South Africa

Experiences of Action Learning Groups for Public Health Sector Mangers in Rural KwaZulu-Natal, South Africa

The objective of this study was to pilot an action learning group program, (an informal, practically based management training program which allow trainees to reflect on their own work environment) with managers in a rural public health setting and to explore participants’ experience of the program. [adapted from abstract]

Engagement of Non-Government Organizations and Community Care Workers in Collaborative TB/HIV Activities Including Prevention of Mother to Child Transmission in South Africa: Opportunities and Challenges

Using South Africa as a case study, this article reports on the engagement of non-governmental organizations and community care workers in the implementation of collaborative tuberculosis/HIV activities in rural South Africa, including extent of participation and constraints and opportunities to enhance effective participation. [adapted from abstract]

Is There Really a Pot of Gold at the End of the Rainbow? Has the Occupational Specific Dispensation, as a Mechanism to Attract and Retain Health Workers in South Africa, Leveled the Playing Field?

This study evaluates the effectiveness of the introduction of the Occupation Specific Dispensation, which sought to improve the public services’ ability to attract and retain health workers in South Africa, thereby reducing incentives to emigrate. [adapted from abstract]

Task Shifting of Antiretroviral Treatment from Doctors to Primary-Care Nurses in South Africa (STRETCH): A Pragmatic, Parallel, Cluster-Randomised Trial

This article aimed to assess the effects on mortality, viral suppression, and other health outcomes and quality indicators of program for task shifting of antiretroviral therapy from doctors to nurses, which provides educational outreach training for nurses to initiate and represcribe. [adapted from summary]

Implementing Nurse-Initiated and Managed Antiretroviral Treatment (NIMART) in South Africa: A Qualitative Process Evaluation of the STRETCH Trial

The STRETCH (Streamlining Tasks and Roles to Expand Treatment and Care for HIV) progra was an intervention implemented in South Africa to enable nurses providing primary HIV/AIDS care to expand their roles and include aspects of care and treatment usually provided by physicians. The effects of STRETCH on pre-ART mortality, ART provision, and the quality of HIV/ART care were evaluated through a randomised controlled trial. This study was conducted alongside the trial to develop a contextualised understanding of factors affecting the implementation of the program. [adapted from abstract]

MHealth4CBS in South Africa: A Review of the Role of Mobile Phone Technology for Monitoring and Evaluation of Community-Based Health Services

This study sought to understand what the field of mHealth had to offer, to explore how mHealth is implemented in practice and to use these two sources of information to reflect on the lessons and implications for implementing mHealth at scale for monitoring and evaluation of community based services and community health workers. [adapted from summary]

Developing Lay Health Worker Policy in South Africa: A Qualitative Study

The aim of this study was to explore contemporary lay health worker policy development processes and the extent to which issues of gender are taken up within this process. [from abstract]

Text Messages as a Learning Tool for Midwives

This study aimed to assess whether the use of cell phone text messaging to improve access to continuing healthcare education in under-resourced settings is acceptable to South African midwives in both the public and private sectors. [adapted from author]

Caring for the Caregivers: Models of HIV/AIDS Care and Treatment Provision for Health Care Workers in Southern Africa

This article describes 3 staff care programs that provide convenient, confidential, and holistic care for HIV-infected health care workers and health care workers affected by caring for HIV-infected patients. [from author]

Voices from the Field: Perspectives from Community Health Workers on Health Care Delivery in Rural KwaZulu-Natal, South Africa

As the primary link between the formal health care sector and the household level in South Africa, community health workers (CHWs) provide a critical perspective on barriers
that exist in rural health care delivery. The results of this study suggest that CHWs recognize the need for HIV/AIDS- and TB-related interventions but are unable to provide a response commensurate to this need. [from abstract]

Promoting Health Lifestyles: Community Health Workers' Intervention Programme for Primary Prevention of Non-Communicable Diseases in Khayelitsha, an Urban Township in Cape Town

A community-based project to increase community awareness about primary prevention of non-communicable diseases (NCDs) was implemented in an urban township of Cape Town. The aims of project were to utilise community health workers as change agents in their community and to develop a NCD model for an urban township community. [adapted from author]

Survey of the Quality of Nursing Care in Several Districts in South Africa

The purpose of this study was to describe and compare the quality of nursing service and care in three health districts in the KwaZulu Natal Province and to identify deficiencies which could be addressed by education and training for nurses. [adapted from abstract]

Denying Reality No Longer an Option: Stark HR Report

The report takes a look at the haemorrhaging general pracitioner and specialist cadres and the skeletal, ageing and special skills-starved nursing sector in what it describes as South Africa’s “failing health system.” [adapted from abstract]

Quality Healthcare and Workers on the Move

This report on South Africa is part of a global research project on the origin and destination countries for migration of health workers around the world. It contends that the health and social worker migration must be considered in the broader context of the human right to health and decent work, ethical migration and recruitment processes, global human resources for health and the health related Millennium Development Goals.

