was hospital costs, while only 4.9% (R85 669 068) was for vaccinations.  ‘The average cost of admission to ICU, per patient, was R533 969. There is no doubt that vaccinations not only save lives but also reduce the burden on the public healthcare system, as well as save the country billions in costs related to treating Covid. Vaccinations are a fraction of the cost of treating Covid.’ Both in the public and private sector, the unvaccinated are filling our hospitals. Dr Waasila Jassat, from NICD, announced at the end of November that ‘unvaccinated patients suffered more severe symptoms than vaccinated ones and were most likely to face hospitalisation if infected by the new Covid-19 variant.’  She said that 90% of patients admitted to hospital in Pretoria (one of the current hotspots) are unvaccinated. ‘Not only is there a higher incidence of hospital admissions but also that the chances of death amongst unvaccinated are considerably higher.’ Callakoppen says there is enough clinical evidence to show that the vaccination reduces the severity of Covid and he encourages everyone to be vaccinated. He urges those who have been vaccinated to encourage others to do the same. However, this doesn’t mean you can forgo following the Covid protocols: Wearing a mask; sanitising your hands, maintaining social distancing; staying in well ventilated spaces; coughing or sneezing into your elbow or a tissue. Bonitas has reported the following Covid related figures for 2021 as of 22 November. Total lives older than 18 estimated to have received at least 1 jab 66.4% Total tests performed:  441 929 Total Covid-19 hospital admissions: 20 376. (12 264 during 2021) Bonitas lives currently in hospital: 0.3% Admission rate: 25% ICU Admission Rate: 22% Total Covid deaths: 3 515 (2 292 in 2021)  Total Bonitas membership vaccinated: 70% Highest number of people vaccinated is in the 35-49 age group followed by the over 60s ‘I must reiterate that our best defence against Covid-19 is to be vaccinated,’ says Callakoppen. ‘It won’t necessarily stop you from getting the coronavirus but it will reduce the severity of the disease. I contracted Covid in September but thankfully because I was fully vaccinated, my symptoms were mild which meant I was able to heal and recover at home. My experience is not unique.’   Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund answers some common questions around Omicron What is it? It’s a new, heavily mutated Covid variant known as BI.I.529. When was Omicron first detected? The earliest sample was detected on 11 November in Botswana. Is it more transmissible? Circumstantial evidence indicates it is. Within two weeks of its detection, it has outpaced Delta to become the main strain in Gauteng. Will vaccines work against it? Yes, most likely. A crucial objective remains to increase vaccination rates. Current vaccines remain critical to reducing severe disease, hospitalisation and death. Should updated vaccines be developed, they will be rolled out globally and used as guided by WHO. Will prior infection provide me with immunity? Preliminary evidence suggests there may be an increased risk of reinfection with Omicron but information is limited. More information on this will become available in the coming days and weeks. What about treatment? Currently Oxygen and Dexamethasone have been saving lives. There is however very exciting data coming from two antivirals. What about the current tests? The widely used PCR tests continue to be the global standard to detect infection including Omicron. Studies are ongoing to determine whether there is any impact on other types of tests including rapid antigen tests.

