scholarly journals A two-step quality-improvement intervention to address Pap smear quality at public health facilities in South Africa

2018 ◽  
Vol 108 (11) ◽  
pp. 926
Author(s):  
M Mulongo ◽  
A M Oberlin ◽  
C Firnhaber ◽  
B Goeieman ◽  
S Ramotshela ◽  
...  
Keyword(s):  
Public Health ◽  
South Africa ◽  
Quality Improvement ◽  
Pap Smear ◽  
Health Facilities ◽  
Quality Improvement Intervention ◽  
Public Health Facilities ◽  
Improvement Intervention

scholarly journals Effectiveness of a quality improvement intervention to increase adherence to key practices during female sterilization services in Chhattisgarh and Odisha states of India

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0244088
Author(s):  
Ashish Srivastava ◽  
Geeta Chhibber ◽  
Neeta Bhatnagar ◽  
Angela Nash-Mercado ◽  
Jyoti Samal ◽  
...  
Keyword(s):  
Public Health ◽  
Quality Improvement ◽  
Service Providers ◽  
Health Facilities ◽  
Quality Improvement Intervention ◽  
Female Sterilization ◽  
Public Health Facilities ◽  
Operative Care ◽  
Urine Testing ◽  
The Impact

Background In response to longstanding concerns around the quality of female sterilization services provided at public health facilities in India, the Government of India issued standards and quality assurance guidelines for female sterilization services in 2014. However, implementation remains a challenge. The Maternal and Child Survival Program rolled out a package of competency-based trainings, periodic mentoring, and easy-to-use job aids in parts of five states to increase service providers’ adherence to key practices identified in the guidelines. Methods The study employed a before-and-after quasi-experimental design with a matched comparison arm to examine the effect of the intervention on provider practices in two states: Odisha and Chhattisgarh. Direct observations of female sterilization services were conducted in selected public health facilities, using a checklist of 30 key practices, at two points in time. Changes in adherence to key practices from baseline to endline were compared at 12 intervention and 12 comparison facilities using a difference in difference analysis. Results Several key practices were well-established prior to the intervention, with adherence levels over 90% at baseline, including hemoglobin and urine testing, use of sterile surgical gloves and instruments, and recommended surgical technique. However, adherence to many other practices was extremely low at baseline. The program significantly increased adherence to nine practices, including those related to ascertaining client’s medical eligibility, client-provider interaction, the consent process, and post-operative care. The greatest improvement was observed in the provision of written instructions for clients prior to discharge. At endline, however, adherence remained below 50% for 14 practices. Conclusion Low adherence to key practices at baseline confirmed the need for quality improvement interventions in female sterilization services. While the intervention improved adherence to certain practices around admission and post-operative care, inadequate human resources and infrastructure, among other factors, may have blunted the impact of the intervention.

scholarly journals Costs of integrating HIV self-testing in public health facilities in Malawi, South Africa, Zambia and Zimbabwe

2021 ◽  
Vol 6 (Suppl 4) ◽  
pp. e005191
Author(s):  
Linda Alinafe Sande ◽  
Katleho Matsimela ◽  
Lawrence Mwenge ◽  
Collin Mangenah ◽  
Augustine Talumba Choko ◽  
...  
Keyword(s):  
Public Health ◽  
South Africa ◽  
Hiv Testing ◽  
Health Facilities ◽  
Public Health Facilities ◽  
Time And Motion ◽  
Self Testing ◽  
Secondary Distribution ◽  
Facility Level ◽  
The Cost

IntroductionAs countries approach the UNAIDS 95-95-95 targets, there is a need for innovative and cost-saving HIV testing approaches that can increase testing coverage in hard-to-reach populations. The HIV Self-Testing Africa-Initiative distributed HIV self-test (HIVST) kits using unincentivised HIV testing counsellors across 31 public facilities in Malawi, South Africa, Zambia and Zimbabwe. HIVST was distributed either through secondary (partner’s use) distribution alone or primary (own use) and secondary distribution approaches.MethodsWe evaluated the costs of adding HIVST to existing HIV testing from the providers’ perspective in the 31 public health facilities across the four countries between 2018 and 2019. We combined expenditure analysis and bottom-up costing approaches. We also carried out time-and-motion studies on the counsellors to estimate the human resource costs of introducing and demonstrating how to use HIVST for primary and secondary use.ResultsA total of 41 720 kits were distributed during the analysis period, ranging from 1254 in Zimbabwe to 27 678 in Zambia. The cost per kit distributed through the primary distribution approach was $4.27 in Zambia and $9.24 in Zimbabwe. The cost per kit distributed through the secondary distribution approach ranged from $6.46 in Zambia to $13.42 in South Africa, with a wider variation in the average cost at facility-level. From the time-and-motion observations, the counsellors spent between 20% and 44% of the observed workday on HIVST. Overall, personnel and test kit costs were the main cost drivers.ConclusionThe average costs of distributing HIVST kits were comparable across the four countries in our analysis despite wide cost variability within countries. We recommend context-specific exploration of potential efficiency gains from these facility-level cost variations and demand creation activities to ensure continued affordability at scale.

