The Community Crisis in the Rural South

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.

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Resource recovery from and management of wastewater in rural South Africa: Possibilities and practices

Journal of Water Process Engineering ◽

10.1016/j.jwpe.2021.101978 ◽

2021 ◽

Vol 40 ◽

pp. 101978 ◽

Cited By ~ 1

Author(s):

Masego Montwedi ◽

Mujuru Munyaradzi ◽

Luc Pinoy ◽

Abhishek Dutta ◽

David S. Ikumi ◽

...

Keyword(s):

South Africa ◽

Resource Recovery ◽

Rural South ◽

Rural South Africa

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From “Secret” to “Sensitive Issue”: Shifting Ideas About HIV Disclosure Among Middle-Aged and Older Rural South Africans in the Era of Antiretroviral Treatment

Journal of Aging and Health ◽

10.1177/08982643211020202 ◽

2021 ◽

pp. 089826432110202

Author(s):

Enid Schatz ◽

Ifeolu David ◽

Nicole Angotti ◽

F. Xavier Gómez-Olivé ◽

Sanyu A. Mojola

Keyword(s):

Older Persons ◽

Antiretroviral Treatment ◽

Hiv Disclosure ◽

Death Sentence ◽

Treatment As Prevention ◽

Negative Consequences ◽

Middle Aged ◽

Group Discussions ◽

Rural South ◽

South Africans

Objective As HIV shifts from “death sentence” to “chronic condition,” disclosure of HIV status to intimate partners and family is a significant component of both prevention and treatment adherence. While disclosure is closely considered in many studies, few examine middle-aged and older persons’ (age 40+) perspectives or practices. We trace older rural South Africans’ views on HIV disclosure to their partners and family members in a high prevalence community over a period of extensive antiretroviral treatment (ART) rollout. Methods Community focus group discussions (FGD) conducted in 2013 and 2018 show shifts in older persons’ thinking about HIV disclosure. Findings Our FGD participants saw fewer negative consequences of disclosure in 2018 than in 2013, and highlighted positive outcomes including building trust (partners) as well as greater support for medication collection and adherence (family). Discussion Particularly as the epidemic ages in South Africa and globally, tracing changes in older persons’ views on disclosure is an important step in developing messaging that could enhance treatment as prevention and ART adherence.

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