scholarly journals Decentralised clinical training in optometry: a developmental strategy for eye health in KwaZulu Natal?

2018 ◽  
Vol 20 ◽  
Author(s):  
Diane van Staden
Keyword(s):  
Public Health ◽  
South Africa ◽  
Public Sector ◽  
Health Service ◽  
Health Services ◽  
Clinical Training ◽  
Health Service Delivery ◽  
The Public ◽  
Eye Health ◽  
Kwazulu Natal

AbstractBackgroundDecentralised clinical training (DCT) in optometry is an emerging concept in South Africa. In 2016, the University of KwaZulu Natal (UKZN) implemented this adaptive model of clinical training for undergraduate health professions. The initiative, which emanated through an agreement between UKZN’s College of Health Sciences and the KwaZulu Natal Department of Health, centres on the placement of undergraduate optometry students within public health facilities for clinical training purposes. Optometry services in South Africa have, however, had a historical bias towards a private sector model of training and a curative practice approach resulting in access barriers for the rural poor and high levels of unmet need. It has further contributed to a general state of underdevelopment of eye health services within the public sector.DiscussionDCT challenges historical undergraduate programme structures and modes of teaching and learning in optometry. It is largely underpinned by a need to strengthen health service delivery through a primary health care-centred, community-based training approach and produce ‘fit-for-purpose’ graduates who have contextually appropriate competencies for effective, local health service delivery. The historical absence of optometry services within the public sector has, however, contributed to limited planning for, and development of eye health services in this sector. This has inadvertently contributed to the burden of avoidable vision impairment in the country. The public health system in South Africa, therefore, faces various developmental challenges which impact eye health services and student clinical training.ConclusionWhile the model is still in a developmental state and resourcing challenges potentially affecting DCT are noted, early experiences of the Discipline of Optometry at the UKZN are that DCT shows promise in terms of its potential contribution towards the development of eye health services within the public health sector from graduate readiness, resource strengthening, access improvement and health service development perspectives.

Differentiating between average and high-performing public healthcare managers: implications for public sector talent management

2020 ◽  
Vol 44 (3) ◽  
pp. 434
Author(s):  
Sandra G. Leggat ◽  
Zhanming Liang ◽  
Peter F. Howard
Keyword(s):  
Public Sector ◽  
Health Service ◽  
Health Services ◽  
Talent Management ◽  
Healthcare Sector ◽  
Public Healthcare ◽  
High Performing ◽  
The Public ◽  
Public Healthcare Sector ◽  
Service Managers

ObjectiveEnsuring sufficient qualified and experienced managers is difficult for public sector healthcare organisations in Australia, with a limited labour market and competition with the private sector for talented staff. Although both competency-based management and talent management have received empirical support in association with individual and organisational performance, there have been few studies exploring these concepts in the public healthcare sector. This study addresses this gap by exploring the perceived differences in demonstration of core competencies between average and higher-performing managers in public sector healthcare organisations. MethodsMixed methods were used to define and measure a set of competencies for health service managers. In addition, supervisors of managers were asked to identify the differences in competence between the average and high-performing managers reporting to them. ResultsSupervisors could clearly distinguish between average and higher-performing managers and identified related competencies. ConclusionsThe consistent pattern of competence among community health and hospital public sector managers demonstrated by this study could be used to develop a strategic approach to talent management for the public healthcare sector in Australia. What is known about this topic?Although there are validated competency frameworks for health service managers, they are rarely used in practice in Australia. What does this paper add?This paper illustrates the perceived differences in competencies between top and average health services managers using a validated framework. What are the implications for practitioners?The public health sector could work together to provide a more effective and efficient approach to talent management for public hospitals and community health services.

scholarly journals Where are we short and who are we short of? A review of the human resources for health in South Africa

2012 ◽  
Vol 17 (1) ◽  
Author(s):  
Gavin George ◽  
Timothy Quinlan ◽  
Candice Reardon ◽  
Jean-François Aguilera
Keyword(s):  
Public Health ◽  
South Africa ◽  
Health Care ◽  
Health Services ◽  
Human Resources ◽  
Nursing Care ◽  
Human Resources For Health ◽  
Health Care Personnel ◽  
Public Health Services ◽  
The Public