December 7, 2021
Bonitas – innovation, life stages and quality care

Medical aids can’t bear the brunt of hospital increases

Hospital admissions are one of the biggest cost drivers for any private medical scheme which is why the tariffs are under review and negotiated annually by Bonitas Medical Fund. If no agreement is reached, medical aid members will bear the brunt of high co-payments. According to Lee Callakoppen, Principal Officer of Bonitas Medical Fund, hospital admissions account for half of the Scheme’s annual claims cost. ‘Last year due to the pandemic, hospital admissions and the utilisation of other medical aid benefits fell to record lows. However, the 2021 claims’ experience has shown that a lot of services, particularly the day-to-day benefits and several hospital admission categories, are already close to 2019 levels.  Since the start of the pandemic Bonitas has spent more than R2,7bn on COVID-19 related costs, of which R1,73bn pertain to 2021 year-to-date. More than 80% of these COVID-19 costs relate to hospitalisation. Non-COVID utilisation patterns are almost back to typical levels and, since June this year, overall claim ratios have returned to pre-COVID levels. Schemes are therefore not generating the same level of short-term surpluses in 2021 as was seen in 2020. ‘We anticipate that during 2022, utilisation is going to go back to where it was in 2019 or even higher. Which is why it is critical that schemes, such as Bonitas and hospital groups, through an annual negotiation process agree fair and equitable tariff charges, to ensure the lowest possible increases in the interest of members. This will not only help keep costs down but also ensure quality and affordable healthcare for current and future members, while maintaining the sustainability of schemes. We must acknowledge that over the last three years concerted efforts have been made by hospital groups to support and keep tariffs low. However, there are still significant opportunities to drive healthcare cost down. ‘We know that all sectors had been hard hit by the pandemic and the poor economic outlook in this country. Healthcare and medical schemes are no exception. However, we need to remain mindful that key to the survival of the private medical aid industry is its members. If hospital costs balloon above CPI, so will membership premiums, which will result in medical aid becoming unaffordable. We are appealing to all our service providers, including hospital groups, not to pass their costs on to schemes and, by extension, to members.  The pandemic saw healthcare facilities and healthcare providers intensify their efforts to ensure that South Africans received the appropriate care for Covid-19 as far as possible. And while their efforts have been lauded, consumers have had to contend with tough conditions as well.  Moving into 2022 There are major concerns about 2022 utilisation levels, notably due to the risk of an increased burden of disease due to gaps in care that may have arisen during the pandemic, which is no fault of any party. We anticipate an elective procedure claims catch-up after so many were cancelled in 2020 and 2021 during national lockdowns. Other areas of concern include the unknown impact of long-haul COVID as well as new or more expensive COVID-19 treatment costs, including booster vaccines, which may emerge,  All stakeholders in the healthcare value chain need to be prudent in managing their costs of doing business. The intention of negotiated hospital tariffs is to reach an agreement that supports sustainability of the healthcare ecosystem and, ultimately, members. The issue comes when there is no agreement reached and members may have to pay in the difference between what the hospitals charge versus what the scheme is able to pay. We try to avoid such a situation so as not to have a negative member impact, but if parties are unreasonable in their demands, this situation may arise.’ To assist our members and reduce the effect of significant contribution increases for 2022, Bonitas used R600m of its reserves to keep increases as low as possible. Contribution increases were kept below 5% for both 2021 and 2022 despite underlying claims expenditure increasing by a significantly higher margin. Bonitas’ medium-term objective is to sustain solvency levels above the statutory minimum of 25% and to make strategic decisions about current reserves in the interests of its members. This while facing significant uncertainty, especially in terms of the cost and prolonged impact of COVID-19, non-COVID-19 utilisation and roll-out of vaccines. All non-healthcare costs are capped below CPI for 2022.  However, if healthcare providers and hospital groups do not negotiate favourable tariffs for the year ahead, it results in higher increases in the long run, for all patients and unnecessary out of pocket costs.  The benefits of negotiations Negotiations resulted in a 3.1% saving in 2021 terms – these savings could exceed R200 million in 2021 – while in 2020 strategic purchasing yielded hospital negotiation savings of R346 million. These savings contribute to a lower contribution increase. The impact of failed negotiations However, when the costs of doing business is passed on to schemes and, by extension, customers – or medical aid members – things become complicated, especially where tariff increases agreements cannot be reached.  In these instances, there are two possible scenarios: A scheme pays what it deems to be a reasonable rate and the hospital bills its rate. This means the member would be required to pay in the shortfall on the account unless the hospital decides to override the difference A scheme excludes the hospital from on its network and actively discourages a member from using this hospital. The member may need to pay a deductible or co-payment if they choose to be admitted at this facility unless the hospital decides to override the difference. ‘Neither of these situations is a favourable outcome,’ says Callakoppen. ‘Which is why reaching a workable middle ground on hospital cost/tariffs is imperative.’

November 17, 2021
Parenting Hub

Walking the road to wellness

Being healthy and living a full life is what we all want, for ourselves and our family.  An important part of life’s wellness journey is about having the right people to support you – physically, emotionally, mentally and even financially – when it matters most. The latest television ad by Bonitas Medical Fund underpins this ‘holistic’ healthcare message in a simple, real and compelling way. It addresses the fact that medical aid is a necessity but expands on the message to show how the Scheme acts in the best interests of its members and ‘has a plan’ for everyone.  The story is one of perseverance and tenacity as a father tackles his tough wellness journey with the support of his family, friends – and medical aid – in order to walk his daughter down the aisle. ‘The story is about protecting our loved ones and making sure they have the best care possible,’ says Lee Callakoppen, Principal Officer of Bonitas. Produced by Joe Public and shot over three days in various locations, the advert reinforces the Bonitas’ brand strategy of being the ‘Medical Aid for South Africa’ while it introduces a campaign takeout referencing affordable and accessible quality healthcare and better benefits that don’t impact your savings. ‘We are a unique medical scheme,’ explains Callakoppen. ‘In that we offer medical aid solutions for all sectors of the market and the South African population. Our advertising needs to be slightly disruptive and set us apart, which is why we chose to portray a real life family dealing with a healthcare situation that was impacting their lives and future.  ‘We’re always taking strides to see how we can provide our members with more value – and connect with them more strongly. Be it through competitive plan design, the introduction of new benefits that add meaning to their lives or innovation in the way we communicate and engage with them.’ There are several versions of the ad including a 60s, 30s and three 10s which will be flighted across a range of DStv channels as well as Business Day TV, ENCA, eTV and SABC. Supporting the campaign will be radio, print and digital adverts. ‘We are passionate about ensuring South Africans make informed decisions about their healthcare and that they have the cover they need, when they need it. Our hope is that this TV advert will resonate well with viewers and get them thinking about the future of their health.  We believe ‘when I becomes we, illness becomes wellness’ and would like to be the medical aid that takes the wellness journey with them.’ Click here to view the latest Bonitas Medical Fund TV advert

November 10, 2021
Bonitas – innovation, life stages and quality care

Keeping kids healthy throughout the year

Parents are often very good about getting their children off to a healthy start at the beginning of the year with medical check-ups and healthier schools lunches but it’s equally important to maintain a healthy lifestyle throughout the year. So, here are some tips on what you should be doing to maintain your child’s health.

November 8, 2021
Bonitas – innovation, life stages and quality care

Keep your kids moving

Winter is here and with it comes colder weather, making getting outside to play and exercise more of a challenge. But it’s still important. Bonitas Medical Fund suggests you try and keep your child active throughout the year and provides some suggestions to get them moving, exercising and having fun.

