scholarly journals Critical reflections on a visit to an inner-city primary health care clinic in Rio de Janeiro

Author(s):  
Louis S. Jenkins ◽  
Marcos A. Goldraich

Introduction: Brazil and South Africa share many sociodemographic and health features that provide many learning opportunities. Brazil’s national health system, the Sistema Único de Saúde (SUS) prioritises primary health care since 1994, the year democracy came to South Africa. Two family physicians from these countries met in Rocinha favela in Rio de Janeiro, a densely populated area where poverty, danger, drugs, tuberculosis and mental illness are the focus of the health system.Maria do Socorro Family Clinic: Central to the SUS are the Family Health Teams, consisting of community health workers, nurses, doctors and allied health workers. This clinic in Rocinha has 11 teams, caring for 2700 people each, all visited monthly, preventing illness and promoting health. Patients with mental illness are cared for in a therapeutic residency, with an onsite psychiatrist, psychologist and social worker. The relationships between the health carers and the clinic and the community are collegial and equal, sharing care. Larger than life photos of patients from the community line the walls.Training: A culture of learning is evident, with 18 family medicine residents, student nurses, a small library and a learning centre at the clinic. Local authorities compensate trainees in family medicine more than traditional specialties.Conclusion: Brazil has made massive progress in providing universal health coverage over the last 20 years. South Africa, with not too dissimilar challenges, is embarking on this road more recently. The lessons learnt at clinic and community level in this inner-city clinic could be very useful for similar settings in South Africa and other countries.

Curationis ◽  
2007 ◽  
Vol 30 (4) ◽  
Author(s):  
T.J. Molapo ◽  
T.M.M. Maja ◽  
S.C.D. Wright

Sexually transmitted infections are a major public health problem in South Africa. The high incidence and prevalence of sexually transmitted infections in South Africa pose a serious threat to public health for two main reasons. Firstly, the long-term consequences of these infections are a major cause of loss of health or life, and secondly, sexually transmitted infections are important co-factors in driving the human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) epidemic. The control and prevention of sexually transmitted infections has become an urgent priority. At a primary health care clinic, the nursing personnel experienced an increasing number of persons daily seeking treatment for sexually transmitted infections. The purpose of the study was therefore to investigate the knowledge, attitudes and perceptions of people seeking treatment at Stanza Bopape Clinic regarding sexually transmitted infections. The study was a contextual, quantitative survey. The population was all patients (15 years and older) who visited the clinic for a health-related problem during November 2004 to January 2005. The sampling method was convenient. The data gathering method was self-report using a structured questionnaire basic on current knowledge. The data analysis was done with descriptive statistics.


2002 ◽  
Vol 32 (4) ◽  
pp. 33-40 ◽  
Author(s):  
Nokuthula Shabalala ◽  
Anna Strebel ◽  
Tammy Shefer ◽  
Leickness Simbayi ◽  
Tanya Wilson ◽  
...  

Sexually transmitted infections (STIs) are one of the most common illnesses among adolescents and adults in developing countries. While research from other countries indicates that a lack of financial, infra-structural and human resources are central determinants of the quality of care for STIs, South African studies suggest that there are also problems in health workers' interactions with STI patients. This study investigates the quality of care for STIs at 24 primary health care (PHC) centres in four provinces of South Africa (SA). Semi-structured interviews were conducted with STI patients and health providers. In addition, in-depth interviews were conducted with a sample of STI patients, and focus group discussions were held with diverse community groupings. Simulated patients also completed questionnaires on the care they received at the centres. Frequencies were computed on close-ended questions in order to describe patterns and trends in the data. Cross-tabulations were calculated to check for gender, provincial and urban-rural differences. Composite scores were also generated for the purpose of comparing quality of care across the different participating groups. Finally, the depth interviews and focus groups were analysed thematically. The results show that PHC centres in SA are relatively well-resourced. However, problems were found in the actual encounter between health workers and STI patients, which severely undermines the quality and effectiveness of treatment. It is strongly recommended that attention be given to health providers, in particular through the provision of further training and support in relation to effective STI management.


2013 ◽  
Vol 04 (01) ◽  
pp. 25-36 ◽  
Author(s):  
P. Rautenbach ◽  
N. Mbananga ◽  
T. Mashamba ◽  
H. Kwinda ◽  
V. Horner

Summary Background: There are problems of quality in maternity services at primary health care level in South Africa. Many of these problems can be traced to non-adherence to the maternity care guidelines and lack of tools to support clinic staff and managers in their roles. Objective: The aim of this research was to investigate the utility of e-health (computerized) decision support systems at addressing the problem of compliance of health workers to the maternity care guidelines at primary health care in South Africa. At present there are no documented studies on e-health clinical decision support systems for primary health care in South Africa, though clinical decision support systems for primary health care are listed as part of the e-health strategy of the National Department of Health. Methods: An e-health decision support system named the Bacis (Basic Antenatal Care In-formation System) Program was developed, then implemented and evaluated at a primary health care clinic. The duration of the study was two years: this includes development, implementation and evaluation. Results and Conclusion: There was an overall improvement in compliance from 85.1 % to 89.3%. This result was not statistically significant. However when results were stratified into specific categories, the Bacis Program showed statistically significant improvement in compliance over the checklist system in three out of nine important categories. These are compliance at booking, patients younger than 18 years and patients booking after week 20. Further, insights and experience were also gained on development and implementation of clinical information systems at resource strained environments such as primary health care in South Africa. These results, insights and experience are invaluable for the implementation of the proposed e-health strategy in South Africa. Citation: Horner V, Rautenbach P, Mbanang N, Mashamba T, Kwinda H. An e-health decision support system for improving compliance of health workers to the maternity care protocols in South Africa. Appl Clin Inf 2013; 4: 25–36http://dx.doi.org/10.4338/ACI-2012-10-RA-0044


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