Stop Making Excuses: Accountability for Maternal Health Care in South Africa

This report uses a human rights framework to examine accountability for maternal health care. It sets out several specific steps that South African and Eastern Cape governments should take to better integrate accountability into maternal health care programs and ensure their implementation through the health system. [from author]

National Policy on the Management of Public Hospitals

The aims of this policy include: ensuring the appointment of competent and skilled hospital managers; providing for the development of management accountability frameworks; and ensuring the training of managers in leadership, management and governance. [adapated from author]

HR Strategy for the Health Sector: 2012/13-2016/17

This HRH Strategy provides a distillation of the ideas arising from a review of HRH in South Africa themes based on evidence, followed by recommended strategic priorities and interventions, and forecast modeling of the future requirement of the health professions. [adapted from summary]

Changes in Healthcare Workers' Knowledge about Tuberculosis Following a Tuberculosis Training Programme

This article outlines a study designed to measure knowledge changes among healthcare workers who participated in a tuberculosis training programme and to make recommendations about future tuberculosis training for healthcare workers in the KwaZulu-Natal Department of Health. [adapted from abstract]

More Doctors and Dentists Are Needed in South Africa

This article outlines a project to research the number and needs of specialists and subspecialists within South Africa. [adapted from author]

Study of Patient Attitudes Towards Decentralization of HIV Care in an Urban Clinic in South Africa

In South Africa, limited human resources are a major constraint to achieving universal antiretroviral therapy (ART) coverage. Decentralization or “down-referral” (wherein ART patients deemed stable on therapy are referred to their closest Primary Health Clinics (PHCs) for treatment follow-up) is being used as a possible alternative of ART delivery care. This cross-sectional qualitative study investigates attitudes towards down-referral of ART delivery care among patients currently receiving care in a centralized tertiary HIV clinic. [from abstract]

Improving Breast Cancer Control via the Use of Community Health Workers in South Africa: A Critical Review

This article explores community health worker (CHW) programs and describes their potential use in low- and middle-income countries. It uses South Africa as an example of how CHWs could improve access to breast health care because of its middle-income status, existing cancer centers, and history of CHW programs. [adapated from abstract]

Task Shifting and Integration of HIV Care into Primary Care in South Africa: The Development and Content of the Streamlining Tasks and Roles to Expand Treatment and Care for HIV (STRETCH) Intervention

Task shifting and the integration of HIV care into primary care services have been identified as possible strategies for improving access to antiretroviral treatment. This paper describes the development and content of an intervention involving these two strategies. [from abstract]

Community Health Workers and the Response to HIV/AIDS in South Africa: Tensions and Prospects

This paper examines the case of South Africa, where there has been rapid growth of a range of lay workers (home-based carers, lay counselor, DOT supporters etc.) principally in response to an expansion in budgets and programmes for HIV, most recently the rollout of antiretroviral therapy. [from author]

Influence of Burnout on Skills Retention of Junior Doctors at Red Cross War Memorial Children's Hospital: a Case Study

This study used the Maslach Burnout Inventory to evaluate the degree of burnout among junior doctors at Red Cross War Memorial Children’s Hospital and the influence on the retention of valuable skills in the hospital. [from author]

Educational Factors that Influence the Urban-Rural Distribution of Health Professionals in South Africa: a Case-Control Study

This study aimed to evaluate the influence of educational factors on the choice of rural or urban sites of practice of health professionals in South Africa. [from abstract]

Contribution of South African Curricula to Prepare Health Professionals for Working in Rural or Under-Served Areas in South Africa: a Peer Review Evaluation

The Collaboration for Health Equity through Education and Research was formed in 2003 to examine strategies that would increase the production of health professionals who choose to practise in rural and under-served areas in South Africa. This article aimed to identify how each faculty is preparing its students for service in rural or under-served areas. [from abstract]

Fit for Purpose? The Appropriate Education of Health Professionals in South Africa

This editorial explores what health sciences training institutions achieved in the past 50 years to address the health care priorities of South Africans who are most in need. [adapted from author]

Smart Phones Improving Clinical Outcomes

This article outlines a mobile health information pilot project in South Africa that provides nurses with instant access to a clinical library and treatment guidelines to improve their performance and positively impact patient care. [adapted from author]

Health System Weaknesses Constrain Access to PMTCT and Maternal HIV Services in South Africa: a Qualitative Enquiry

This study documented women’s experiences of accessing ART and prevention of mother-to-child HIV transmission (PMTCT) program. In-depth interviews identified considerable weaknesses within operational HIV service delivery including: shortage in staff and supplies, lack of healthworker knowledge, stigma, and inadequacy of data and information systems for monitoring and evaluation. The analysis suggests that there is great scope for health system change, much of which centers on health personnel capacity and performance. [adapted from author]

South African Health Review 2010

The 2010 edition of the SAHR focuses on two main issues: Reflections on the Millennium Development Goals (MDGs) and the Perspectives on a National Health Insurance (NHI) for South Africa. As is customary, the Review ends with the Indicators section which provides a range of indicators relevant to the MDGs and NHI. [from summary]