scholarly journals SANTA vs. public tuberculosis hospitals: the patient experience in the Free State, 2001/2002

Curationis ◽  
2007 ◽  
Vol 30 (1) ◽  
Author(s):  
J.C Heunis ◽  
H.C.J. Van Rensburg ◽  
H. Meulemans
Keyword(s):  
South Africa ◽  
Health Beliefs ◽  
Patient Experience ◽  
Hospital Care ◽  
Public Hospitals ◽  
Positive Patient ◽  
Free State ◽  
Adherence To Treatment ◽  
Nongovernmental Organisation ◽  
District Hospitals

This paper reflects on the appropriateness of the decision to close down a nongovernmental organisation (NGO), state-aided tuberculosis (TB) hospital in the Free State in 2003. Henceforth hospitalisation of TB patients would take place at public district hospitals. A survey conducted late-2001/'early-2002 revealed a more positive patient experience of hospitalisation forTB in public hospitals than in the NGO hospital. Consideration of the patient experience serves to inform the debate concerning continued outsourcing of TB hospital care to NGOs in South Africa. This study discusses comparative findings in respect of patients’ biographic and socio-economic characteristics, health beliefs, satisfaction with hospitalisation, experience of stigmatisation, adherence to treatment and absconding from hospital.

Barriers to HIV counselling and testing uptake by health workers in three public hospitals in Free State Province, South Africa

AIDS Care ◽  
2014 ◽  
Vol 27 (2) ◽  
pp. 198-205 ◽  
Author(s):  
Rabia Khan ◽  
Annalee Yassi ◽  
Michelle C. Engelbrecht ◽  
Letshego Nophale ◽  
André J. van Rensburg ◽  
...  
Keyword(s):  
South Africa ◽  
Health Workers ◽  
Public Hospitals ◽  
Free State ◽  
Free State Province ◽  
Hiv Counselling And Testing ◽  
Testing Uptake

Costs of district hospitals in South Africa

2005 ◽  
Vol 16 (4) ◽  
pp. 431-440
Author(s):  
Abiodun Olukoga ◽  
Geoff Harris
Keyword(s):  
South Africa ◽  
Average Length ◽  
Unit Cost ◽  
Hospital Costs ◽  
Indirect Costs ◽  
Public Hospitals ◽  
Vulnerable Groups ◽  
District Health ◽  
Unit Costs ◽  
District Hospitals

The district hospitals are an integral part of the district health system (DHS) in South Africa fulfilling several important functions. Using data obtained from relevant published reports. The district hospital costs were allocated using the ‘ingredients approach’ that combined a top-down method and step-down sequence. The costs in the treatment of patients were grouped into six cost centres: buildings, drugs, equipment, materials, personnel and utilities. The unit costs were broadly grouped into two categories using the hospital departments (fixed and variable costs) and input use (direct and indirect costs). More than 30% of the total public expenditure on hospitals in the country was on district hospitals between 1996/97 and 1998/99. They had more beds per population (1.08/1000) than other public hospitals. The bed occupancy rates in these hospitals were generally very low varying between 57% and 75%. The average length of stay (ALOS) was within acceptable range in the hospital except in Osindisweni hospital. Personnel costs were more than 70% and drugs only 3% to 6% of the total costs. McCord hospital was the most expensive using total and unit costs. Harrismith hospital had the lowest total costs and Osindisweni hospital the lowest unit cost. Most of the costs were fixed or direct costs in all the hospitals. There is the need for the adoption of measures to ensure that the hospitals are efficiently run while maintaining access for vulnerable groups.

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 Instrumental Support for Professional Nurses Caring for Patients Living with HIV/AIDS in the Tshwane District of Gauteng, South Africa

2018 ◽  
Vol 19 (3) ◽  
Author(s):  
Nthomeni Dorah Ndou
Keyword(s):  
South Africa ◽  
Nurse Managers ◽  
Opportunistic Infections ◽  
Immune Deficiency Syndrome ◽  
Deficiency Syndrome ◽  
Public Hospitals ◽  
Instrumental Support ◽  
District Hospitals ◽  
Professional Nurses ◽  
Hiv Aids

