Barriers and Facilitators to Caring for a Child with Cerebral Palsy in Rural Communities of the Western Cape, South Africa

Community health workers (CHWs) have been identified as a key component of the health workforce in South Africa. However, the efficacy of CHW programs continues to be limited by a poor understanding of facilitators and barriers to CHW engagement. This study explores intrinsic and extrinsic factors that CHWs face. We conducted in-depth interviews with 20 CHWs in order to understand the challenges they may face as they implement their duties linked to the primary health care strategy in the Western Cape, South Africa. All interviews were audiotaped, transcribed verbatim, coded and analyzed using NVivo 12. Drawing on narratives of CHWs, we illustrate the complex issues surrounding CHW outreach in poor rural communities. The CHWs identified five key areas of challenges with respect to personal health, gender issues, poor community understanding of CHWs roles, environmental challenges and lack of patient adherence. These all hinder the ability of CHWs to meet their personal and familial needs, as well as those of the community members they support. There is a need to address the intrinsic needs of CHWs in order to ensure their emotional and physical well-being, as well as a need to create an awareness of the roles of CHWs.

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From darkness to light: Barriers and facilitators to mental health recovery in the South African context

International Journal of Social Psychiatry ◽

10.1177/0020764020981126 ◽

2020 ◽

pp. 002076402098112

Author(s):

Anneliese de Wet ◽

Chrisma Pretorius

Keyword(s):

Mental Health ◽

South Africa ◽

Focus Groups ◽

Service Providers ◽

Public Mental Health ◽

Psychiatric Hospitals ◽

Barriers And Facilitators ◽

Service Users ◽

Western Cape ◽

Public Mental Health Care

Background: South Africa is a low and middle income country facing many challenges in public mental health care and implementation of recovery. Aims: To contribute to what barriers and facilitators to recovery might be for service users in South Africa, from the perspective of service users, carers and service providers from three psychiatric hospitals in the Western Cape province. Method: Interviews and focus groups were conducted with service users, carers and service providers. Interviews and focus groups were transcribed and analysed using atlas.ti software and reflexive thematic analysis, from the bottom up. Results: The barriers, environment, family, public mental health services, stigma and service users’ attitude or behaviour generated, were found to be the most salient. The facilitators to recovery generated were support, family or friends, service providers, structure and empowerment. The need for support was identified as an underlying component to all these themes. Conclusion: Barriers and facilitators to recovery seemed to have both intrapersonal and external sources that intersect at times. Recovery needs to be supported at an individual level, especially through an under-utilised resource such as peer support work, but in conjunction with the development of recovery-enabling environments in services and communities in South Africa.

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Assessment of activities performed by clinical nurse practitioners and implications for staffing and patient care at primary health care level in South Africa

Curationis ◽

10.4102/curationis.v39i1.1479 ◽

2016 ◽

Vol 39 (1) ◽

Cited By ~ 4

Author(s):

Jude Igumbor ◽

Alta Davids ◽

Catharina Nieuwoudt ◽

Jessica Lee ◽

Rifqah Roomaney

Keyword(s):

South Africa ◽

Rural Communities ◽

Nurse Practitioners ◽

Public Healthcare ◽

Western Cape ◽

Mobile Clinic ◽

Cross Sectional ◽

Clinical Nurse ◽

Primary Health ◽

Mobile Clinics

Background: The shortage of nurses in public healthcare facilities in South Africa is well documented; finding creative solutions to this problem remains a priority.Objective: This study sought to establish the amount of time that clinical nurse practitioners (CNPs) in one district of the Western Cape spend on clinical services and the implications for staffing and skills mix in order to deliver quality patient care.Methods: A descriptive cross-sectional study was conducted across 15 purposively selected clinics providing primary health services in 5 sub-districts. The frequency of activities and time CNPs spent on each activity in fixed and mobile clinics were recorded. Time spent on activities and health facility staff profiles were correlated and predictors of the total time spent by CNPs with patients were identified.Results: The time spent on clinical activities was associated with the number of CNPs in the facilities. CNPs in fixed clinics spent a median time of about 13 minutes with each patient whereas CNPs in mobile clinics spent 3 minutes. Fixed-clinic CNPs also spent more time on their non-core functions than their core functions, more time with patients, and saw fewer patients compared to mobile-clinic CNPs.Conclusions: The findings give insight into the time CNPs in rural fixed and mobile clinics spend with their patients, and how patient caseload may affect consultation times. Two promising strategies were identified – task shifting and adjustments in health workerd eployment – as ways to address staffing and skills mix, which skills mix creates the potential for using healthcare workers fully whilst enhancing the long-term health of these rural communities.

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Proposal for Improving Records Management Practices of Traditional Institutions in Ga Molepo, South Africa

Mousaion ◽

10.25159/2054 ◽

2017 ◽

Vol 35 (1) ◽

pp. 46-67

Author(s):

Mahlaga Johannes Molepo ◽

Linda M. Cloete

Keyword(s):

South Africa ◽

Rural Communities ◽

Management Practices ◽

Records Management ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Record Keeping ◽

Local Municipalities ◽

Management Procedures ◽

Traditional Institutions

The way in which an institution treats its records is crucial for its survival in a rapidly changing society. The purpose of the study was to investigate the records management practices and challenges faced by traditional institutions of leadership and governance in Ga Molepo, Limpopo, South Africa. The researcher employed a cross-sectional survey in order to quantitatively examine the challenges faced by members of traditional councils. A researcher administered questionnaire was used as a data collection tool to study a stratified sample of 35 members from an estimated population of 350. The findings revealed patterns and trends of non-compliance with records management standards and guidelines. Although there were sporadic cases of record keeping, a greater number of respondents revealed that traditional institutions lack the facilities, equipment, education and trained/skilled personnel to apply correct records management procedures in their daily administration of their traditional communities. The main value of the study is to create awareness of records management as one of the neglected areas in traditional institutions â€“ which are by current legislative arrangement, the closest form of leadership and governance for rural communities in light of their relationship with local municipalities and the Department of Cooperative Governance and Traditional Affairs.

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