South Africa

Increasing the proportion of rural-origin students in health sciences faculties has been shown to be one way of addressing of health care professionals in rural areas. This article discusses a retrospective descriptive study to determine the proportion of rural-origin students
at all medical schools in South Africa. [adapted from abstract]

This presentation from the 2004 Seminar on Health and Migration details factors contributing to international migration of healthcare workers and strategies to counter this trend.

The HIV status of surgeons is a contentious matter in the context of the informed consent obtained from patients. This article presents the results of a survey of the views of practicing surgeons in South Africa regarding aspects of HIV and its impact on surgeons. [adapted from introduction]

With the scarcity of African health professionals, volunteers are earmarked for an increased role in HIV/AIDS management, with a growing number of projects relying on grassroots community members to provide home nursing care to those with AIDS - as part of the wider task-shifting agenda. Yet little is known about how best to facilitate such involvement. This paper reports on community perceptions of a 3-year project which sought to train and support volunteer health workers in a rural community in South Africa. [from abstract]

The human resources crisis in Africa is especially acute in the public health field. This paper describes the innovative aspects of the distance education program at the School of Public Health of the University of the Western Cape, South Africa. Strategies are proposed for scaling up such a program to meet the growing need in this essential area of health human resource capacity development in Africa. [adapted from abstract]

This study aims to undertake a national assessment of existing district management structures, competencies and current training programmes in order to inform a national strategy and plan to strengthen district management capacity to ensure effective delivery of primary health care in South Africa. [from introduction]

The objective of this study was to investigate the effect of scaling up antiretroviral treatment (ART) on the working environment and motivation of health workers in South Africa; and to suggest strategies to minimize negative effects and maximise positive effects. [from summary]

Nurses and managers interviewed in Cape Town primary care facilities share their insights, experiences and how they cope with the impact of the HIV/AIDS epidemic. [from introduction]

This paper describes the results of a study to assess patients consulting full-time traditional health practitioners (THP) and the THPs' practices after they had been trained on HIV/Sexually Transmitted Infections prevention and care. [adapted from abstract]

This paper describes the results of safer circumcision training designed to improve circumcision knowledge, attitude and practice which was successfully delivered to traditional surgeons and nurses in South Africa. [adapted from abstract]

This study investigated the role of traditional healers in sexually transmitted infections including HIV/AIDS as well as a collaboration between the traditional and biomedical health care systems as seen by nurses and traditional healers. Qualitative analyses are presented on themes including attitude and respect; collaboration between traditional healers and nurses; control and regulation of traditional health practices; and the training needs of healers and nurses. [adapted from abstract]

Work satisfaction of nurses is important, as there is sufficient empirical evidence to show that it tends to affect individual, organizational and greater health and social outcomes. This paper presents a national study that compares and contrasts satisfaction levels of nurses in both public and private sectors. [from abstract]

Contracts can be used to govern the relationship between the public and the private sectors where the private sector delivers services on behalf of the state. On occasion, this allows the state to offer services such as basic medical provision where public sector provision does not reach. Researchers examine the case of primary care in South Africa where such contracts are being utilised. [from author]

It is well-recognised that medical students whose training exposure is largely limited to tertiary-level training hospitals may be inappropriately equipped to deal with the most relevant health issues affecting rural communities. This article evaluated the perceived educational value of a 2 week clinical rotation undertaken by senior undergraduate medical students at rural district hospitals and health care centers in the Western Cape Province, South Africa. [from abstract}

Interviews were conducted with staff of 4 hospitals thought to be functioning relatively well. The purpose of this study was to understand some of the factors contributing to the relative success of 4 South African distric hospitals, in order to share lessons learned with other institutions. A number of key factors were identified through this process, many of which relate to the performance, management and interactions of the health workers, which appear to be important in effective functioning of district hospitals. [adapted from summary]

This paper provides a review of the reported barriers that prevent doctors from managing HIV infected patients. The four most commonly reported barriers were: fear of contagion, fear of losing patients, unwillingness to care, and inadequate knowledge /training about treating HIV patients. [from abstract]