This review showed that thinking about the shortage of health care personnel merely in terms of insufficient numbers prevents sound strategic interventions to solve the country’s human resources for health (HRH) problem. It revealed that the numbers shortage was one facet of a broader problem that included the mal distribution of HRH, production of the wrong skills in the nursing care, the attrition of staff from the public health services and, contextually, the ever-changing demands on the health services. The challenge in South Africa was furthermore to train and retain health care personnel with skills and expertise that are commensurate with the changing demands on the public health services.Uit hierdie oorsig het dit duidelik geblyk dat die tekort van gesondheidsorgpersoneel slegs in terme van ontoereikende getalle val en ’n omvattende strategiese ingryping om die land se menslike gesondheidshulpbron krisis op te los, belemmer. Dit het aangedui dat die getalletekort  maar slegs een fasset van ’n groter probleem uitmaak, wat onder andere die volgende insluit: die oneweredige verspeiding van menslike gesondheidshulpbronne, ’n fokus op ontoepaslike vaardighede in die opleiding van verpleegpersoneel, die behoud van personeel in die openbare gesondheidsektor, asook die konstant-veranderlike eise van die gesondheidsdienste. Verder was die uitdaging in Suid Afrika die opleiding en behoud van gesondheidsorgpersoneel met kennis en vaardighede wat tred hou met die veranderlike eise van die openbare gesondheidsdienste.

scholarly journals Facilitation of free residential training inside the country – The fundamental health service responsibility of the Government and its regulatory body

2015 ◽  
Vol 53 (197) ◽  
pp. 40-69 ◽  
Author(s):  
Madhur Dev Bhattarai
Keyword(s):  
Public Health ◽  
General Practice ◽  
Health Service ◽  
Health Services ◽  
Health Management ◽  
Health Service Delivery ◽  
Regulatory Body ◽  
Medical Council ◽  
Public Health Programme ◽  
The Government

For optimum Peripheral Health Service and implementation of various Vertical Public Health Programme Services, network of public Rural and Urban Health Centers with trained Specialists in General Practice (GP) is essential. Later such Specialist GPs will thus fulfill both comprehensive training and experience required for Health Management and Planning Service in the centre.  About 40%-50% of all Residential Trainings and Specialists are required in GP. There are further up to 100 to 150 possible specialties in which remaining doctors can be trained for Specialty Health Services. Though free Residential Training has numerous advantages, its shortage inside country is the bottleneck to provide above mentioned Health Services. Planning for health service delivery by at least trainee residents under supervision or appropriately trained specialists guides Residential Training’s regulations. Fulfillment of objective training criteria as its core focus is the concept now with the major role of Faculty as supervising residents to provide required service in the specialty and simultaneously updating themselves and their team for Evidence-Based Medicine practice. Similarly the need of Ambulatory Health Service and joint management of in-patients by specialists in hospitals has changed unit and bed divisions and requirements for Residential Training. Residents, already the licensed doctors, are thus providing required hospital service as indispensable part of its functional hierarchy for which they need to be paid. With such changing concepts and trends, there are some essential points in existing situation to facilitate free Residential Training inside country. For Government doctors, relevant amendment in their regulation is accordingly required. Keywords: ambulatory care; general practice; health service; hospitalist; medical council; medical education; public health; regulatory body; research; residential training.

scholarly journals Understanding the Challenges Facing Occupational Health Services in the Swedish Public Sector

2017 ◽  
Vol 7 (3) ◽  
Author(s):  
Lisa Schmidt ◽  
John Sjöström ◽  
Ann-Beth Antonsson
Keyword(s):  
Public Sector ◽  
Health Service ◽  
Occupational Health ◽  
Health Services ◽  
Safety Management ◽  
Health And Safety ◽  
Occupational Health Services ◽  
External Resources ◽  
The Public ◽  
Public Sector Organizations