scholarly journals A Quality Improvement Intervention to Inform Scale-Up of Integrated HIV-TB Services: Lessons Learned From KwaZulu-Natal, South Africa

2021 ◽  
Vol 9 (3) ◽  
pp. 444-458
Author(s):  
Santhanalakshmi Gengiah ◽  
Kogieleum Naidoo ◽  
Regina Mlobeli ◽  
Maureen F. Tshabalala ◽  
Andrew J. Nunn ◽  
...  
Keyword(s):  
South Africa ◽  
Quality Improvement ◽  
Scale Up ◽  
Lessons Learned ◽  
Quality Improvement Intervention ◽  
Kwazulu Natal ◽  
Improvement Intervention

scholarly journals Health workers’ disrespectful and abusive behaviour towards women during labour and delivery: A qualitative study in Durban, South Africa

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261204
Author(s):  
Sphindile Mapumulo ◽  
Lyn Haskins ◽  
Silondile Luthuli ◽  
Christiane Horwood
Keyword(s):  
Public Health ◽  
South Africa ◽  
Health Workers ◽  
Working Women ◽  
Adverse Outcomes ◽  
Health Facilities ◽  
Health Concern ◽  
Disrespect And Abuse ◽  
Public Health Facilities ◽  
Abusive Behaviour

Background A high prevalence of disrespectful and abusive behaviour by health workers towards women during labour and delivery has been widely described in health facilities, particularly in Africa, and is a worldwide public health concern. Such behaviours are barriers to care-seeking, and are associated with adverse outcomes for mothers and newborns. This paper reports experiences of disrespectful care among informal working women in three public health facilities in Durban, South Africa. Methods A qualitative longitudinal study was conducted among a cohort of informal working women recruited during pregnancy in two clinics in Durban. The study comprised a series of in-depth interviews conducted at different time points from pregnancy until mothers had returned to work, followed by focus group discussions (FGDs) with cohort participants. We present data from participatory FGDs, known as ‘Journey with my Baby’, conducted at the end of the study, during which women’s experiences from pregnancy until returning to work were reviewed and explored. Thematic analysis was used with NVIVO v12.4. Results Three ‘Journey with my Baby’ FGDs were conducted with a total of 15 participants between March and October 2019. Many participants narrated experiences of disrespectful behavior from nurses during labour and childbirth, with several women becoming very distressed as a result. Women described experiencing rudeness and verbal abuse from nurses, lack of privacy and confidentiality, nurses refusing to provide care, being denied companionship and being left unattended for long periods during labour. Women described feeling anxious and unsafe while in the labour ward because of the behaviour they experienced directly and observed other patients experiencing. Such experiences created bad reputations for health facilities, so that women in the local community were reluctant to attend some facilities. Conclusion Disrespect and abuse continues to be a serious concern in public health facilities in South Africa. We challenge the health system to effectively address the underlying causes of disrespectful behavior among health workers, initiate robust monitoring to identify abusive behavior when it occurs, and take appropriate actions to ensure accountability so that women receive the high-quality maternity care they deserve.

Community Service Nurses’ Experiences Regarding Mentoring in South Africa

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Sisinyana Hannah Khunou
Keyword(s):  
Public Health ◽  
South Africa ◽  
Community Service ◽  
Practical Experience ◽  
Health Facilities ◽  
North West ◽  
Public Health Facilities ◽  
Quality Patient Care ◽  
The North ◽  
Contextual Design

Newly qualified nurses are mandated to do compulsory community service after completion of their education. Anecdotal evidence indicates that these newly qualified nurses are not properly mentored. The purpose of the study was to explore and describe the experiences of community service nurses (CSNs) regarding their mentoring in the public health facilities in the North West province (NWP), South Africa. A qualitative exploratory descriptive contextual design was applied to get a better understanding of mentoring as experienced by CSNs in the NWP. A tape recorder was used to capture the interviews conducted with 28 newly qualified nurses who completed their community service two to three years ago and who were working at public health facilities in the NWP. ATLAS.ti 7 was used to analyse the data obtained from the participants. Three themes, namely (1) a lack of mentoring, (2) challenges of performing community service nursing, and (3) positive experiences emerged from the data collected from the CSNs. These themes were supported by the following sub-themes: Lack of supervision and support; no proper orientation in general; negative attitudes of other nurses to CSNs; unrealistic expectations from CSNs; getting blamed and bullied; CSNs’ lack of practical experience; inadequacy regarding their professional role; use of their education; and gained independence. The study recommended that the facility managers and different stakeholders work together in supporting the CSNs. This will minimise stress and a lack of confidence among CSNs and improve quality patient care.

Sign in / Sign up

Export Citation Format

Share Document