November 1, 2021
Bonitas – innovation, life stages and quality care

Home-based care – there is no place like home

The shift towards home-based care was accelerated by the Covid pandemic. Although not necessarily always possible for Covid patients, the benefits of home-based care vs hospitalisation have been highlighted for both patients and their families for several procedures and illnesses.  Dr Morgan Mkhatshwa, Head of Operations at Bonitas Medical Fund, says the Scheme has a renewed focus on home-based as an alternative to in-hospital care, without compromising the health of its members.  What is home-based care? It’s defined as the provision of health services, by healthcare practitioners and formal and informal caregivers, in the home. Home-based care is to promote, restore and maintain a patient’s maximum level of comfort, function and health, including care towards a dignified death. It can be classified into preventive, promotive, therapeutic, rehabilitative, long-term maintenance and palliative care categories. When is home-based care appropriate? Post-operative care – after a surgery or procedure so that you gain your independence and become as self-sufficient as possible Generalised illness – when you are ill enough to be admitted to hospital but can be treated at home by healthcare practitioners Palliative care – when you have life-limiting illnesses and the focus is on the relief of symptoms, pain and stress. Some patients may also receive therapeutic treatment.  The primary benefit of home care is that you are in a space which is familiar and usually surrounded by loved ones. This is beneficial not only for those recovering from a disease or needing palliative care but especially those who have cognitive diseases such as dementia.   The alternative to hospital strategy (ATH) Dr Mkhatshwa says, ‘Hospital-at-home enables some patients who need acute-level care to receive care in their homes, rather than in a hospital. This care delivery model has shown to reduce costs, improve outcomes and enhance the patient experience. The need for home-based care is not only because of the cost of hospital care but a shortage of beds, nursing staff and other healthcare professionals, particularly in the public sector.’   ‘Bonitas is constantly looking for ways in which to minimise contributions and add value for members.  It is common knowledge that hospitalisation costs are the main cost driver for all medical schemes. Even with 24-hour professional care at home the costs are far less. Most medical aids will pay for nursing care at home For this reason, Bonitas’ partnered with Quro Medical, an innovative South African digital health company, to provide patients with active treatment by healthcare practitioners at home. The technology-enabled hospital-at-home service brings all the essential elements of in-hospital care to the patients’ home, without moving away from evidence-based protocols and state-of-the-art vital sign monitoring. Patients are monitored wirelessly, automatically and continuously to enable early identification of significant clinical change or deterioration. In fact, research has shown that, ‘patients admitted in the home programme were less likely to return to the hospital within 30 days of their discharge’. ‘The partnership also offers earlier and safer relocation to the home,’ says Dr Mkhatshwa’ home-based care is offered to all members, subject to pre-authorisation and Managed Care protocols. ‘It’s important to note that the treating doctor remains at the centre of the patient’s care. While patients who are medically stable may qualify for home-based care, each and every one is different and their response to hospitalisation and/or surgery differs. This means each request has to be reviewed carefully to ensure we provide quality care to deliver the best possible health outcome for the patient.’ The advantages of home-based care Health care at home, in a comfortable environment, improves patient participation in treatment. Having family members and loved ones participating in the care of a loved one – such as helping with bathing, feeding – makes a significant difference in the outcome.  Personal attention Hospitals, out of necessity, have strict rules so instead of the patient adjusting to these, they can be at home, amongst family and in familiar surroundings.  Nursing sisters or carers come to the home for a few hours a day, full time or when the need arises There are no visiting hours and the patient is the primary focus of the caregiver, so needs are met faster and more time is spent with patients.   This also means a faster recovery and the chances of picking up an infection, which can happen in hospital when they are exposed to germs, is reduced. Independence and companionship Losing independence is always a huge concern for those chronically ill or the elderly.  Having home-based care means they have more control and can decide when they want to eat, drink, socialise and sleep.   Companionship A caregiver provides your loved one with a familiar face, friendly conversation and a meaningful human connection, all of which can have a big impact on overall health and well-being. Family involvement Home care enables the family to play a larger part in their loved one’s care plan, this includes a direct line of communication with the caregiver and a care manager providing frequent updates regarding care. Pets It is common knowledge that pets are beneficial to those who are vulnerable and home-based care means pets can stay with their owners. They help calm dementia patients, reducing heart disease and stress related conditions and generally make patients happier.  What about home-based care for COVID-19 For patients with mild disease, home management may be possible, provided they are not at high risk of deterioration (i.e., older than 65 years or presence of co-morbidities). Dr Mkhatshwa says, ‘It must be stressed that while hospital care is indispensable for patients in critical condition, home health care is equally right for thousands of people. This personal approach to treatment gives patients the confidence they need to lead independent, full lives. We have no doubt that this is going to play a key role in the future of healthcare.’

October 13, 2021
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Advice from the experts
Milas Meals

Nutrient Enhancers: my kind of food additives!

