African Journal of Primary Health Care & Family Medicine最新文献

Background:  There is a recognised need for rehabilitation services at primary health care (PHC) level. In addition, there are clear policies (international and national) and guidelines for use by healthcare planners in South Africa to implement rehabilitation services. Although rehabilitation services are provided on the primary platform, its operationalisation has not been in an integrated manner. Clarity on the level of integration within existing PHC rehabilitation service delivery is required for its inclusion in a reengineered PHC.

Aim:  The study explored the extent to which rehabilitation services are integrated into PHC service delivery based on the expressed reality of rehabilitation professionals.

Setting:  The Johannesburg Metropolitan District of Gauteng, South Africa.

Methods:  In-depth interviews with 12 PHC rehabilitation professionals were completed to elicit their experiences with PHC rehabilitation services.

Results:  The theme the current state of rehabilitation services - 'this is the reality; you need to do what you need to do' along with its two subcategories, was generated from this study. The theme describes the expressed reality of suboptimal, underdeveloped and poorly integrated rehabilitation services within the Johannesburg Metropolitan District. Rehabilitation service providers have adapted service delivery by including isolated components of rehabilitation integration models, but this has not yielded an integrated service.

Conclusion:  Rehabilitation services although recognised as a crucial service in PHC must be critically analysed and adapted to develop integrated service delivery models. There should be a shift from selected coping mechanisms to targeted, integrated services.Contribution: The study describes PHC rehabilitation services and explores best practice models for integrated service planning and delivery.

Quality vocational training is important to ensure that family physicians can strengthen the district health system. Competent clinical trainers and supervisors, with the necessary educational knowledge and skills, are required for this job. In 2014, a formal Train the Clinical Trainer (TCT) course was introduced in South Africa as a collaborative effort between the Royal College of General Practitioners (RCGP) and the South African Academy of Family Physicians (SAAFPs). To make the training relevant, the course was aligned with the National Unit Standards for Family Medicine, as these defined the learning outcomes for registrars. The aim of the TCT course was to equip workplace-based clinical trainers with an essential set of educational skills, which could be further developed through mentoring and support. Accredited trainers present the face-to-face course yearly to two family physicians from each of the nine departments of family medicine in South Africa. The TCT course is built around the educational principles of learner-centredness and andragogy. During these 5 days of training the roles and responsibilities of trainers and learners, the learning environment, alignment with the curriculum, assessment for and of learning, and leadership are covered. Recently online assessment, the e-portfolio and the use of entrustable professional activities were added to the course content. In the future we would like to accredit more clinical trainers through a process of workplace-based self-evaluation and 360-degree feedback from peers and students. Lastly, we want to expand the training course in the African region.Contribution: The Train the Clinical Trainer (TCT) course, established in 2014 through RCGP and SAAFP collaboration in South Africa, ensures family physicians have essential educational skills. Aligned with national standards, the course embraces learner-centered principles. Ongoing enhancements include online assessments and future plans involve accrediting more trainers through self-evaluation and expanding across the African region.

Family medicine has existed as a training pathway through a private university in Tanzania since 2004. As global calls have increased to embrace primary health care as a pathway to ensuring universal health coverage, so has Tanzania recently turned to explore family medicine as a specialty to improve access to comprehensive, high-quality healthcare for her entire population. This article outlines ongoing efforts to define competencies and skills of a family medicine physician in Tanzania, engage government support and open the first public university training programme for family medicine postgraduate education.

No abstract available.

No abstract available.

Background: In light of the rising global effort to lower maternal mortality rates, it is crucial for low- and middle-income countries with poor maternal indices to investigate the problem of maternal satisfaction and the key elements that affect it. To this effect, this study explored the experiences of postnatal women in relation to labour services and investigated the factors that contribute to their overall satisfaction.

Aim: The study set out to explore factors influencing maternal satisfaction with labour care services in Ogbomoso, Oyo State, Nigeria. This study ultimately seeks to advance our understanding of this phenomenon to impact labour care and policy.

Setting: The study was conducted among multiparous women who had their antenatal care and delivery in Ogbomoso, Oyo State, Nigeria.

Methods: A qualitative study was performed using in-depth interviews among postnatal women.

Results: The results revealed a number of variables that could affect the women's satisfaction with labour care, including the choice of health facility, healthcare providers, environment of the facility, assurance of privacy, treating patients with dignity, provision of needed amenities and having a well-planned postnatal care assessment.

Conclusion: The study revealed that the costs of care, the skill of the caregiver, the provision of confidential and dignified care, and the availability of supplies all have an impact on maternal satisfaction. Hospital administration should address these issues to enhance the experience of women and labour care services.Contribution: The study's findings provide insights that will inform strategies to improve the quality of care being provided to parturients in Nigeria.

Background:  Adverse events are considered a universal challenge and a burden in the provision of healthcare. For that reason, significant event analysis (SEA) is a critical undertaking in primary health care (PHC), particularly in South Africa where 84% of the population relies on the public health system for their care.

Aim:  The study aimed to describe the types of perceived significant events medical students experienced during an integrated primary care block placement.

Setting:  Eighteen PHC settings included clinics, community health centres and district hospitals across three provinces in Gauteng, Mpumalanga and the North West.

Methods:  Using a qualitative descriptive design with purposeful sampling and maximum variation, structured reflection reports were retrieved from logbooks of final-year medical students studying at a South African university in 2014. Conventional content analysis was used to record the relevant facets of secondary data from 124 logbooks that contained a recording of a significant event using MAXQDA software version 2020.4.

Results:  An iterative process revealed three major themes of significant events that were prevalent in PHC settings. These comprised medication and prescription errors, diagnostic errors and suboptimal patient management.

Conclusion:  Significant event analysis became a critical quality improvement reflective learning tool. Logbooks offered an opportunity for medical students to explore significant events as a strategic way towards addressing quality and safe practices in PHC settings.Contribution: This study demonstrated medical students' ability to identify incidents in the care of patients using the SEA approach and their role in assessing patient safety issues in PHC settings.

Background: Traditional health practitioners (THPs) play an important role in communities by providing necessary health services for a variety of health problems. Possessing complementary biomedical knowledge and skills is vital in saving lives of patients. However, less is known about biomedical knowledge and skills among THPs.

Aim: This study aimed to explore and describe the training needs of THPs on biomedical knowledge and skills in urban townships in South Africa.

Setting: The study was conducted in a township in the City of Tshwane Metropolitan Municipality of Gauteng province, South Africa.

Methods: A qualitative, explorative, descriptive design with 18 THPs was employed through snowballing sampling. Data were collected through a lekgotla group discussion and thematic content analysis undertaken.

Results: Themes that emanated include knowledge of the basic physiological functioning of the human body; biomedical knowledge and skills required for the assessment of patients; managing emergency health conditions and understanding diagnostic concepts used in traditional health practice versus biomedical systems.

Conclusion: Traditional health practitioners have demonstrated interest in being trained on certain skills used within the biomedical system to care for patients. Performing the necessary first-aid skills by THPs will assist patients in the communities while waiting for emergency services or referrals. Provision of training programmes for THPs on first aid interventions during emergencies is therefore recommended.Contribution: The study revealed that capacitating THPs with biomedical knowledge and skills can improve their ability to promote healthy living and prevent health problems in communities where access to resources is limited.