#**Manuscript Submissions** To submit a manuscript to the _South African Health Review_ (SAHR) please click on the ‘Submit a manuscript’ button above. **Deadline for full manuscripts for the 2026 edition is: Friday 26 June 2026.** _Only manuscripts that have been invited to be submitted for peer review will be considered._ All submission enquiries should be directed to: [sahr@hst.org.za](sahr@hst.org.za).
#**SAHR Submissions Checklist** _Before submitting your manuscript, please refer to the following checklist and ensure that all the required specifications set out in the Authors' Guidelines below have been met:_ 1. Authors’ names must NOT appear on the manuscript to ensure anonymity during the peer review process. 2. 5 000 word maximum length (including all references, figures, tables, graphs, etc.). The abstract is excluded from this. 3. MS Word format (DOCX), Arial font, size 12, double-line spacing 4. UK English 5. Headers and sub-headers are created in sentence case using Word’s style tool. 6. Tables are created in accordance with the SAHR Tables and Figures style guide, using Word’s table tools Download the [SAHR Tables and Figures style guide](https://drive.google.com/file/d/1tYKAM5sss2z8bYfH9mzpyAiADLxKNPUP/view?usp=sharing). 7. Figures/ graphs are supplied as images and each image is exactly one JPEG, PNG, or TIFF file inserted into the docx (min 300dpi). 8. Source files of tables and graphs must also be uploaded as separate files. 9. A complete list of all acronyms and abbreviations used in the manuscript (to be updated with any revisions thereafter) pasted at the end of the document. Please use the [supplied template](https://docs.google.com/document/d/1-kFGt2eokXb9GJR_paAEcSpi0Lh_3-_s/edit?usp=sharing&ouid=113344297420572609744&rtpof=true&sd=true). 9. AMA style referencing and numeric citations are positioned correctly, URLs in References begin with “http://” or “https://”. Where available, doi numbers must be included. ##**Key documents and attachments** 1. Signed declaration of originality of work 2. Ethical clearance or a motivation of why this is not applicable. 3. A declaration of any AI tools and technologies that have been employed to assist in the generation of the manuscript including the name of the tools used, the purpose for which they were employed and the extent of human oversight involved. 4. Declaration of conflict of interest. 6. Table of abbreviations using the [supplied template](https://docs.google.com/document/d/1-kFGt2eokXb9GJR_paAEcSpi0Lh_3-_s/edit?usp=sharing&ouid=113344297420572609744&rtpof=true&sd=true). 7. All source files for tables, figures and graphs.
#**SAHR Author Guidelines** ##**Abstract (300 words)** Abstracts should be structured in four paragraphs, using the following sub-headings: 1. Aim: describe the overall purpose of the study/paper 2. Method: describe the methodology/ approach used 3. Results (Quantitative)/ Findings (Qualitative) 4. Conclusion: MUST include key recommendations *Abbreviations should not be used in the abstract *Citations or references should not be included in the abstract *The body of the abstract may not exceed 300 words
##**Article design and construction** **Length of manuscript** Articles should be a MAXIMUM of 5 000 words in length (including ALL references, figures, graphs, tables, appendices). This excludes the 300 word abstract. **Referencing style** References must be incorporated in AMA style (see guidelines below). All manuscripts not submitted in AMA will be returned to the authors.
##**Structure of paper**
###**Research and review articles** Research and review articles should be structured as follows: • **Abstract:**, see structure and guidelines above (300 words maximum) • **Introduction:** to include a brief background of the study/ topic; _must state the aim of the paper and aims and objectives of the study_ as relevant. • **Method:** a description of the methodology or approach used • **Results** (Quantitative)/ **Findings** (Qualitative) • **Discussion***: must include any limitations • **Recommendations:** should be strongly present and as specific as possible • **Conclusion:** should offer fresh insights, and detailed discussion of lessons learnt • **Acknowledgements** (optional) * Results/ Findings and Discussion may be presented together under the heading: **Results/ Findings and Discussion** if this reduces repetition and makes for better flow of the paper.
