Are we winning? Improving perinatal outcomes at a deeply rural district hospital in South Africa

Gaunt, Charles Benjamin

doi:10.7196/samj.3699

Cited by 19 publications

(16 citation statements)

References 4 publications

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“…39,42–45 Six years ago, fewer than 50% of women in this area delivered in hospital; now the number of women delivering in the hospital has reached 89% and perinatal mortality has dropped by almost 50%. 34 …”

Section: Resultsmentioning

confidence: 99%

“…Success can be attributed to work done building relationships with health teams at different levels of the health care system, as well as having shared goals and supportive clinic and hospital leadership. 34,39 In this instance, the intervention was supported by the Department of Health and requested by the senior hospital doctors, who have led a focused effort to improve perinatal outcomes. 34 The enthusiastic support by chiefs and headmen for the programme and welcoming attitudes of families in the area have made Mentor Mothers feel respected and appreciated, easing the burden of a difficult job.…”

Section: Resultsmentioning

confidence: 99%

“…In part of the remote King Sabata Dalindyebo sub-district of the OR Tambo District in the Eastern Cape, an integrated system of care has been established with a district hospital, area clinics, and Philani Mentor Mothers to create a quality, fully integrated, PHC system. 34 …”

Section: Introductionmentioning

confidence: 99%

“…Patients in some areas must walk over an hour to reach a clinic, and several hours to reach the hospital. 34 The undulating geography and deep river valleys further complicate access, especially in the rainy season when rivers may be too full to cross for several days.…”

Section: Introductionmentioning

confidence: 99%

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The role of community health workers in the re-engineering of primary health care in rural Eastern Cape

Roux

Roux²,

Mbewu³

et al. 2015

South African Family Practice

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Background Primary Health Care in South Africa is being re-engineered to create a model of integrated care across different levels of the health care system. From hospitals to clinics, in the community and in the home, health care will focus more on prevention, health-promotion and advocacy for healthy lifestyles and wellbeing, in addition to clinical services. We provide a best practise model of integrating community health workers (CHWs) trained as generalists into a multi-level health system in the Oliver Tambo district of the rural Eastern Cape. Methods Based at Zithulele Hospital, a health care network between the hospital, 13 clinics, and 50 CHWs has been created. The functions of each tier of care are different and complementary. This article describes the recruitment, training, supervision, monitoring, and outcomes when CHWs who deliver maternal, child health, nutrition and general care through home visits. Results CHWs, especially in rural settings, can find and refer new TB/HIV cases, ill children and at-risk pregnant women; rehabilitate malnourished children at home; support TB and HIV treatment adherence; treat diarrhoea, worm infestation and skin problems; and, distribute Vitamin A. CHWs provide follow-up after clinic and hospital care, support families to apply health information, problem-solve the health and social challenges of daily living, and assist in accessing social grants. Case examples of how this model functions are provided. Conclusion This generalist CHW home intervention is a potential model for the re-engineering of the primary health care system in South Africa.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The role of community health workers in the re-engineering of primary health care in rural Eastern Cape

Roux

Roux²,

Mbewu³

et al. 2015

South African Family Practice

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“…The catchment has a population of around 130,000 people and the area is considered deeply rural [17]. The area where the study took place is approximately 90 km from the nearest city of Mthatha [18].…”

Section: Methodsmentioning

confidence: 99%

A mother’s choice: a qualitative study of mothers’ health seeking behaviour for their children with acute diarrhoea

Cunnama

Honda

2016

BMC Health Serv Res

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BackgroundDiarrhoea presents a considerable health risk to young children and is one of the leading causes of infant mortality. Although proven cost-effective interventions exist, South Africa is yet to reach the Sustainable Development Goals set for the elimination of preventable under-five mortality and water-borne diseases. The rural study area in the Eastern Cape of South Africa continues to have a parallel health system comprising traditional and modern healthcare services. It is in this setting that this study aimed to qualitatively examine the beliefs surrounding and perceived quality of healthcare accessed for children’s acute diarrhoea.MethodsPurposive sampling was used to select participants for nine focus-group-discussions with mothers of children less than 5 years old and 11 key-informant-interviews with community members and traditional and modern practitioners. The focus-group-discussions and interviews were held to explore the reasons why mothers seek certain types of healthcare for children with diarrhoea. Data was analysed using manual thematic coding methods.ResultsIt was found that seeking healthcare from traditional practitioners is deeply ingrained in the culture of the society. People’s beliefs about the causative agents of diarrhoea are at the heart of seeking care from traditional practitioners, often in order to treat supposed supernatural causes. A combination of care-types is acceptable to the community, but not necessarily to modern practitioners, who are concerned about the inclusion of unknown ingredients and harmful substances in some traditional medicines, which could be toxic to children. These factors highlight the complexity of regulating traditional medicine.ConclusionSouth African traditional practitioners can be seen as a valuable human resource, especially as they are culturally accepted in their communities. However due to the variability of practices amongst traditional practitioners and some reluctance on the part of modern practitioners regulation and integration may prove complex.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1911-7) contains supplementary material, which is available to authorized users.

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Death audits and reviews for reducing maternal, perinatal and child mortality

Willcox

Price

Scott

et al. 2020

Cochrane Database of Systematic Reviews

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Are we winning? Improving perinatal outcomes at a deeply rural district hospital in South Africa

Cited by 19 publications

References 4 publications

The role of community health workers in the re-engineering of primary health care in rural Eastern Cape

The role of community health workers in the re-engineering of primary health care in rural Eastern Cape

A mother’s choice: a qualitative study of mothers’ health seeking behaviour for their children with acute diarrhoea

Death audits and reviews for reducing maternal, perinatal and child mortality

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