Public hospitals across South Africa are flooded by patients diagnosed with the human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) related illnesses. The AIDS situation has completely changed the medical landscape and placed a great burden on the shoulders of professional nurses. The purpose of this study was to explore and describe instrumental support for the professional nurses. Challenges faced by the professional nurses were fatigue, ill health, resignation and poor HIV/AIDS care to patients admitted with opportunistic infections. The study was conducted at one of the Tshwane district hospitals in Gauteng, South Africa. Instrumental support was explored focusing on tangible assistance provided by the hospital and nurse managers. A qualitative approach with explorative, descriptive and contextual designs was employed. Purposive sampling method was used to select 25 participants who participated in the individual face-to-face interviews. Data gathered from the participants were analysed using Tesch’s eight-step criteria of open-coding techniques. The findings of the study revealed that the hospital and nurse managers did not provide effective tangible support. It was recommended that instrumental support for professional nurses who care for patients diagnosed with HIV/AIDS-related illnesses be effectively provided by the hospital and the nurse managers through the development of a model to deal with instrumental challenges.

Verbal compliance-gaining strategies used by male physicians and patient healthcare experience

2017 ◽  
Vol 13 (2) ◽  
pp. 185-202 ◽  
Author(s):  
Annabel Levesque ◽  
Han Z. Li
Keyword(s):  
Health Status ◽  
Patient Experience ◽  
Lifestyle Changes ◽  
Positive Patient ◽  
Negative Experience ◽  
Healthcare Experience ◽  
Healthcare Experiences ◽  
Compliance Gaining ◽  
Family Practice Clinic ◽  
Motivation Strategies

This study explores male physicians’ use of verbal compliance gaining strategies to encourage patients to adhere to medication regimens, lifestyle changes, or future appointments, and assesses which strategies are associated with patients’ reported healthcare experiences. Five physicians from a family practice clinic in northern British Columbia, Canada, were audio-recorded while interacting with 31 patients during actual consultations. Compliance-gaining utterances were coded into five categories of strategies, while patient experience with care was assessed using a questionnaire. A number of intriguing findings emerged: direct orders were related to a more negative experience with interpersonal aspects of care, but were fairly frequently used, especially with female patients. Persuasion was the only strategy that promoted a positive patient experience, but was rarely used. However, the effect of persuasion on patient experience was no longer significant when adjusting for patients’ health status. Physicians relied mostly on motivation strategies to encourage adherence, but these strategies were not related to patients’ assessment of their healthcare experiences. These results suggest that the most frequently used verbal compliance gaining strategies by physicians are not always appreciated by patients. To be more effective, it is necessary to inform physicians about which compliance-gaining strategies promote a positive patient healthcare experience.

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 Circulation pattern controls of wet days and dry days in Free State, South Africa

2021 ◽  
Author(s):  
Chibuike Chiedozie Ibebuchi
Keyword(s):  
South Africa ◽  
Indian Ocean ◽  
Atmospheric Circulation ◽  
Southern Africa ◽  
Austral Summer ◽  
Free State ◽  
Austral Spring ◽  
Study Region ◽  
Southwest Indian Ocean ◽  
South Indian

AbstractAtmospheric circulation is a vital process in the transport of heat, moisture, and pollutants around the globe. The variability of rainfall depends to some extent on the atmospheric circulation. This paper investigates synoptic situations in southern Africa that can be associated with wet days and dry days in Free State, South Africa, in addition to the underlying dynamics. Principal component analysis was applied to the T-mode matrix (variable is time series and observation is grid points at which the field was observed) of daily mean sea level pressure field from 1979 to 2018 in classifying the circulation patterns in southern Africa. 18 circulation types (CTs) were classified in the study region. From the linkage of the CTs to the observed rainfall data, from 11 stations in Free State, it was found that dominant austral winter and late austral autumn CTs have a higher probability of being associated with dry days in Free State. Dominant austral summer and late austral spring CTs were found to have a higher probability of being associated with wet days in Free State. Cyclonic/anti-cyclonic activity over the southwest Indian Ocean, explained to a good extent, the inter-seasonal variability of rainfall in Free State. The synoptic state associated with a stronger anti-cyclonic circulation at the western branch of the South Indian Ocean high-pressure, during austral summer, leading to enhanced low-level moisture transport by southeast winds was found to have the highest probability of being associated with above-average rainfall in most regions in Free State. On the other hand, the synoptic state associated with enhanced transport of cold dry air, by the extratropical westerlies, was found to have the highest probability of being associated with (winter) dryness in Free State.

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