The International Council of Nurses expressed concerns regarding the aggressive international recruitment of nurses and maintained that internationally recruited nurses might be particularly at risk of exploitation or abuse. The purpose of this study was to explore and describe how recruitment agencies contributed to the emigration of South African nurses. [adapted from abstract]

The global shortage of nurses, creating opportunities for South African nurses to work in foreign countries, as well as a variety of factors related to nursing, health care and the general living conditions in South Africa influence nurses’ decisions to emigrate. The purpose of this study was to explore and describe the factors that influence nurses’ decisions to emigrate. [from abstract]

This qualitative study was undertaken to explore and describe the experiences of professional nurses in their relationships with nurse managers. [from abstract]

The theme of this edition is primary health care in South Africa. It includes national and international perpescitves on primary health care and focuses on areas such as policy and legislation, infectious diseases, maternal and child health and human resources. Chapter 11 discusses strengthening human resources for primary care. [adapted from summary]

This article profiles three leaders from Afghanistan, South Africa, and Southern Sudan who have made a significant difference in those countries’ HR situations. By taking a comprehensive approach and working in partnership with stakeholders, these leaders demonstrate that strengthening health workforce planning, management, and training can have a positive effect on the performance of the health sector. [from author]

In South Africa, first-contact primary care is delivered by nurses in small clinics and larger community health centres (CHC). CHCs also employ doctors, who often work in isolation from the nurses, with poor differentiation of roles and little effective teamwork or communication. Worcester CHC, a typical public sector CHC in rural South Africa, decided to explore how to create more successful practice teams of doctors and nurses.

There is a gross shortage of nurses, yet there is a need to provide quality care and defend patient care. Widening scope of practice is not new to all categories of nurses and given the Occupational Specific Dispensation for nurses there is a need to critically engage with these issues.

Scaling up the implementation of new health care interventions can be challenging and demand intensive training or retraining of health workers. This paper reports on the results of testing the effectiveness of two different kinds of face-to-face facilitation used in conjunction with a well-designed educational package in the scaling up of kangaroo mother care. [from abstract]

This article focuses on professional nurses in a study of patterns of planning, recruitment, training and task allocation associated with an expanding antiretroviral program in the districts of Free State. [from abstract]

The so-called brain drain is a complex phenomenon with a web of push-pull factors determining final outcomes. There are no quick fixes. Yet, those on the front lines addressing the critical personnel shortages in South Africa’s public health system - especially in rural areas - have pointed to approaches that could slow the exodus and eventually turn the situation around. [from author]

This paper presents field narratives selected as illustrations of mythologising and masking in popular responses to HIV/AIDS in South Africa. The stories appear in the context of traditional health practitioners and the testimony of the healers is used to demonstrate the ways in which they interpret these narratives, and seek to challenge them.2 The examination then re-assesses these accounts, and the healers’ responses to them, in relation to the antipathy that exists between western medicine and traditional healing in the context of HIV/AIDS. [introduction]

This paper documents the results of the second year of operation of the HOPE Cape Town (HIV Outreach Program and Education) Pilot Traditional Healer Project, an innovative HIV/AIDS collaboration between traditional health practitioners and western medicine in the Western Cape Province. The paper identifies the project’s achievements, and explores key problems in operation and management, including recommendations for the design and implementation of future initiatives. [from introduction]

Knowing that quality is never an accident, always the result of high intention, sincere effort, intelligent direction and skillful execution, and that it represents the wise choice of many alternatives, this abbreviated version of the Policy attempts to provide the strategic direction health facilities and officials need to follow to assure quality in health care and continuous improvement in the care that is being provided. Health care personnel are encouraged to use this copy of the Policy to focus their intentions and guide their efforts. [from foreword].

Telemedicine is viewed as a new way of offering medical services. It is seen as a means of overcoming the growing shortage of health practitioners in developing countries. The aim of this paper is to highlight the need for the formulation of guidelines for the ethical practice of telemedicine in South Africa. [from abstract]