scholarly journals Protocol for Investigating the Technical Efficiency of District Hospitals in the Public Health Sector of KwaZulu-Natal, South Africa (Preprint)

2018 ◽  
Author(s):  
Tesleem K Babalola ◽  
Indres Moodley
Keyword(s):  
South Africa ◽  
Health Care ◽  
Resource Allocation ◽  
Technical Efficiency ◽  
Policy Formulation ◽  
Data Availability ◽  
Research Approach ◽  
Policy Makers ◽  
District Hospitals ◽  
Kwazulu Natal

BACKGROUND The central objective of policy makers and health managers is efficiency in the delivery of health care. With frequent reports of global economic crises, there is a need to continuously measure the performance of various sectors of the health care system. This can inform the decision-making process toward allocating scarce resources with the aim of maximizing output. OBJECTIVE The aim of this study is to determine the technical efficiency (TE) of public sector district hospitals in the province of KwaZulu-Natal, South Africa to provide information that will assist in policy formulation that may further assist in more efficient resource allocation decisions. METHODS This is a health system research based on a quantitative research approach. All 38 public district hospitals in the 11 municipalities of the province will be included in this study. The data for the study will include inputs from hospitals’ operations that contribute toward subsequent outputs. The input data will include information such as the number of health professionals (doctors, nurses, and other personnel) and number of hospital beds, whereas the output data will include information such as outpatient visits and number of admissions or discharge. Other data categories to be included will be determined by data availability and will be uniform for all facilities. Data for each facility for a 3-year period from 2014 to 2017 will be obtained from databases of the district health information, basic accounting, and personnel salary systems. On the basis of the data obtained, a model will be developed that can be used to assess how TE of public districts hospitals may be improved. TE will be determined using Data Envelopment Analysis, and factors influencing efficiency will be computed using StataCorp statistical package. RESULTS As of February 2019, the study is at the data collection, data input, and analysis stages. The results are expected to be available from the second quarter of 2019. CONCLUSIONS Findings from this study can add to tools available to policy makers, health planners, and managers in making decisions about resource allocation in health care systems. Moreover, these findings will be disseminated electronically and in print. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/12037

scholarly journals Technical efficiency and productivity of public district hospitals in KwaZulu-Natal province, South Africa

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Tesleem K. Babalola ◽  
Indres Moodley
Keyword(s):  
South Africa ◽  
Technical Efficiency ◽  
Significant Proportion ◽  
Health Service Delivery ◽  
Public Hospitals ◽  
District Health ◽  
District Hospitals ◽  
Study Results ◽  
Kwazulu Natal ◽  
Efficiency And Productivity

Background: District hospitals (DHs) constitute a significant proportion of public hospitals and consume a more substantial percentage of the government’s total hospital budget. With the level of resources disbursed to DHs, it is essential to ensure efficient allocation and utilization. Hence, this study set out to assess the technical efficiency and productivity of public DHs in KwaZulu-Natal province, South Africa. Methods: Data envelopment analysis (DEA) and Malmquist total factor productivity (MTFP) were used to assess technical efficiency, identify adjustments required to make inefficient facilities more efficient, and determine overall productivity growth. Input data such as medical personnel and output information such as outpatient visits were retrieved from the databases of the district health information system (DHIS), and personnel salary systems (PERSAL) for three consecutive financial years (2014/15, 2015/16 and 2016/17). A total of 38 district hospitals were included in the study. Results: The proportion of technically efficient facilities according to constant return to scale (CRS) were 12 (31.6%), 16 (42.1%) and 14 (36.8%) in 2014/15, 2015/16 and 2016/17, respectively, while according to the variable return to scale (VRS) technically efficient facilities were 22 (57.9%), 19 (50.0) and 21 (55.2%), respectively, for the three consecutive years. On average, the total productivity of DHs increased by 4.8 percent over the three years, which is attributed majorly to technical growth of 6.9 percent. Conclusion: This study showed that a significant proportion of the district hospitals were technically inefficiency. Also, steps that could enable more efficient use of healthcare resources to yield optimal health service delivery were recommended.

scholarly journals An investigation into the level of empowerment of rural women in the Zululand district of KwaZulu-Natal province of South Africa

Curationis ◽  
2010 ◽  
Vol 33 (2) ◽  
Author(s):  
B.R. Bhengu
Keyword(s):  
South Africa ◽  
Health Care ◽  
Primary Health Care ◽  
Rural Women ◽  
Group Discussion ◽  
Research Approach ◽  
Women's Groups ◽  
Primary Health ◽  
Women’S Groups ◽  
Kwazulu Natal