This is an excerpt from my book ‘Mila’s Meals: The Beginning & The Basics’ I’m talking about egg yolk, ghee, flaxseed oil, coconut oil, hemp seed oil, olive oil, sauerkraut liquid, kefir, cinnamon, nutmeg, clove, vanilla, ginger, cardamom, allspice, turmeric, broth, dulse, liver, blackstrap molasses, baobab, cacao, hemp, lucuma, maca, moringa.  It is important for me to make every mouthful of food that Mila swallows as nutritious as possible because: Good nutrition is so important at this stage of life Only a small amount of food is going to go in (at the beginning for some, or forever like with Mila) And because a lot of food is going to be turned away or spat out when the toddler emerges… So I developed a list of ‘nutrient enhancers’ – nutrient-dense foods which can be added to almost any purée or meal without significantly changing the taste, texture or appearance… because trust me… there is no greater food detective than an 18-month old! An excellent example of where nutrient enhancers shine their bright light is in the preparation of plain noodles. “Plain noodles?” I can hear you exclaim! Trust me, there will come a time when your toddler will only want to eat plain noodles, repeatedly, for months on end – and you will make them for her… because you need to choose your battles wisely, because it is the end of a long day, because you have another baby to take care of or because you are tired! So this is as plain as Mila’s plain noodles got: I cooked the gluten-free noodles in bone broth with some seaweed (wakame or kombu). Once cooked, I stirred in a raw egg yolk, some coconut oil, a pinch of sea salt and a sprinkle of dulse. Ta da! Plain noodles… that were eaten with glee! Get creative… there is no end to how sneaky you can be! Nutrient Enhancer: Why is it valuable? Eggs Eggs are a source of high-quality protein and have all the B vitamins (including vitamins B1, B2, B3, B5, B6, B12), as well as choline, biotin, folate and cholesterol, selenium, iodine, omega-3 fatty acids, vitamins A, D and E. Avoid the egg whites for your little one’s first year as these contain difficult-to-digest proteins and are what usually cause an allergic reaction. Egg yolks should be softly cooked in the beginning, but from 1 year of age you can add them in raw. They can be blended into all plant-based purées to add fat and protein. GheeFlaxseed oilCoconut oilHemp seed oilOlive oil Adding some healthy fats to your little one’s plant-based purées and meals will aid the absorption of vitamins A, D, E and K. Healthy fats are essential for your little one’s brain development Sauerkraut liquidKefir These will supply probiotics – vital friendly gut bacteria that complete the digestion process, produce vitamins, keep pathogenic (‘bad’) bacteria in check, and support the immune system. Get my sauerkraut recipe here CinnamonNutmegCloveVanillaGingerCardamomAllSpiceTurmeric Spices are a great way to develop your little one’s flavour palette. They also have medicinal qualities and are a source of nutrients. Cinnamon is a great source of manganese, fibre, calcium, potassium, iron, zinc, magnesium and vitamin A. It is known to have antioxidant, anti-diabetic, antiseptic, local anaesthetic, anti-inflammatory, warming and anti-flatulent properties. Nutmeg is a good source of potassium, calcium, iron, manganese, vitamins A, B’s and C. It is a useful remedy for: insomnia, anxiety, nausea and vomiting, indigestion (gas) and diarrhoea as well as being anti-inflammatory and antibacterial. Cloves are a great source of manganese, vitamin K, dietary fibre, iron, magnesium and calcium. They are well known for their ability to relieve tooth and gum pain, aid digestion and provide relief from asthma and bronchitis. Vanilla has antioxidant, anti-depressant and anti-inflammatory properties. Ginger is a good source of vitamin C, magnesium, potassium, copper and manganese. It is a remedy for headaches, motion sickness, nausea, indigestion, wind, colic, cold, flu, bronchitis. Ginger tea is a useful remedy for morning sickness. It boosts the immune system and protects against bacteria and fungi. Cardamom is a great source of iron, manganese, potassium, calcium, magnesium, dietary fibre, riboflavin, niacin and vitamin C. It is used as an antiseptic, antispasmodic, carminative, digestive, diuretic, expectorant, stimulant and tonic. It is a remedy for sore throats, constipation, indigestion and colic. Allspice has a good amounts of potassium, manganese, iron, copper, selenium, magnesium, vitamin A, vitamin B6, riboflavin, niacin and vitamin C. It has antiinflammatory, warming and soothing and anti-flatulent properties and is known to aid digestion. Turmeric is a powerful anti-inflammatory and antioxidant and an excellent source of iron, manganese, vitamin B6, dietary fibre, potassium, vitamin C and magnesium Broth Instead of using water to thin a purée or to cook the vegetables in, use bone broth. Bone broth: builds a healthy gut and digestion aids muscle repair and growth fights inflammation creates a balanced nervous system and a strong immune system inhibits infection caused by cold and flu viruses helps protein and mineral absorption promotes strong, healthy bones It is a source of calcium, magnesium, phosphorus, sulphur, boron, zinc, peptides (healing amino acids and natural antibiotics), collagen, omega-9s, iron, vitamin B6 and B12. All the nutrients are easily absorbed by your little one’s body (bio-available). Get the bone broth recipe here Dulse Dulse is an excellent source of calcium, potassium and vitamin B12 – making it a useful addition to any dairy-free or vegan diet. It is also a great source of protein, vitamins B6 and A, iron, phosphorus, manganese and iodine. Sprinkle dulse flakes into purées, or other meals. Liver Liver is an excellent source of high quality protein, omega-3 fatty acids, vitamin B complex (including choline, B12 and folate), a highly bio-available form of iron, vitamin D, vitamin E, pre-formed vitamin A (retinol), vitamin K2, various amino acids and trace minerals such as copper, zinc, chromium and cholesterol. A small amount (1 teaspoon) of raw liver can be grated into any purée. The liver must be frozen for 2 weeks before using it raw (fourteen days will ensure the elimination of pathogens and parasites). Alternatively add some Chicken Liver pâté into purées of other meals. Blackstrap molasses Blackstrap molasses is one way to boost your little one’s iron intake. Its other nutrients include manganese,

July 13, 2020
Paarl Dietitians

Vegan – Is it healthier?

