PHC re-engineering may relieve overburdened tertiary hospitals in South Africa

Mohapi, Morongwa Caroline; Basu, Debashis

doi:10.7196/samj.5443

Cited by 15 publications

(16 citation statements)

References 4 publications

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“…Therefore, to prevent further increases in multimorbidity, it is necessary to strengthen PHC services by emphasizing primary prevention, especially in highly vulnerable contexts such as in LMICs. The Argentinian health system shows an imbalance with prominence given to secondary and tertiary health care, as seen in other parts of the world, with greater expenditures in city hospitals [84,85]. …”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Chronic Diseases and Multimorbidity in a Primary Care Context of Central Argentina: A Web-Based Interactive and Cross-Sectional Study

Olivares

Chambi

Chañi

et al. 2017

IJERPH

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Global health agencies estimate an increase of chronic diseases in South America. Nevertheless, few studies have investigated chronic diseases and their risk factors in the perspective of multimorbidity. This research aimed to identify these aspects in a primary health care setting of central Argentina. The Pan America version of the STEP wise approach surveillance (STEPS) instrument of the World Health Organization was applied to 1044 participants, 365 men and 679 women, with a mean age of 43 years. High prevalence of overweight (33.5%), obesity (35.2%), central obesity (54%), dyslipidemia (43.5%), metabolic syndrome (21.1%), low intake of fruit and vegetables (91.8%), low levels of physical activity (71.5%), risky alcohol consumption (28%), and smoking (22.5%) were detected. Hypertension and diabetes were the most prevalent chronic conditions and the total prevalence of multimorbidity was 33.1%, with 2, 3, 4, 5 and 6 chronic conditions found in 19.9%, 9.1%, 2.6%, 1.1% and 0.4% of the population, respectively. Multimorbidity affected 6.4% of the young, 31.7% of the adults, and 60.6% of the elderly, and was more prevalent among women, and in participants with lower levels of education. Having multimorbidity was significantly associated with obesity, central obesity, and higher concentrations of total blood cholesterol, low-density lipoprotein cholesterol, triglycerides, and glucose. A website was made available to the participants in order to share the experimental results and health-promoting information.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Chronic Diseases and Multimorbidity in a Primary Care Context of Central Argentina: A Web-Based Interactive and Cross-Sectional Study

Olivares

Chambi

Chañi

et al. 2017

IJERPH

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“…These were concurrently addressed with a model of pragmatic problem solving with cognitive-behavioural intervention strategies. The South African government has begun to implement a similar model through a process they have termed “re-engineering primary healthcare” [25] and plans to deploy about 65,000 CHWs. We found significant benefits in overall maternal and infant well-being for WLH and all neighbourhood women and demonstrated the specific domains of improvement, especially for WLH.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of home visits for pregnant mothers and their infants

Roux¹,

Tomlinson

Harwood³

et al. 2013

Aids

162

210

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Objective To evaluate the effect of home visits by Community Health Workers (CHW) on maternal and infant well-being from pregnancy through the first six months of life for women living with HIV (WLH) and all neighbourhood mothers. Design and Methods In a cluster randomised controlled trial in Cape Town townships, neighbourhoods were randomised within matched pairs to either: 1) Standard Care, comprehensive healthcare at clinics (SC; n=12 neighbourhoods; n=169 WLH; n=594 total mothers), or 2) Philani Intervention Program, home visits by CHW in addition to SC (PIP; n=12 neighbourhoods; n=185 WLH; n=644 total mothers). Participants were assessed during pregnancy (2% refusal) and reassessed at one week (92%) and six months (88%) post-birth. We analysed PIP’s effect on 28 measures of maternal and infant well-being among WLH and among all mothers using random effects regression models. For each group, PIP’s overall effectiveness was evaluated using a binomial test for correlated outcomes. Results Significant overall benefits were found in PIP compared to SC among WLH and among all participants. Secondarily, compared to SC, PIP WLH were more likely to complete tasks to prevent vertical transmission, use one feeding method for 6 months, avoid birth-related medical complications, and have infants with healthy height-for-age measurements. Among all mothers, compared to SC, PIP mothers were more likely to use condoms consistently, breastfeed exclusively for 6 months, and have infants with healthy height-for-age measurements. Conclusions PIP is a model for countries facing significant reductions in HIV funding whose families face multiple health risks.

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“…The introduction of National Health Insurance (NHI) and Primary Health Care (PHC) re-engineering has tried to protect health care users from financial barriers that could minimize access to health services [12,14]. PHC is meant take services to the people, and offer basic life sustaining services to everyone regardless of financial, social or ethnic status [15]. PHC re-engineering is a health sector strategy that buttresses the overall government strategy of ensuring "A long and Healthy life for all South Africans [3,15].…”

Section: Introductionmentioning

confidence: 99%

“…PHC is meant take services to the people, and offer basic life sustaining services to everyone regardless of financial, social or ethnic status [15]. PHC re-engineering is a health sector strategy that buttresses the overall government strategy of ensuring "A long and Healthy life for all South Africans [3,15]. It is centered on four main core outputs: increasing life expectancy, decreasing maternal child mortality, combating Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) and strengthening health system effectiveness [3,15].…”

Section: Introductionmentioning

confidence: 99%

“…PHC re-engineering is a health sector strategy that buttresses the overall government strategy of ensuring "A long and Healthy life for all South Africans [3,15]. It is centered on four main core outputs: increasing life expectancy, decreasing maternal child mortality, combating Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS) and strengthening health system effectiveness [3,15]. Cataract services are offered for free in government hospitals including in rural areas where only 16% have medical cover and an estimated 84% do not have [12].…”

Section: Introductionmentioning

confidence: 99%

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Access to cataract services in selected rural communities in South Africa

Khoza¹,

Nunu²,

Manganye³

et al. 2019

Preprint

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Background Despite government efforts to improve access to health care services through the re-engineered Primary Health Care and National Health insurance platform, access still remain a challenge particularly in rural areas. The aim of this study was to analyse secondary data on cataract patients who were attended to in selected hospitals in rural Limpopo of South Africa. Methodology A cross section survey was conducted on 411 patient records from five selected hospitals in Vhembe district. A pre tested structured checklist was used to guide retrieval of variables from patient records. The collected data was entered into excel spreadsheet, cleaned and imported into Statistical Package for Social Sciences version 26 for analysis. Proportions of demographic characteristics were presented and these were cross tabulated with the outcome variable “success of operation” using Chi Squared tests. Results Findings point out that majority of patients who attended hospital for eye services were aged 65 years above and females (63%). There was no association between the tested demographic characteristics and the outcome variable. Most patients were diagnosed in the period 2015-2018 (60%). Over 90% of those that were operated had successful operations. Of the remaining 10% that had unsuccessful operations, 30% cited complications as being the reason why these operations were unsuccessful. Conclusions It is evident from the findings that cataract services offered in rural areas have low impact as they are not accessible to the patient. It is critical to have a worker retention strategy to retain experts.

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PHC re-engineering may relieve overburdened tertiary hospitals in South Africa

Cited by 15 publications

References 4 publications

Risk Factors for Chronic Diseases and Multimorbidity in a Primary Care Context of Central Argentina: A Web-Based Interactive and Cross-Sectional Study

Risk Factors for Chronic Diseases and Multimorbidity in a Primary Care Context of Central Argentina: A Web-Based Interactive and Cross-Sectional Study

Outcomes of home visits for pregnant mothers and their infants

Access to cataract services in selected rural communities in South Africa

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