scholarly journals The impact of family physician supply on district health system performance, clinical processes and clinical outcomes in the Western Cape Province, South Africa (2011–2014)

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Rekai L. Chinhoyi ◽  
Moleen Zunza ◽  
Klaus B. Von Pressentin
Keyword(s):  
South Africa ◽  
Health System ◽  
Family Physician ◽  
System Performance ◽  
Health System Performance ◽  
Western Cape ◽  
Western Cape Province ◽  
District Health ◽  
District Health System ◽  
The Impact

Background: A revised family physician (FP) training programme was introduced in South Africa in 2007. A baseline assessment (2011) of the impact of FP supply on district health system performance was performed within the Western Cape Province, South Africa. The impact of an increased FP supply within this province required re-evaluation.Aim: To assess the impact of FP supply on indicators of district health system performance, clinical processes and clinical outcomes in the Western Cape Province. The objectives were to determine the impact of FPs, nurses, medical officers (MOs) and other specialists.Setting: The study sample included all five rural districts and eight urban subdistricts of the Western Cape Province.Methods: A secondary analysis was performed on routinely collected data from the Western Cape Department of Health from 01 March 2011 until 30 April 2014.Results: The FP supply did not significantly impact the indicators analysed. The supply of nurses and MOs had an impact on some of the indicators analysed.Conclusion: This study did not replicate the positive associations between an increase in FP supply and improved health indicators, as described previously for high-income country settings. The impact of FP supply on clinical processes, health system performance and outcome indicators in the Western Cape Province was not statistically significant. Future re-evaluation is recommended to allow for more time and an increase in FP supply.

scholarly journals How far does family physician supply correlate with district health system performance?

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Robin E. Dyers ◽  
Robert Mash ◽  
Tracey Naledi
Keyword(s):  
Health System ◽  
Family Physician ◽  
System Performance ◽  
Family Physicians ◽  
Health System Performance ◽  
Western Cape ◽  
Physician Supply ◽  
District Health ◽  
District Health System ◽  
The Impact

Background: Since 2011, a new cadre of family physicians, with 4 years of postgraduate training, was deployed in the district health services of the Western Cape, and tasked witha considerable range of duties aimed at a general improvement in care and health outcomes. There is a need to evaluate the contribution of these family physicians to the district health system.Aim: To develop a methodology for describing the correlation between family physician supply and district health system performance, clinical processes and outcomes, and to measure this correlation at baseline.Method: A cross-sectional study was undertaken that analysed data at an ecological level for the period of 01 April 2011 to 31 March 2012. This was a pilot project analysing data from the first year of a 4-year project. The correlations between family physician supply and 18 health system indicators were assessed within a logic model. The supplies of other categories of staff were also measured.Results: Although most of the correlations with family physicians were positive, the study was unable to demonstrate any strong or statistically significant correlations at baseline. There were significant correlations with other categories of staff.Conclusions: This study developed a methodology for monitoring the relationship between family physician supply using routinely collected indicators of health system performance, clinical processes and outcomes over time. Additional research will also be needed to investigate the impact of family physicians and triangulate findings as this methodology has many limitations and potential confounding factors.

scholarly journals Assessment of the impact of family physicians in the district health system of the Western Cape, South Africa

2014 ◽  
Vol 6 (1) ◽  
Author(s):  
Meyer Swanepoel ◽  
Bob Mash ◽  
Tracey Naledi
Keyword(s):  
South Africa ◽  
Health Outcomes ◽  
Health System ◽  
System Performance ◽  
Positive Impact ◽  
Family Physicians ◽  
Health System Performance ◽  
District Health ◽  
District Health System ◽  
The Impact

Background: In 2007, South Africa made family medicine a new speciality. Family physicians that have trained for this new speciality have been employed in the district health system since 2011. The aim of the present study was to explore the perceptions of district managers on the impact of family physicians on clinical processes, health system performance and health outcomes in the district health system (DHS) of the Western Cape.Methods: Nine in-depth interviews were performed: seven with district managers and two with the chief directors of the metropolitan and rural DHS. Interviews were recorded, transcribed and analysed using the ATLAS-ti and the framework method.Results: There was a positive impact on clinical processes for HIV/AIDS, TB, trauma, noncommunicable chronic diseases, mental health, maternal and child health. Health system performance was positively impacted in terms of access, coordination, comprehensiveness and efficiency. An impact on health outcomes was anticipated. The impact was not uniform throughout the province due to different numbers of family physicians and different abilities to function optimally. There was also a perception that the positive impact attributed to family physicians was in the early stages of development. Unanticipated effects included concerns with their roles in management and training of students, as well as tensions with career medical officers.Conclusion: Early feedback from district managers suggests that where family physicians are employed and able to function optimally, they are making a significant impact on health system performance and the quality of clinical processes. In the longer term, this is likely to impact on health outcomes.

scholarly journals When people do not ‘Zol’: Reduced emergency centre attendance of patients with chronic obstructive pulmonary disease during coronavirus disease 2019 lockdown with the accompanying tobacco sales ban in South Africa

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Piero Saieva ◽  
Louis S. Jenkins
Keyword(s):  
South Africa ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Prevalence Rate ◽  
Chronic Obstructive ◽  
Western Cape ◽  
Western Cape Province ◽  
Obstructive Pulmonary Disease ◽  
Tract Infections ◽  
The Impact

The coronavirus disease 2019 (COVID-19) pandemic has spread throughout the world, with devastating effects of the virus as well as the repercussions of the resulting ‘lockdowns’. South Africa went into a national lockdown in March 2020 to mitigate the impact of the virus. This included a ban on the sales of tobacco and electronic cigarette products. The ban has been a highly contentious issue in South Africa, discussed worldwide, which has drawn many criticisms. The prevalence rate of smoking in South Africa was around 21.5%, with the Western Cape province having a prevalence rate of 39%. We compared the number of chronic obstructive pulmonary disease (COPD) presentations at a large regional referral hospital in the Western Cape province from January to August 2019 with the same period in 2020. Electronic emergency centre data showed a reduction of 69.28% in COPD presentations. To control for some confounders for the same period, we also reviewed patients presenting with urinary tract infections, which showed only a 30.60% reduction. This notable reduction in COPD presentations reduced service pressure of emergency centre and most likely benefitted patients’ health. Further research and policies are needed to ensure ongoing reduction in the prevalence of smoking.

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