As popular campaigns like ‘Veganuary’ fuel New Year’s pledges to cut back on meat, MANY people has been asking my opinion on vegan diets and on documentaries such as ‘The Game Changers’. If you are intrigued – keep reading.

July 13, 2020
Paarl Dietitians

Lockdown Weight Gain

Since being back at the practice and seeing patients, we found that majority of people have gained 1-3kg during the lockdown period. This weight gain occurred despite eating ‘ok’ and doing some form of exercise.

June 29, 2020
Happy Family Organics

How to incorporate yoghurt into your child’s diet by Happy Family Organics

The yoghurt section in the grocery store seems to be expanding every year, and it’s no wonder why! Yoghurt is a versatile food that can be eaten as part of a meal or snack, and can be incorporated into many recipes from dips to dressings to desserts. Yoghurt contains protein, fat and carbohydrates, as well as the nutrients calcium, potassium, phosphorus and is often enriched with vitamin D.

June 25, 2020
OneAid

Face masks in children: how safe are they?

If you follow me on social media you would have noticed me going on a lot about face masks recently. It’s very important for the public to know how to use them correctly because otherwise it’s such a wasted effort.

June 22, 2020
Parenting Hub

Infertility: Don’t wait until it’s too late!

Parenthood is undeniably one of the most universally desired goals in adulthood, and most people have life plans that include children. However, not all couples who want a pregnancy will achieve one spontaneously and a proportion will need to seek medical treatment to help resolve underlying fertility problems. It’s therefore understandable that infertility has been recognised as a public health issue worldwide by the World Health Organisation (WHO).  “Infertility is when you cannot get or stay pregnant after trying for at least a year and you are under the age of 35,” says Dr Sulaiman Heylen, President of the Southern African Society of Reproductive Medicine and Gynaecological Endoscopy (SASREG). One in every four couples in developing countries is affected by infertility, while one in six couples worldwide experience some form of infertility problem at least once during their reproductive lifetime. The current prevalence of infertility lasting for at least 12 months is estimated to affect between 8 to 12% worldwide for women aged 20 to 44. In recent years, the number of couples seeking treatment for infertility has dramatically increased due to factors such as postponement of childbearing in women, development of newer and more successful techniques for infertility treatment, and increasing awareness of available services. This increasing participation in fertility treatment has also raised awareness and inspired investigation into the psychological ramifications of infertility. It can cause stress, depression and anxiety, which is why it is important to know that there are options available for treatment. Age is a key factor “Up to 50% of all patients who visit a fertility centre are 35 or older. We cannot stress enough how important it is for people not to wait too long when they consider having children. Young women need to be aware that there is a slow decline in fertility from their 20s until the age of 35, after which it starts to decrease rapidly until the age of 45,” says Dr Heylen. “It’s extremely important for couples to investigate fertility options and fertility preservation earlier in life, rather than leaving it too late. A woman who is not ready to have a child can choose to freeze her eggs to try to preserve her ability to have a child later,” says Dr Heylen.  It’s estimated that 20 to 30% of infertility cases are explained by physiological causes in men, 20 to 35% by physiological causes in women, and 25 to 40% of cases are because of a problem in both partners. In 10 to 20% no cause is found. Infertility is also associated with lifestyle factors such as smoking, body weight and stress. A woman’s age is one of the most important factors affecting whether she is able to conceive and give birth to a healthy child. This is due to several changes that are a natural part of ageing:  The number and quality of eggs (ovarian reserve) decreases naturally and progressively from the time a woman is born until the time she reaches menopause.  It is not only more difficult to get pregnant (conceive), but miscarriage and chromosomal abnormalities in the child (such as Down syndrome) are more common in older mothers. Fibroids, endometriosis, and tubal disease are more common and can affect fertility. Women who become pregnant at an older age have a higher risk of complications during the pregnancy, such as gestational diabetes and preeclampsia. The decrease in a man’s fertility appears to occur later in life than in a woman’s fertility. In their mid-to-late 40s, men experience changes in their sperm that can cause issues with fertility, and chromosomal or developmental problems with their children. Lifestyle and family history If you have any of the following risk factors, you may also consider seeking advice earlier: Family history (i.e., mother or sister) of early menopause (before age 51) History of cigarette smoking in either partner Previous ovarian surgery Exposure to chemotherapy or radiation to treat cancer in either partner Shortening in the time between periods Skipped or missed periods History of injury to the testicles Exposure to toxic chemicals (certain pesticides or solvents) Pregnancy is a complex process Pregnancy is the result of a process that has many steps. To get pregnant: A woman’s body must release an egg from one of her ovaries (ovulation). A man’s sperm must join with the egg along the way (fertilise). The fertilised egg must go through a fallopian tube toward the uterus. The fertilised egg must attach to the inside of the uterus (implantation). Infertility may result from a problem with any or several of these steps. For the pregnancy to continue to full term, the embryo must be healthy and the woman’s hormonal environment adequate for its development. When just one of these factors is impaired, infertility can result. Couples, dependent on the ages of the partners, are generally advised to seek medical help if they are unable to achieve pregnancy after a year of unprotected intercourse. The doctor will conduct a physical examination of both partners to determine their general state of health and to evaluate physical disorders that may be causing infertility. Usually both partners are interviewed about their sexual habits in order to determine whether intercourse is taking place properly for conception. If no cause can be determined at this point, more specific tests may be recommended. For women, these include an analysis of ovulation, x-ray of the fallopian tubes and uterus, and laparoscopy. For men, initial tests focus on semen analysis. “Based on the results of the specific tests, a treatment plan will be made which can include medication, surgery or assisted reproduction,” says Dr Heylen.  Treatment options Not all couples who desire a pregnancy will achieve one spontaneously and some will need medical help to resolve underlying fertility problems. It is now estimated that more than 9 million babies have been born worldwide since the first IVF baby was born in 1978. Most assisted reproductive technology (ART) treatments take place in women aged between 30 and 39. The most common fertilisation technique is ICSI

