scholarly journals Identifying and bridging the knowledge-to-practice gaps in rehabilitation professionals working with at-risk infants in the public health sector of South Africa: a multimethod study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e039242
Author(s):  
Pragashnie Govender
Keyword(s):  
Public Health ◽  
South Africa ◽  
At Risk ◽  
Neonatal Intensive Care ◽  
Qualitative Data ◽  
Health Sector ◽  
Critical Time ◽  
Reliability And Validity ◽  
The Public ◽  
Public Health Sector

IntroductionEarly childhood is a critical time when the benefits of early interventions are intensified, and the adverse effects of risk can be reduced. For the optimal provision of early intervention, professionals in the field are required to have specialised knowledge and skills in implementing these programmes. In the context of South Africa, there is evidence to suggest that therapists are ill-prepared to handle the unique challenges posed in neonatal intensive care units and wards with at-risk infants in the first few weeks of life. This is attributed to several reasons; however, irrespective of the causative factors, the need to bridge this knowledge-to-practice gap remains essential.Methods and analysisThis study is a multimethod stakeholder-driven study using a scoping review followed by an appreciative inquiry and Delphi process that will aid in the development, implementation and evaluation of a knowledge translation intervention to bridge knowledge-gaps in occupational and physiotherapists working in the field. Therapists currently working in the public health sector will be recruited for participation in the various stages of the study. The analysis will occur via thematic analysis for qualitative data and percentages and frequencies for descriptive quantitative data. Issues around trustworthiness and rigour, and reliability and validity, will be ensured within each of the phases, by use of a content validity index and inter-rater reliability for the Delphi survey; thick descriptions, peer debriefing, member checking and an audit trail for the qualitative data.Ethics and disseminationThe study has received full ethical approval from the Health Research and Knowledge Management Directorate of the Department of Health and a Biomedical Research Ethics Committee. The results will be published in peer-reviewed academic journals and disseminated to the relevant stakeholders within this study.

scholarly journals Challenges to the Success of HIV and Tuberculosis Care and Treatment in the Public Health Sector in South Africa

2007 ◽  
Vol 196 (s3) ◽  
pp. S491-S496 ◽  
Author(s):  
Krista Dong ◽  
Zinhle Thabethe ◽  
Rocio Hurtado ◽  
Thobe Sibaya ◽  
Hlubi Dlwati ◽  
...  
Keyword(s):  
Public Health ◽  
South Africa ◽  
Health Sector ◽  
The Public ◽  
Public Health Sector ◽  
Care And Treatment ◽  
Tuberculosis Care

Introducing the female condom through the public health sector: Experiences from South Africa

AIDS Care ◽  
2000 ◽  
Vol 12 (5) ◽  
pp. 589-601 ◽  
Author(s):  
J. E. Mantell ◽  
E. Scheepers ◽  
Q. Abdool Karim
Keyword(s):  
Public Health ◽  
South Africa ◽  
Health Sector ◽  
Female Condom ◽  
The Public ◽  
Public Health Sector

scholarly journals Effective public-private partnerships for sustainable antiretroviral therapy: outcomes of the Right to Care health services GP down-referral program

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Idah Mokhele ◽  
Sello Mashamaite ◽  
Pappie Majuba ◽  
Thembi Xulu ◽  
Lawrence Long ◽  
...  
Keyword(s):  
Public Health ◽  
South Africa ◽  
Viral Load ◽  
Antiretroviral Therapy ◽  
Health Sector ◽  
Adjusted Relative Risk ◽  
Viral Load Suppression ◽  
The Public ◽  
Public Health Sector ◽  
Hospital Outpatient

Abstract Background The recently increased access to antiretroviral therapy (ART) in South Africa has placed additional strain on human and infrastructure resources of the public health sector. Capacity from private-sector General Practitioners (GPs) could be leveraged to ease the current burden on the public health sector. Methods We conducted a retrospective record review of routine electronic medical record data on a systematic sample of HIV-infected adults (≥18 years old) initiated on ART at a tertiary hospital outpatient HIV clinic in Johannesburg, South Africa and down-referred to private-GPs for continued care after stabilization on ART. We compared these patients (“GP down-referred”) to a control-cohort who remained at the referring site (“Clinic A”) and patients from a regional hospital outpatient HIV clinic not offering down-referral to GPs (“Clinic B”). Study outcomes assessed are viral load suppression (VL < 50 copies/ml) and attrition from care (all-cause-mortality or > 90-days late for a last-scheduled visit) by 12 months of follow-up following down-referral or eligibility. Results A total of 3685 patients, comprising 373 (10.1%) GP down-referred, 2599 (70.5%) clinic A controls, and 713 (19.4%) clinic B controls were included in the analysis. Overall, 1535 patients (53.3%) had a suppressed viral load. A higher portion of GP down-referred patients had a suppressed viral load compared to clinic A and B patients (65.7% vs 49.1% vs 58.9%). After adjusting for demographic and baseline clinical covariates, we found no difference in viral load suppression between GP down-referred and control patients (adjusted relative risk [aRR] for clinic A vs GP down-referred 1.0; 95% CI: 0.9–1.1), (aRR for clinic B vs GP down-referred 1.0; 95% CI: 0.9–1.2). Clinic B controls experienced the highest attrition compared to GP down-referred and clinic A controls (33.2% vs 11.3% vs 5.9%) and had a higher risk of attrition compared to GP down-referred patients (adjusted hazard ratio [aHR] 4.2; 95% CI: 2.8–6.5), whereas clinic B controls had a lower risk of attrition (aHR 0.5; 95% CI: 0.3–0.7). Conclusions and recommendations Our results show that private-GPs can contribute to caring for stabilized public sector HIV patients on life-long ART. However, they require special efforts to improve retention in care.

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