###**Case studies** Case studies are defined as a detailed analysis of a specific situation/ incident. They should be structured as follows: • **Abstract**: see structure and guidelines above (300 word maximum) • **Introduction**: Must state the aim of the paper and why it is important to consider this case study • **Case description**: Describe the particular circumstances of the case in question. • **Discussion**: Include any challenges/ limitations/ possibilities contextualised with reference to literature/ wider experience. • **Lessons learnt**: include detail on how these lessons were generated as well as opportunities for extrapolation • **Conclusion**: should offer fresh insights, and detailed discussion of lessons learnt • **Acknowledgements** (optional)
###**Good practice** Good Practice articles demonstrate proven methods for achieving a particular goal. They should be structured as follows: • **Abstract**: see structure and guidelines above (300 word maximum) • **Introduction**: must state the aim of the paper and describe the broad problem to which this example of good practice could be applied • **Case description**: describe the context/ particular circumstances necessitating the intervention • **Approach**: describe the intervention • **Results**: outputs and outcomes • **Discussion**: discuss challenges/ limitations/ **replicability** here • **Recommendations:** should be strongly present and as specific as possible • **Conclusion:** should offer fresh insights, and detailed discussion of lessons learnt • **Acknowledgements** (optional) * Results/ Findings and Discussion may be presented together under the heading: **Results/ Findings and Discussion** if this reduces repetition and makes for better flow of the paper.
**Font and line spacing** Manuscripts must be presented in ARIAL size 12 with double-line spacing. **File format** • Manuscripts should be produced in MS Word using Word's style and table tools and should be supplied in a DOCX format.
##**Writing style** Manuscripts should be written in the third* person in an accessible style that is suitable for both academic and lay audiences. * In instances when the paper focuses specifically on an intervention or circumstances in which the author/s were intimately involved (e.g., reporting on a case study or best practice), then the first person may be used. **Spelling** UK English should be used as the set language for the document. **Spacing and Punctuation** 1 space after every comma; 1 space after every fullstop. **Heading styles** • Headers and sub-headers should be created using Word’s style tool. • Headings must be written in sentence case. • Headings should not be followed by a full-stop/period. • The following formatting should be used: Title: size 16, bold Heading level 1: **size 14, bold** Heading level 2: **size 12, bold** Heading level 3: _**size 12, bold, italics_** Heading level 4: _size 12, not bold, italics_ (try to avoid using level 4 headings) • Level 1 headings should be followed by a single line space. Text should follow directly beneath all other heading levels. • All text should be defined as ‘Normal’. **Quotations** • Use “double quotations” for a direct quote, and insert reference. • Use ‘single quotation’ to emphasise a point, denote a common meaning or expression, or to highlight an issue. **Footnotes** • AMA referencing does not support the use of footnotes. Please incorporate the information into the body of the text, or present in another format, e.g., as a table. • Footnotes associated with data inside tables have different requirements (see Tables). **Numbers** • Spell out whole numbers that are less than 10 (i.e. one to nine) and use numerals (figures) for 10 or more. • Hyphenate all compound numbers from twenty-one to ninety-nine. • Numbers should have one space between thousands (not commas): 1 000 or 10 000. • Where decimals are used, a full-stop is used to indicate the decimal place: 10.56. • Write non-decimal fractions in words, not figures, and hyphenate: Two-thirds of the patients exhibited symptoms of the disease. • Use the en dash (–) between digits (values, dates, etc.) to indicate range, e.g., Strategy 2015–2017; 15–24–year age group • When a number has four or more digits, it should be split by means of a non-breaking space (Ctrl+Shift and the hyphen key), not a comma, after every three digits to the left or right of the decimal point. **Dates** • When a number has four or more Write dates as: day, month (spell out in full), year. E,g., The meeting was held on 29 September 2010. • The th or rd is only used when the day is used with the date, e.g., Tuesday 9th, Thursday 3rd, but without the month and the year. • In the shortened, numerals-only format, use the slash: 29/09/2010. • The International/ British format is used for the short format of the date. **Lists (and their punctuation)** Lists should be used sparingly to maximise their impact. • Items in a list should be set apart by bullets. • If the list highlights sequential steps, numbers should be used. It is also easier to refer to a number if a listed item is mentioned in the text. A full stop should be placed after each number, for example: 1. Then the point. • Authors must ensure that each item in a list matches or follows on from the sentence introducing the list, both in grammatical style and in content. o If each item comprises less than a complete sentence, use a colon to start the list, and begin each bulleted item with a lower-case letter. Punctuation at end of each bullet point is not needed. o If some of the bulleted items are longer than one line, use a colon to start the list, begin each bulleted item with a lower-case letter, end each bulleted item with a semi-colon and place a full stop at the end of the final bulleted item. o If the items in the list comprise one or more complete sentences, use a full stop to start the list, each sentence should begin with a capital letter and end with a full stop. **Provinces: order and abbreviations** Where data are given by provincial breakdown, list provinces in this order and with these designations/spellings: Eastern Cape: EC Free State: FS Gauteng: GP KwaZulu-Natal: KZN Limpopo: LP Mpumalanga: MP North West: NW Northern Cape: NC Western Cape: WC South Africa: SA **Racial groups** In tables, figures, boxes and graphics, racial groups should be designated: black, coloured, Indian, and white.