The aim of the study was to evaluate the outcome of the empowerment of rural women in relation to gender issues, power, and communication within the Zululand District of KwaZulu-Natal in South Africa after implementation of a four-year Primary Health Care project in partnership with the Provincial Department of Health, and two Schools of Nursing at the University of KwaZulu-Natal and McMaster University in Canada. This project is based on substantial evidence which reveals that rural women are being neglected to the extent that these women have missed out on opportunities for development. The reasons for this disempowerment of women, particularly rural women, are thought to be due to the feminisation of poverty, as well as female submission, educational deprivation, privacy of domestic violence, exploitation, domination by men and cultural oppression (patriarchy).A qualitative research approach was used. Focus group discussion was utilised as the data collection technique, and this was also applied during the collection of baseline data. An interview guide covered issues of concern in the communities and households, including what the women would, or had done about these, how they engaged in decision-making in their families, how they handled situations when there was a difference of opinion, and their awareness of, and ability to claim their rights, including control of their lives. The data was collected from six clinics, from groups of six to ten women in the predominantly rural Zululand District of KwaZulu-Natal.The project has revealed improvement in the women’s realisation of their rights, albeit limited, in communication, self-confidence, and reliance, including partnerships between Primary Health Care Nurses and women’s groups. The formation of women’s groups facilitated community development and participation in their own health, socio-economic and emotional development.The project suggests that such groups be encouraged and allowed to network for support as they understand their own problems better, they merely require facilitation.

scholarly journals First experiences of accrediting district hospitals for excellence in newborn care in KwaZulu-Natal, South Africa: Successes and challenges

2018 ◽  
Vol 7 (3) ◽  
pp. 25 ◽  
Author(s):  
Lyn Haskins ◽  
Dolly Nyasulu ◽  
Ruth Davidge ◽  
Neil McKerrow ◽  
Christiane Horwood
Keyword(s):  
South Africa ◽  
Health Care ◽  
Newborn Care ◽  
Health Facilities ◽  
Quality Health Care ◽  
District Hospitals ◽  
Kwazulu Natal ◽  
Quality Health ◽  
Successes And Challenges

Objective: Providing quality health care is what all health facilities seek to achieve. Accreditation of health services are used to assess and improve the quality of health care in different settings. This study describes experiences of developing and conducting accreditation for excellence in newborn care in district hospitals in KwaZulu-Natal (KZN), South Africa following a 3-year programme of support to all nurseries in KZN.Methods: A facility review was conducted in district hospitals in KZN to evaluate the quality of care provided to newborn babies to accredit hospitals in newborn care. Multiple tools were used to assess different components of care from different perspectives, including record reviews, assessment of staff skills and interviews with mothers. Awarding accreditation was based on scores achieved in various domains, which contributed to an overall score. Compliance with key priority indicators was required for accreditation to be awarded.Results: Overall scores for accreditation ranged between 57%-93%. Mothers reported high levels of satisfaction with care received. Record reviews identified shortfalls in care provided, and skills assessments showed poor resuscitation skills in labour wards in some hospitals. Of 39 district hospitals, eight were awarded silver and five were awarded gold accreditation status.Conclusions: This accreditation of newborn care provides a workable model for undertaking accreditation in district hospitals and can be used by managers to identify and address shortfalls in care. Regular accreditation would support ongoing quality improvement (QI) in neonatal care and such a process could be applied to other aspects of care in health facilities.

scholarly journals Integrated Decentralized Training for Health Professions Education at the University of KwaZulu-Natal, South Africa: Protocol for the I-DecT Project (Preprint)

2017 ◽  
Author(s):  
Pragashnie Govender ◽  
Verusia Chetty ◽  
Deshini Naidoo ◽  
Ntsikelelo Pefile
Keyword(s):  
South Africa ◽  
Health Care ◽  
Specific Model ◽  
Ministry Of Health ◽  
Policy Makers ◽  
Learning Platform ◽  
Kwazulu Natal ◽  
Context Specific ◽  
The University ◽  
Roll Out

BACKGROUND The Integrated Decentralized Training (i-DecT) project was created to address the current need for health care in South Africa among resource poor climates in rural and periurban settings. The University of KwaZulu-Natal (UKZN) in South Africa has embarked on a program within the School of Health Sciences (SHS) to decentralize the clinical learning platform in order to address this disparity. Framed in a pragmatic stance, this proposal is geared towards informing the roll out of decentralized clinical training (DCT) within the province of KwaZulu-Natal. There currently remains uncertainty as to how the implementation of this program will unfold, especially for the diverse SHS, which includes specialities like audiology, dentistry, occupational therapy, optometry, pharmacy, physiotherapy, speech-language pathology, and sport science. Consequently, there is a need to carefully monitor and manage this DCT in order to ensure that the participating students have a positive learning experience and achieve expected academic outcomes, and that the needs of the communities are addressed adequately. OBJECTIVE The study aims to explore the factors that will influence the roll-out of the DCT by developing an inclusive and context-specific model that will adhere to the standards set by the SHS for the DCT program at UKZN. METHODS Key role players, including but not limited to, the South African Ministry of Health policy makers, clinicians, policy makers at UKZN, clinical educators, academicians, and students of UKZN within the SHS will participate in this project. Once the infrastructural, staffing and pedagogical enablers and challenges are identified, together with a review of existing models of decentralized training, a context-specific model for DCTl will be proposed based on initial pilot data that will be tested within iterative cycles in an Action Learning Action Research (ALAR) process. RESULTS The study was designed to fit within the existing structures, and emerging framework and memorandum of understanding between the partners of this initiative, namely, the Ministry of Health and UKZN in order to develop health care professionals that are competent and prepared for the changing dynamics of healthcare in a developing world. CONCLUSIONS It is envisioned that this study, the first to include a combination of health professionals in a DCT platform at UKZN, will not only contribute to effective service delivery, but may also serve to promote an interprofessional cooperation within the SHS and tertiary institutions in similar settings.