June 19, 2020
Happy Family Organics

Baby and tot picky eater meal plan by Happy Family Organics

It seems we constantly hear about kids being picky eaters; it may feel like we are condemned to have a child who will eat nothing but chicken fingers and pizza. Is there anything you can do to raise an adventurous eater? Plenty actually, starting right now!

June 17, 2020
Bonitas – innovation, life stages and quality care

Virtual medical consultations now available 24/7

Staying healthy remains a priority for South Africans especially during the COVID-19 lockdown. However it can be a challenge to seek medical help when the Government is asking us to stay home, wear masks, wash our hands frequently and practice social distancing. The solution lies in virtual care.

June 15, 2020
STBB

Applying for a protection order against Domestic Abuse

It is not uncommon for people in South Africa to find themselves trapped in an abusive relationship. Children are often the victims of domestic violence either directly, or indirectly by being a witness to the abuse which can have a dire and lasting impact on them.

June 12, 2020
I Walk Awake

Manage Teen Burnout: Try Resilience Coaching

To break-through these struggles we need to build our motivation and self-esteem from the inside out. This means that at the beginning of each day you should take a conscious look at how you are doing. For example, you should score yourself out of 10 on physical energy, emotional wellness, mental sharpness and connection to purpose or a greater cause. Where you score lower, you can ask yourself what you need to make happen in your day ahead that will raise that score. What are you grateful for right now? What is your intention for today? What affirmation can you choose or create to frame your day ahead?

Done with compassion and genuine curiosity, this “checking in” morning practice will not only get you conscious, but will also support you in building and staying true to healthy personal habits.

June 9, 2020
Happy Family Organics

What are superfoods and why do we need them?

The term “superfood” is relatively new, but it has become extremely popular. “Superfoods” refer to foods that have exceptionally high nutritional value in the form of vitamins and minerals, and minimal calories. They are also known for being packed with antioxidants.