#**Tables, boxes, figures and maps** **General rules (see the SAHR [style guide for tables and figures](https://drive.google.com/file/d/1tYKAM5sss2z8bYfH9mzpyAiADLxKNPUP/view?usp=sharing) for further details]** • Use Microsoft Word Table and Chart tools to create tables and figures. • **All tables, figures, boxes and maps must have an appropriate heading**. • Tables and boxes have the heading **above** them. • Figures and maps have the heading **below** them. • Headings are written in **sentence case** and in **bold**. They are **flush left** and are **NOT underlined**. • All figures, tables, boxes and graphics are **numbered sequentially**, e.g., Table 1, Table 2…, Map 1, Map 2… etc. • All figures, tables, boxes and maps must have the **source** acknowledged beneath them, including the date and citation number. If author is the source, write: Source: Author/s. • Source is not written in bold. • Do not change the text font size for headings and source. • If using a graphic from another source, please ensure that the original heading is removed from the copied version. • Any explanation of symbols/abbreviations used is recorded directly under the source. Use the = sign to explain symbols, e.g., Fe = iron. • List all symbols/abbreviations horizontally, separated by a semi-colon. No full-stop at the end of the list. • **All table and figure source files must be uploaded to Scholastica as separate files, in addition to being included in the text.** • As far as possible, tables should be placed after first mention, must always be referred to in the text, and should not be more than one page away from first mention. • All **figures should be supplied with at least 300dpi** for the best resolution in the published article. • **Graphs** must have both axes clearly labelled with units of measurement, as appropriate. • A **key** must be provided for bar graphs, histograms, pie charts etc. _**For further details and examples of the correct punctuation and formatting styles, please download the SAHR [style guide for tables and figures](https://drive.google.com/file/d/1tYKAM5sss2z8bYfH9mzpyAiADLxKNPUP/view?usp=sharing).**_
#**AMA Referencing Style** ##**General** • Authors are required to verify the cited references against the original sources before submitting their manuscripts, and to provide reference information in full. • Authors are requested to use, as far as possible, relevant South African journals and sources and to refer to South African research pertaining to the article content. • All references must be in AMA style. _**Papers that do not comply with the AMA referencing requirements will be returned to the authors.**_
##**AMA In-text referencing** **General rules for positioning of citation numbers** 1. AMA referencing uses a superscript number in-text. References are listed numerically (not alphabetically) in the Reference list. 2. If the same reference is cited more than once, it keeps its original citation number throughout the document (use Word’s cross-reference tool). 3. Number goes **immediately after** (no space) a full-stop (period), comma, question mark, exclamation mark, or quotation mark. 4. Number goes **before** a colon, semi-colon, or en-dash. 5. Use commas to separate multiple citations.  …standard screening approaches were employed.^3,4,8 6. Use an en dash if the citations are numbered sequentially.  …numerous paediatric studies^5-9 have demonstrated… **Rules for brackets (parentheses)** 1. If **only part of the information** inside a bracket comes directly from a source, then citation number is inside the brackets.  ...(according to Smith, 80% of cases are fatal³)... 2. If a **single piece of information** inside the brackets comes directly from one source, then citation number is outside the brackets.  ...(80% of cases are fatal)³... 3. If **two or more pieces of information come from a single source**, but weren’t originally written in the same sentence (so they are separated via semi-colons), then citation number is outside the brackets.  …cancer deaths in women (348 189 deaths; 7.1 deaths per 100 000 women; 8.1% of female cancer deaths).¹ 4. If **two or more pieces of information come from different sources**, then citation numbers are included inside the brackets.  …cancer deaths in women (348 189 deaths1; 7.1 deaths per 100 000 women2; 8.1% of female cancer deaths³). **Referring to authors and AI in the body of the text** 1. **One or two authors**: …Somaroo and Ramiah¹² deduced that… 2. **Three or more authors**: only include the first author’s name followed by ‘et al.’  …in their study of perioperative care, Oodit at al.⁶ found that… 3. Use of **artificial intelligence (AI)**: AMA does not recognise AI as a ‘person’ therefore AI should not be referenced in the text or the reference list. **AI may not be used in the critique, analysis or authoring of a paper published in the SAHR.** If AI tools have been employed, their use must be mentioned in the ‘Acknowledgements’ section of the paper and/or discussed in the ‘Method’ section. **Citing personal communication, interviews and focus groups** Personal communication as well as quotations from interviews and focus groups are not listed in the Reference list. Rather, they are acknowledged directly in the text. • Do not use footnotes. • Do not use italics. • (Name of person, relevant credential/qualification, type [oral/email/listserv] of communication, date)  According to the participant (A. Nkosi, MD, oral communication, February 18, 2025), the flu epidemic in the US “is the worst in 15 years.” **Citing unpublished reports, PhD theses, conference presentations etc.** AMA does not include any unpublished work in the Reference list. These must be included in parentheses in the text, as follows: **Unpublished thesis/dissertation** (Author AA. _Thesis title_. University name. Unpublished doctoral dissertation; Year).  …(Hudson CA. _Heart failure incidence in healthy young adults_. Pretoria University. Unpublished doctoral dissertation; 2024). **Unpublished conference paper/poster** (Author AA. Title of Paper/Poster. Paper/Poster presented at: Name of Conference; Month Dates, Year; City, Province/Country).  …(Singh Y. Complex regional pain syndrome diagnosis. Poster presented at South African Society of Physiotherapy 17th Annual Conference; June 10-12, 2023; Durban, KwaZulu-Natal).
##**AMA rules for the Reference list** **Number of authors and editors** 1. **Six or less**: all six must be listed. 2. **More than six**: list the _first three_ followed by ‘et al.’ **General rules** 1. Do not use full-stops after the initials of a person. 2. Separate authors with a comma. 3. Do not use ‘and / &’ before the last person.  Joosse IR, van den Ham HA, Mantel-Teeuwisse AK, Suleman F. 4. Title is written in sentence case. 5. If a colon is used, first letter after the colon is lower-case (see ‘Journal articles’ example below). 6. If a DOI (digital object identifier) is provided, do not include an Accessed date. 7. ‘DOI’ is written in lower case: ‘doi’ and there is no space between the colon and the first digit of the doi number.  …_citation date_. doi:10.1016/S0140-6736(14)62038-9 8. **DOIs are the preferred identifier for HST.** 9. If a URL is used, then an Accessed date is required and ‘URL’ is not written.  ..._citation date_. Accessed May 31, 2025. https://www.knowledgehub... 10. There is no full-stop after a URL or DOI. **Journal articles** Pay careful attention to spaces (or lack thereof) between punctuation marks. Note that the _journal name_ is written in italics, not the title of the paper. All journal titles must be abbreviated according to the conventions of the National Library of Medicine catalogue: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=journals **Journal article with DOI** Author AA, Author BB. Title of article. _Journal abbreviation_. Year;volume(issue):pp-pp. doi:...  Fourie L, Pather M, Hendricks G. Point-of-care ultrasound: the new district focus. _Afr J Prim Health Care Fam Med_. 2023;15(1):17-25. doi:10.4102/phcfm.v15i1.3576 **Journal article with URL** Author AA, Author BB. Title of article. _Journal abbreviation_. Year;volume(issue):pp-pp. Accessed Month (in full) date, year. http://...  Joosse IR, van den Ham HA, Mantel-Teeuwisse AK, Suleman F. Alignment in the registration, selection, procurement and reimbursement of essential medicines for childhood cancers in South Africa. _BMJ Glob Health_. 2023 Sep;8(9):e012309. Accessed February 20, 2025. https://gh.bmj.com/content/8/9/e012309 **Referencing an article from a previous publication of the _South African Health Review_** Author AA, Author BB. Title of article. In: Editor AA, Editor BB, eds. _S Afr Health Rev_, year. Publisher; Year:pp-pp. doi:…  Ras T, Adeleke O, Moodley J. The role of primary practitioners in cancer control in South Africa: a systems-based case study. In: Moeti T, Padarath A, Parkes J, Singh S, Ruff P, eds. _S Afr Health Rev_, 2023. Health Systems Trust, 2024;1-9. doi:10.61473/001c.119020 **Websites** **Author of webpage is known** Author AA, Author BB. _Title of page_. Name of website; Year published/or updated. Accessed Month (in full) date, year. http://...  