scholarly journals Investigating competencies needed by European-trained doctors in rural South African hospitals

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
James R. Barnacle ◽  
Oliver Johnson ◽  
Ian Couper
Keyword(s):  
South Africa ◽  
South African ◽  
Online Survey ◽  
Rural District ◽  
Eastern Cape ◽  
Rural Medicine ◽  
Rural South ◽  
District Hospitals ◽  
Kwazulu Natal ◽  
Postgraduate Diploma

Background: Many European-trained doctors (ETDs) recruited to work in rural district hospitals in South Africa have insufficient generalist competencies for the range of practice required. Africa Health Placements recruits ETDs to work in rural hospitals in Africa. Many of these doctors feel inadequately prepared. The Stellenbosch University Ukwanda Centre for Rural Health is launching a Postgraduate Diploma in Rural Medicine to help prepare doctors for such work.Aim: To determine the competencies gap for ETDs working in rural district hospitals in South Africa to inform the curriculum of the PG Dip (Rural Medicine).Setting: Rural district hospitals in South Africa.Methods: Nine hospitals in the Eastern Cape, KwaZulu-Natal and Mpumalanga were purposefully selected by Africa Health Placements as receiving ETDs. An online survey was developed asking about the most important competencies and weaknesses for ETDs when working rurally. The clinical manager and any ETDs currently working in each hospital were invited to complete the survey.Results: Surveys were completed by 19 ETDs and five clinical managers. The top clinical competencies in relation to 10 specific domains were identified. The results also indicate broader competencies required, specific skills gaps, the strengths that ETDs bring to South Africa and how ETDs prepare themselves for working in this context.Conclusion: This study identifies the important competency gaps among ETDs and provides useful direction for the diploma and other future training initiatives. The diploma faculty must reflect on these findings and ensure the curriculum is aligned with these gaps.

scholarly journals Views of health care professionals and policy-makers on the use of surveillance data to combat antimicrobial resistance

2020 ◽  
Author(s):  
Mustafa Al-Haboubi ◽  
Andrew Trathen ◽  
Nick Black ◽  
Elizabeth Eastmure ◽  
Nicholas Mays
Keyword(s):  
Health Care ◽  
Antimicrobial Resistance ◽  
Health Care Professionals ◽  
Secondary Care ◽  
Local Level ◽  
Surveillance Data ◽  
Data Availability ◽  
Electronic Prescribing ◽  
Data Systems ◽  
Policy Makers

Abstract Background Providing healthcare professionals with health surveillance data aims to support professional and organisational behaviour change. The UK Five Year Antimicrobial Resistance (AMR) Strategy 2013 to 2018 identified better access to and use of surveillance data as a key component. Our aim was to determine the extent to which data on antimicrobial use and resistance met the perceived needs of health care professionals and policy-makers at national, regional and local levels, and how provision could be improved. Methods We conducted 41 semi-structured interviews with national policy makers in the four Devolved Administrations and 71 interviews with health care professionals in six locations across the United Kingdom selected to achieve maximum variation in terms of population and health system characteristics. Transcripts were analysed thematically using a mix of a priori reasoning guided by the main topics in the interview guide together with themes emerging inductively from the data. Views were considered at three levels - primary care, secondary care and national - and in terms of availability of data, current uses, benefits, gaps and potential improvements. Results Respondents described a range of uses for prescribing and resistance data. The principal gaps identified were prescribing in private practice, internet prescribing and secondary care (where some hospitals did not have electronic prescribing systems). Some respondents under-estimated the range of data available. There was a perception that the responsibility for collecting and analysing data often rests with a few individuals who may lack sufficient time and appropriate skills. Conclusions There is a need to raise awareness of data availability and the potential value of these data, and to ensure that data systems are more accessible. Any skills gap at local level in how to process and use data needs to be addressed. This requires an identification of the best methods to improve support and education relating to AMR data systems.

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