June 8, 2020
Bonitas – innovation, life stages and quality care

Vaccine against Streptococcus Pneumoniae

The World Health Organization (WHO) stresses that although pneumonia vaccines are not effective against COVID -19, vaccinations against respiratory illnesses are highly recommended to protect your health and lowering the risk of becoming infected with any respiratory disease during this time. WHO also states that globally more children, under the age of 5, die from pneumonia than malaria, AIDS and TB combined. In SA, flu and pneumonia rank second – after intestinal infectious disease – as the leading cause of children under 5, which doesn’t make sense when vaccines are available in both the private and public healthcare sector for children and adults. Bonitas Medical Fund recommends having a flu vaccine, it is the first line of defence when it comes to protecting yourself. For those who are at risk of pneumonia, a second vaccination against Streptococcus pneumouniae is also recommended. What is pneumonia? Pneumonia is inflammation of the lungs caused by an infection. Many organisms can cause lower respiratory tract infections or pneumonia. Mixed infections with multiple viral and/or bacterial infections are common. Streptococcus pneumoniae is a bacterium known to be a common cause of bacterial pneumonia in South Africa. Pneumococcal infection may cause mild disease such as a middle ear infection or more complicated infections like pneumonia or an infection of the blood called bacteraemia. In South Africa, individuals at risk of more severe or invasive pneumococcal disease include the elderly, HIV-infected individuals and individuals with chronic medical conditions (e.g. chronic lung disease). Severe disease may require hospitalisation for treatment and may result in death. These streptococcal bacteria can spread from the nose, throat and ears of infected individuals.  Pneumococcal vaccine  Two pneumococcal vaccines are registered for use in adults (over 18 years of age) in South Africa: The 23-valent polysaccharide vaccine (PPV23) and the 13-valent pneumococcal conjugate vaccine (PCV13). PCV13 is also included in the South African Extended Programme of Immunisation (EPI) for childhood vaccines and is given to infants at 6 weeks, 14 weeks and 9 months.  These vaccines aim to provide immunity against the types of Streptococcus pneumoniae that are most commonly associated with severe disease. According to local clinical guidelines from the South African Thoracic Society and Federation of Infectious Diseases Societies of Southern Africa, since the introduction of the PCV13 into the EPI there has been a reduction in the number of cases of pneumococcal pneumonia caused by these types of Streptococcus pneumoniae in South Africa. Who should have the vaccination? Infants routinely receive pneumococcal conjugate vaccines (PCV13) as part of the EPI for childhood disease*. The pneumococcal polysaccharide vaccine (PPSV23) is recommended for individuals who are at risk of developing severe disease*: individuals 65 years or older  anyone with chronic medical conditions affecting the lung, heart or kidneys HIV-infected individuals  Those with a compromised immune system due to other medical conditions (e.g. individuals with cancer) Pneumococcal vaccination during the COVID-19 pandemic The pneumococcal vaccination is not active against the novel coronavirus and will not protect you from becoming infected; it will offer protection against Streptococcus pneumoniae.  However, the National Institute of Communicable Disease (NICD) states the following, ‘any intervention to lower the risk of becoming infected with any respiratory disease at this time may be of benefit. Lowering the risk of acquiring a respiratory infection, will allow for less visits to clinics and less hospital admissions, thus decreasing the burden on the health infrastructure at this time and lowering ones’ exposure to acquiring COVID-19 in the hospitals/clinics.’ Although pneumococcal vaccination does not protect against COVID-19 mild or severe disease or COVID-19 pneumonia, it could play a role in preventing secondary pneumococcal pneumonia infections in those with underlying conditions and the elderly. When to get vaccinated?   If you think you may be within one of the groups at risk of severe pneumococcal disease, contact your pharmacy to check whether stock of the vaccine is available and schedule an appointment to be vaccinated.  Most medical aid plans offer a free flu vaccine annually to members as well as a once off –pneumococcal vaccine for those over the age of 65. As part of the preventative care benefit this is taken from risk cover so it doesn’t deplete members’ savings. Bonitas says that despite the evidence of the efficacy of both the flu and the pneumonia vaccinations, there is not enough uptake. To address this and encourage more members to get vaccinated the Scheme runs email and SMS vaccine drives targeted at the elderly, high risk/emerging risk members as well as children. It reports that this has shown an improvement in people taking the necessarily precautions, but the Fund still believes there is a long way to go.

June 8, 2020
Bonitas – innovation, life stages and quality care

Coronavirus – should you still have a flu vaccine?

The flu season is officially underway and, while Coronavirus is bringing the world to a standstill, it is important to remember that flu can be deadly too. Which is why it is important to have a flu vaccine.

June 3, 2020
RediscoverDairy

Affordable, nutrient-dense dairy is the star of tighter food budgets

As countries around the world, like South Africa, grapple with easing lock-downs and rebuilding economies, COVID-19 remains part of everyday life. Protection from the novel virus is likely to remain a high priority for the foreseeable future. Maintaining our health and supporting our immune systems has probably never been so important for our families. Many South Africans are also tightening the purse strings on their household budgets as the financial consequences of the pandemic response become starker and global recession looms.

June 1, 2020
Bonitas – innovation, life stages and quality care

Making sense of the numbers – cases, co-morbidities and costs

As the number of COVID-19 infections creeps closer to 20 000, both public and private healthcare is going to be under constant pressure. The World Health Organization (WHO) says its COVID-19 data to date suggests that 80% of infections are mild or asymptomatic, 15% are severe infections, requiring oxygen and 5% are critical infections, requiring ventilation.

May 26, 2020
Milas Meals

7 Steps to a Healthy Gut

Did you know that about 70% of our immune system is housed in our gut (or “gutter” as Mila calls it )? Well to be more precise, your gut lining houses 70% of the cells that make up your immune system. (1)

May 25, 2020
Bonitas – innovation, life stages and quality care

Supporting you through your pregnancy

Bonitas Medical Fund believes that as an expecting mom your pregnancy should be a unique and joyful experience. Through targeted support during each trimester, pregnancy education and specific related engagements – via telephone and digital channels – we aim to help you achieve this. With the new Maternity Programme we hope to improve the health of moms-to-be and, as a result, reduce possible complications.

May 19, 2020
Bonitas – innovation, life stages and quality care

Back pain during pregnancy and how to deal with it

Back pain is a common occurrence during pregnancy and can be frustrating to deal with. Unfortunately, if you have any pre-existing back problems you are more likely to struggle with back pain during your pregnancy. If you are suffering from back pain during your pregnancy and are wondering what you can do to help reduce it; we explain what causes it and how you can find some relief. What causes back pain during pregnancy  If you are experiencing back pain during your pregnancy you are probably wondering what is the root cause of it. Generally there are two types of back pain that expecting moms deal with. Pelvic pain, which is felt in the pelvic tailbone area, and lumbar pain which is similar to any lower back pain felt when not pregnant. There are a few culprits of back pain during pregnancy. Hormones, stress, weight changes and posture are all causes of sore and uncomfortable back. During your pregnancy, your hormones change. One of them, known as relaxin, softens the joints in the pelvic region. This can directly impact on your back’s ligaments, causing you back pain. Stress can also cause your back to ache, whether you are pregnant or not. If you are worried about your job, family or pregnancy, you can find that this added anxiety can contribute to back pain. This is due to the fact that anxiety can cause muscle tension, which can then translate into back pain.  Changes in weight as your baby grows and shifts in your centre of gravity can also be a cause of a sore back. If you’re already struggling with poor posture or back ache, then back pain during your pregnancy becomes far more likely. What can help relieve my back pain?  Completely alleviating your back pain may not be possible, but there are things you can try that could help ease and manage your pain. Avoiding lifting heavy objects, opting for flat, supportive shoes and getting plenty of rest are all things you can try to improve your back ache. Exercises that help strengthen your glutes and abs can also help relieve back pain. Prenatal yoga and water aerobic classes are examples of gentle exercises which can help strengthen your body. However, if you are feeling cramps, experiencing vaginal bleeding, feeling feverish, numbness or sporadic pain you should consider consulting with your doctor, as these are all more than just normal pregnancy back pain symptoms.

