scholarly journals Perceptions and Experiences of Frontline Health Managers and Providers on Accountability in a South African Health District

2019 ◽  
Author(s):  
Fidele Kanyimbu Mukinda ◽  
Sara Van Belle ◽  
Helen Schneider
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
South African ◽  
Collective Responsibility ◽  
Care Hospital ◽  
Culture Of Learning ◽  
Primary Health ◽  
African Health ◽  
South African Health ◽  
Health Managers

Abstract Objective This study explored and described accountability as perceived and experienced by frontline health managers and providers of maternal, newborn and child health (MNCH) services in a South African health district.Methods This was a qualitative study involving in-depth interviews with a purposive sample of 58 frontline health managers and providers in the district office and in two sub-districts, examining the meanings of accountability and related lived experiences.Results Accountability was described by respondents as both an organisational mechanism of answerability and responsibility and an intrinsic professional virtue. Accountability relationships were understood to be multidirectional - upwards and downwards in hierarchies, outwards to patients and communities, and inwards to the “self”. The practice of accountability was challenged in organisational environments where impunity and unfair punishment existed alongside each other, where political connections constrained the ability to sanction and by climates of fear and blame. Accountability was enabled by open management styles, teamwork, good relationships between primary health care, hospital services and communities, investment in knowledge and skills development and responsive support systems. The interplay of these enablers and constraints varied across the facilities and sub-districts studied.Conclusions and Recommendations Providers and managers have well-established ideas about, and a language of, accountability. The lived reality of accountability by frontline managers and providers varies and is shaped by micro-configurations of enablers and constraints in local accountability ecosystems. Fairness, open leadership styles, teamwork and collaboration between primary health care and hospitals and community participation were seen as promoting accountability, enabling collective responsibility and a culture of learning rather than blame.

scholarly journals Policy-making for real: Politics and progress in South African health care

Curationis ◽  
1993 ◽  
Vol 16 (3) ◽  
Author(s):  
A. Fourie ◽  
H. C. J. Van Rensburg
Keyword(s):  
Health Care ◽  
South African ◽  
Policy Making ◽  
Status Quo ◽  
African Health ◽  
The Status ◽  
Policy Measures ◽  
South African Health

Problems have been accumulating in South African health care for well over three centuries yet when it comes to resolving the crisis by means of appropriate policy measures, one becomes aware of the powers at play and the interests at stake in maintaining the status quo, thus obstructing much initiative in the process of reform.

scholarly journals Adaptation of the Rapid Estimate of Adult Litera cy in Medicine Revised (REALM -R) to the South African context: Part 1

2010 ◽  
Vol 15 (1) ◽  
Author(s):  
Zelda Wasserman ◽  
Susanna C.D. Wright ◽  
Todd Mavis Maja
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
South African ◽  
Care Setting ◽  
Health Care Setting ◽  
South African Context ◽  
The South ◽  
Primary Health Care Setting ◽  
Primary Health ◽  
African Context

Literacy levels are increasingly important in health care because professional nurses and other health care professionals often use written health education materials as a major component in patient education. In South Africa, no current instrument is available to assess the literacy levels of patients in the primary health care setting, though several instruments have been developed and validated internationally. The purpose of this paper was to adapt and validate the Rapid Estimate of Adult Literacy in Medicine Revised (REALM-R) to the South African context. The REALM-R is a short instrument that is designed to rapidly screen clients in the primary health care setting for low health literacy. A modified Delphi-technique was used to measure the judgement of a group of experts for the purpose of making a decision. Eight experts in the field of Nursing Science were selected purposively to obtain the most reliable consensus. Data was collected by means of a selfreport whereby participants responded to a series of questions posed by the researcher. Descriptive statistics was used for analysing data. The REALM-R was adapted to the South African context to ensure that the literacy level of South African clients is measured with an appropriate instrument.OpsommingGeletterdheidsvlakke word toenemend belangrik in gesondheidsorg aangesien geregistreerde verpleegkundiges en ander gesondheidswerkers dikwels geskrewe gesondheidopvoedkundige materiaal gebruik. Op die oomblik in Suid-Afrika is daar geen geletterdheidsvlaksinstrument beskikbaar om pasiënte in primêre gesondheidsorg se geletterdheid te toets nie. Daar bestaan wel gevalideerde internasionale instrumente. Die doel van die studie was om die REALM-R, ‘n internasionaal gevalideerde mediese geletterdheidsinstrument, aan te pas en te valideer om in die Suid-Afrikaanse konteks gebruik te kan word. Die REALM-R is ‘n kort geletterdheidsinstrument wat ontwikkel was om primêre sorg pasiênte wat moontlik lae geletterdheidsvaardigheid het, te kansif. ‘n Aangepasde Delphi-tegniek is gebruik om die oordeel van ‘n groep kundiges in te win. Agt kundiges in verpleegwetenskappe is doelgerig gekies ten einde ‘n betroubare ooreenkoms te verkry.Data is deur middel van self-raportering ingewin deurdat die deelnemers op vrae, gestel deur die navorser, geantwoord het. Beskrywende statistiek is gebruik om die data te ontleed. Die REALM-R is aangepas vir die Suid-Afrikaanse konteks ten einde ‘n geskikte instrument beskikbaar te stel om die geletterdheidsvaardigheid van primêre sorg pasiente vinnig en akkuraat te kan meet.

scholarly journals Consulting the South African experts in physiotherapeutic stroke rehabilitation

2001 ◽  
Vol 57 (2) ◽  
pp. 32-40 ◽  
Author(s):  
L. A. Hale ◽  
C. J. Eales
Keyword(s):  
South Africa ◽  
Health Care ◽  
South African ◽  
Stroke Rehabilitation ◽  
Delphi Technique ◽  
Rehabilitation Services ◽  
The South ◽  
Innovative Methods ◽  
African Health ◽  
South African Health

This paper presents the opinions of expert physiotherapists on what constitutes optimal stroke rehabilitation in South Africa. Data were collected by the use of the Delphi technique. Consensus was reached after two rounds, and the respondents’ views are summarised and discussed within the framework of South African health care. Results showed that physiotherapy was felt to be very important after stroke, and the survey created a profile of the skills that physiotherapists may require in order to work in this field. However, no new or innovative methods by which appropriate rehabilitation services could be delivered in South Africa were generated by the survey.The Delphi technique is described and its use in this survey considered.

South African health care in black and white

The Lancet ◽  
1998 ◽  
Vol 351 (9113) ◽  
pp. 1421-1424
Author(s):  
Gabrielle Murphy
Keyword(s):  
Health Care ◽  
South African ◽  
Black And White ◽  
African Health ◽  
South African Health
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