Moeti M. _Saving lives – sustaining transformative public health initiatives in Africa_. World Health Organization; 2025. Accessed February 20, 2025. https://www.afro.who.int/publications/saving-lives-sustaining-transformative-public-health-initiatives-africa-legacy If **website is the same as the author**, leave out the ‘Author’ component of the reference. Start with the title of the webpage.  _National Guideline for Cervical Cancer Screening Programme_. National Department of Health. 2000. Accessed November 1, 2023. https://www.kznhealth.gov.za/cervicalcancer.pdf **Podcasts, webinars and other online media** Host AA. Podcast title: episode title. Date created or updated. Accessed Month (in full) date, year. http://  Alfred L. Balanced Black Girl: Episode 261: How to invest in yourself. October 29, 2024. Accessed December 19, 2024. https://www.balancedblackgirl.com/how-to-invest-in-yourself/ **Government documents** **Acts of Parliament** As government Acts do not change once published, an ‘Accessed date’ is not required. Author. _Title of document_. Publication name number, Month date, year. https://...  Minister of Health. _National Health Insurance (NHI)_ Act 20 of 2023. Government Gazette No. 50664, May 16, 2024. https://www.parliament.gov.za/storage/app/media/Acts/2023/Act_20_of_2023_National_Health_Insurance.pdf **Reports, policies and guidelines** Author. _Title of document_. Year published/or updated. Accessed Month (in full) date, year. http://....  South African Nursing Council. _Code of ethics for nursing practitioners in South Africa_. Date unknown. Accessed January 12, 2024. https://www.sanc.co.za/wp-content/uploads/2021/04/Code-of-Ethics-for-Nursing-in-South-Africa.pdf **Books and book chapters** The location/city of the publisher is not included in AMA (ed. 11). Note that the _title of the book_ is written in italics. **Hard copy** Author AA, Author BB. _Book title_. Nth ed. Publisher; year.  Kalanithi P. _When breath becomes air: the ultimate moving life-and-death story_. Vintage; 2017. **eBook** (with editor example) Editor AA, ed. _Book title_. Nth ed. Publisher; year. doi:…  Levy ZD, ed. _Absolute Critical Neurocare Review_. 2nd ed. Springer; 2023. https://doi.org/10.1007/978-3-031-24830-6 **Chapter in a book** Author AA, Author BB. Title of chapter. In: Editor AA, Editor BB, eds. _Book title_. Nth ed. (if relevant) Publisher; Year:pp-pp. doi:…  Gray A, Suleman F. Pharmaceutical Pricing in South Africa. In: Babar ZU-D, ed. _Pharmaceutical Prices in the 21st Century_. Springer International Publishing; 2015:251-265. doi: 10.1007/978-3-319-12169-7_14 **Conference presentations and proceedings (published)** Author AA. Title of Paper/Poster. Paper/Poster presented at: Name of Conference; Month Dates, Year; City, Province/Country. Accessed Month date, year. http://... (or doi: https://...)  Pienaar C. Endometrial cancer in rural women: looking beyond the diagnosis. Paper presented at the South African Congress of Oncology, September 1-3, 2023; Cape Town, Western Cape. doi: https://doi.org/10.4102/sajr.v26i1.3463
#**Endnote Instructions** **Setting up citation numbering using Endnote** Place the cursor after the first word that requires a citation. 1. In the Toolbar select: References 2. Click on the symbol (bottom right-hand side of Footnotes) to expand the box. 3. Select: Endnotes (End of document); Number format (1,2,3…); Numbering (Continuous); Apply; Insert. 4. Endnote will take you to the end of your document where you can now add your reference. 5. For all subsequent citations, just do: References > Insert Endnote. 6. Once your document is complete, change the font style and size in your Reference list to: Arial 12. **If the same reference is referred to again in the text** 1. The reference keeps the original citation number. 2. Place the cursor at the place where the repeated citation needs to be. Click. 3. In the Toolbar, select: Insert > Cross-reference. 4. Select: Reference type (Endnote); tick the box for ‘Insert a hyperlink’. 5. Select the reference that the repeat citation refers to from the list. 6. Insert.
##**For more information, please contact sahr@hst.org.za**

Health and related indicators 2021