May 18, 2020
Organix

HELLO WE’RE ORGANIX!

We’ve been cooking up scrummy, nutritious baby and toddler meals and snacks since 1992. It may seem like common sense to us today, but making sure little ones ate a varied diet, full of texture and taste from real fruit and veggies, was a much less talked about idea back then, when our healthy-eating campaigner Lizzie Vann founded Organix. After searching in vain for healthy organic baby and toddler food she decided to make her own and this was how Organix was born.

May 13, 2020
Bonitas – innovation, life stages and quality care

Lifestyle diseases and Coronavirus

As the number of Covid-19 infections moves over 10 000, the health minister Zweli Mkhize has expressed concern about the huge risk group of South Africans suffering from high blood pressure, diabetes and obesity. In other words Comorbidities.

May 12, 2020
OneAid

Going Viral: Is It COVID-19 Or Something Else?

With COVID-19 following us into winter we are going to have many more other viruses to worry about. Viruses that cause the common cold and Influenza are going to peak over the next few months. Since many of these respiratory illnesses share common symptoms it can become confusing trying to figure out which virus is responsible for your symptoms and even cause you to panic unnecessarily every time you get a tickle in your throat thinking it’s Corona.

May 11, 2020
Toptots Head Office

The Science behind vaccinations

We all hate putting our children through any pain, but when it comes to protecting them from some pretty scary diseases, it is the least we can do for them. Our children are constantly exposed to many different viruses, bacteria, and other microbes from the time they are born. Most are not harmful, some are beneficial, but a few can cause disease. The body’s immune system helps protect us against these harmful infections. When we are exposed to infection, the immune system triggers a series of responses to neutralise the microbes and limit their harmful effects.

May 11, 2020
RediscoverDairy

Dairy under lockdown – all the best hacks

Dairy is such an integral part of our family’s healthy eating that we don’t want lockdown to compromise our daily enjoyment of these nutritious and versatile products. At a time, when we want to look after our health and support our immune systems, dairy in our diets has so much to offer as a unique high-quality protein source with a wide profile of essential micro-nutrients. Luckily, there are a variety of product solutions and lots of fantastic new hacks, shared by Rediscover Dairy, to help you easily manage, buy, store and use dairy during lockdown.

May 5, 2020
OneAid

COVID-19 In Children – What Do We Know?

As parents we worry a lot about our children’s health and most especially now, with this new coronavirus (SARS-Cov-2). With so much information currently available online about COVID-19 it can become difficult for us to sift through the real from the fake news. I hope to simplify things a little in this post and share some of the more convincing theories we have on COVID-19 in children.

May 4, 2020
Milas Meals

Happy Gut, Happy Kid, Happy You

The health of the gut is tied to our children’s overall health and wellness, their immune function, their brain function and even their temperament. (1) (2) (3)

May 4, 2020
Organix

A GUIDE FOR ENSURING YOUR TODDLER IS GETTING ALL THE GOOD NUTRIENTS THEY NEED

Knowing what your little explorer should be having in their diet, from good nutrients to the perfect portion size can be confusing. GOOD NUTRIENTS As your baby grows into a toddler, it’s a time of rapid change and development. Everything is a big new adventure which can make things tricky when it comes to food and mealtimes. Organix (a brand dedicated to making tasty and nutritious organic baby and toddler food) has put together a guide to find out what nutrients your toddler needs… Vitamin D: Needed for healthy bones. Under 5s will need to take a supplement as what they need can’t be found in food alone. Vitamin A: Helps keep little one’s immune system tip top along with their vision. Find it in liver, sweet potato and leafy greens. Zinc: Great for healing scratches and grazes and an energy boost. Lots of dairy foods, meat, fish and eggs contain it. Vitamin C: Helps with growth and repair of skin and other tissues. Oranges, mango, cauliflower, broccoli and berries all contain it. Iron: Essential for making healthy blood cells & carrying oxygen. It’s in red meat, fish, poultry, eggs & beans, lentils & dried fruits. PORTION SIZES There is no ‘ideal’ portion size for toddlers, they should be eating a balanced and healthy diet along with these portions of the four main food groups a day. 5-a-day fruit and veggies: Offer at each meal & as some snacks. Go for a rainbow of colours! 2-a-day protein foods: Meat, fish, eggs, crushed nuts, nut butters & pulses. 5-a-day starchy foods: Such as bread, rice, potatoes, pasta and cereals. 3-a-day dairy foods: Milk, cheese & yogurt (or calcium enriched plant-based alternatives).

May 1, 2020
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