According to Swedish Work Environmental Act, all organizations are required to implement Occupational Health and Safety Management (OHSM). In support of this and when competence within the employer’s own organization is insufficient, regulations state that the employers are required to employ external resources such as an Occupational Health Service (OHS) provider. The aim of this study was to explore how public sector organizations utilized services and support from their OHS provider in preventive OHSM. Eleven public sector organizations were studied, 100 of respondents (politicians, managers, HR, safety representatives, and OHS professionals) interviewed, and the data collected qualitatively and thematically analyzed. The results showed that the OHS providers do not support the public-sector organizations with preventive OHSM according to the intentions of the legislation. A significant conclusion is that the HR department has an important role in the collaboration and for the utilization of preventive services in OHSM.

scholarly journals The management of diabetic retinopathy in the public sector of eThekwini district of KwaZulu-Natal

2016 ◽  
Vol 75 (1) ◽  
Author(s):  
Zaheera Abdool ◽  
Kovin Naidoo ◽  
Linda Visser
Keyword(s):  
South Africa ◽  
Diabetic Retinopathy ◽  
Public Sector ◽  
Fundus Photography ◽  
Screening Methods ◽  
Initial Examination ◽  
District Health ◽  
Ocular Complications ◽  
The Public ◽  
Kwazulu Natal

Background: Estimates from the year 1990–2010 showed an increase in blindness and vision impairment (moderate or severe) because of diabetic retinopathy (DR) in Sub-Saharan Africa’s sub-regions (central, eastern, southern and western Africa).1 The rate of DR in South Africa is expected to increase because of the lack of screening protocols and policies for the management of diabetic eye disease in the district health system of South Africa. Aim: The purpose of this study was to determine the current role of healthcare practitioners (HCPs) towards managing DR in the eThekwini district of KwaZulu-Natal.Method: A cross-sectional study was conducted, and questionnaires were distributed to a total of 104 HCPs in public health institutions situated in the northern eThekwini district of KwaZulu-Natal. Clinics and community health centres (CHCs) were selected based on the assumption that primary healthcare nurses, medical officers (MOs) and ophthalmic nurses and/or optometrists practice at these institutions. The hospitals selected were the referral institutions for the selected clinics and CHCs. The questionnaires distributed included questions relating to diabetic patient registers, referrals to and from other HCPs, management of ocular complications, ocular screening methods, fundus examinations and involvement in screening programmes.Results: Over a third of the ophthalmologists (35.3%) indicated that DR was present at the initial examination in more than 50% of patients, though overall ophthalmologists reported loss of vision in at least one eye in fewer than 5% of patients on presentation. Less than half of the public sector general practitioners or MOs (40.6%) conducted fundus examinations but 90.6% did not dilate pupils, although 71.9% had knowledge on the use of a direct ophthalmoscope. Only 40.6% of the MOs discussed the ocular complications of uncontrolled diabetes mellitus (DM) with patients and 62.5% encouraged regular eye examinations. Less than 50% of the MOs (43.8%) referred patients complaining of visual difficulties to optometrists and 9.4% referred to the ophthalmic nurses. Only 6.25% referred patients with DM needing further evaluation to ophthalmologists. Data from the optometrists were inconclusive because of the poor response rate of 5 (20%). None of the ophthalmic nurses reported doing fundus photography or refractions. Two-thirds of the ophthalmic nurses were interested in training to properly grade DR.Conclusion: The study established that there are key challenges in referral, training and practice in the management of DR. These need to be addressed in order to develop a comprehensive approach for the prevention and management of visual impairment and blindness because of DM.

Public Health

2020 ◽  
pp. 50-60
Author(s):  
Julie Sin
Keyword(s):  
Public Health ◽  
Health Service ◽  
Health Services ◽  
Public Health Practice ◽  
Population Level ◽  
Healthcare Systems ◽  
Health Improvement ◽  
Health Practice ◽  
The Public ◽  
Insight Into

This chapter is about the terminology and practice of the public health specialty to assist insight into its connections with health services for populations. Public health practice is about considering health at a population level. For orientation, the semantics of the term public health are also discussed as part of aiming for effectiveness of dialogue in this area of health service practice. In the public health specialty there are three core domains of public health practice, and healthcare systems will interact with all three. One of these domains, Healthcare Public Health (HCPH) is particularly relevant to the commissioning of health services. This is concerned with improving health outcomes through health services quality and effectiveness. Its work is an integral part of the commissioning function for health services. All three domains are described for the commissioner’s orientation, namely the work of health improvement, health protection, and healthcare public health.

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