Perceptions of registered nurses regarding factors influencing service delivery in expanding programmes in a primary healthcare setting

Abstract

The aim of this study was to explore and describe the perceptions of registered nurses regarding factors influencing service delivery regarding expansion programmes in a primary healthcare setting, using a qualitative approach. The registered nurses, who have been working in the clinics for more than two years and have been exposed to the expansion programmes there, were purposively sampled. Two focus group interviews were conducted in a neutral place and the data collected by the researcher Nnoi A. Xaba (N.A.X.). Data were analysed by the researcher and an independent co-coder using the Tesch method. Categories, subcategories and themes were identified; those that formed the basis of discussion were disabling factors, enabling factors, client-related factors, service-related factors and solutions to problems. It is recommended that integration of programmes and coordination be done at a provincial level and planned together with the training centres in order to alleviate problems in service delivery. Training on expansion programmes in the form of in-service education should be carried out continually in the region.Die doel van die studie was om die persepsie van geregistreerde verpleegkundiges met betrekking tot die faktore wat dienslewering van die uitbreidingsprogramme in ‘n primêre gesondheid opset beinvloed; te eksploreer en te beskryf. ‘n Kwalitatiewe benadering is gevolg in die iutvoering van die studie. ‘n Doelgerigte steekproef is uitgevoer vanuit geregistreerde verpleegkundiges wat vir langer as twee jaar in die klinieke werksaam was en blootgestel is aan die uitbreiding programme. Twee fokus groep onderhoude is deur die navorser Nnoi A. Xaba (N.A.X.) in ‘n neutrale opset uitgevoer. Data is deur die navorser en ʼn onafhanklike kodeerder ontleed volgens Tesch se metode van analise. Kategorieë, sub-kategorieë en temas was geidentifiseer. Die kategorieë fundamenteel tot die bespreking behels: remmende faktore, bydraende faktore, kliënt-verwante faktore, diens-verwante faktore, en oplossing van probleme. Daar word aanbeveel dat die integrasie en koordinasie van programme op provisiale vlak beplan word in samewerking met opleidings instansies om die dienslewerings probleem te verlig. In die streek behoort opleiding met betrekking tot die uitbreidingsprogramme deurlopend deur middel van indiensopleiding gedoen word.

Using diaries to explore the work experiences of primary health care nursing managers in two South African provinces

“…The nursing managers both reacted and responded to the health system deficiencies in their own way, either by trying to cope with staff shortages or by responding creatively to the lack of water in rural clinics, through partnering with the local community. Other studies have also found that PHC clinic managers often balance operational management and service delivery to many patients amidst staff shortages in the health system ( 33 – 35 ). Although the diary entry on the lack of running water in some FS clinics appears to be an isolated incident, the lack of running water at rural clinics is a common finding in national infrastructure assessments ( 43 ).…”

“…In South Africa, there have been a number of studies that focus on nurses working at PHC facilities ( 32 – 37 ). However, the majority of these tend to focus on registered nurses (with 4 years of training) who are the direct service providers ( 33 – 35 , 37 ), rather than on PHC clinic managers.…”

“If you are on duty, you may be afraid to come out to attend to a person”: Fear of crime and security challenges in maternal acute care in Nigeria from a realist perspective.

“…These range from the limitation of provision and access to services, to service providers changing jobs to facilities where they perceive to be more secure [14,15,25,26,45]. Low retention of public sector nurses in South Africa has been related to lack of security in the public facilities [25].…”

“…Risk management practices are used when one nds oneself in a dangerous situation and/or location and takes precautionary measures to be a less suitable target for victimization [22,24]. These concepts, though mostly originating from higher-income countries, support transferable principles to low and middle-income contexts, where women are even perceived as more vulnerable and of comparably lower socioeconomic status, especially in the rural areas [14,15,25,26]. This paper explores the role of health facility security and feeling of safety, which determine the provision and uptake of health services respectively, from the perspective of health staff, who were all females and health service users (pregnant women).…”

“If you are on duty, you may be afraid to come out to attend to a person”: Fear of crime and security challenges in maternal acute care in Nigeria from a realist perspective.

“…Lack of security in facilities (absence of perimeter fencing, inadequate lighting, lack of within-facility accommodation and absence of security guards) have raised issues of access across some other LMICs (Tanzania, Nepal, Swaziland, South Africa and Kenya) to varying degrees, especially in the rural areas. These range from the limitation of provision and access to services, to service providers changing jobs to facilities where they perceive to be more secure [14,15,25,26,45]. Low retention of public sector nurses in South Africa has been related to lack of security in the public facilities [25].…”