Browsing by Author "Goliath, C."

Now showing 1 - 4 of 4
  • Thumbnail Image
    Item
    Capacity-building needs assessment of rural health managers : the what and the how ...
    (Health and Medical Publishing Group, 2015-07) Goliath, C.; Mukinda, Fidele K.; Dudley, Lilian
    ENGLISH SUMMARY : Background: There has been a renewed focus on leadership and governance within the South African health workforce as a key to strengthening the health system. Several studies have highlighted that managers feel poorly prepared for their role and responsibilities and argue for support and development for healthcare managers. This study describes a ‘training’ need assessment conducted for health managers in a rural district which has informed Stellenbosch University Rural Medical Education Partnership Initiative (SURMEPI) continuing professional development activities. Objective: To determine the capacity-building needs and preferred approaches to capacity building for health managers in a rural district. Methods: The study used a mixed method design. A survey was conducted among healthcare managers followed by structured interviews with randomly selected participants. Results were discussed at a workshop and meetings with the district management, which allowed for triangulation and verification of results. Results: Thirty-two (68%) of the 47 health managers in the district completed the questionnaires. Training needs for competencies related to: leadership; communication and knowledge management; infection prevention and control; community/public health and health systems research and strengthening were slightly higher than other areas. Facility managers were prioritised as a target group for leadership and management capacity development. The preferred learning approach was for more practice-based learning in the workplace, supported by e-learning rather than didactic classroom-based teaching. Conclusion: Innovative approaches to capacity development and work-based support in developing intrinsic management competencies for front-line managers were highlighted in this needs assessment.
  • Thumbnail Image
    Item
    Fit for purpose? a review of a medical curriculum and its contribution to strengthening health systems in South Africa
    (Health and Medical Publishing Group, 2015) Dudley, Lilian; Young, T. N.; Rohwer, A. C.; Willems, B.; Dramowski, Angela; Goliath, C.; Mukinda, Fidele K.; Marais, Frederick; Mehtar, Shaheen; Cameron, N. A.
    ENGLISH SUMMARY : Background: Medical education in the 21st century needs to produce health professionals who can respond to health systems challenges and population health needs. Although research on medical education is increasing, insufficient attention is paid to the outcomes of medical training, in particular graduates’ competencies and the effects of their training on healthcare and population health in Africa. Method: This baseline study assessed whether the current Stellenbosch University medical curriculum enabled graduates to acquire health systems strengthening competencies. The teaching of competencies in public health, evidence-based healthcare, health systems and services research, and infection prevention and control was assessed through a document review of study guides and a survey of recent medical graduates. Results: We found that teaching of most competencies was included in the curriculum, but appeared fragmented with a lack of continuity across phases of the curriculum. Health systems and health leadership and management teaching was weak, and important public health competencies in human rights and health advocacy received little attention. Recent graduates said their training was ‘adequate’, but were unable to apply knowledge and skills to address health systems challenges within working environments. They wanted more integrated, practical, problem-based teaching in environments in which they would one day work, and their teachers to be role models for the competencies students were expected to acquire. This study is contributing to improvements to the medical curriculum at Stellenbosch University.
  • Thumbnail Image
    Item
    Impact of a quality improvement project to strengthen infection prevention and control training at rural healthcare facilities
    (Health and Medical Publishing Group, 2015) Dramowski, Angela; Marais, Frederick; Goliath, C.; Mehtar, Shaheen
    Background: South Africa (SA) has a dire shortage of skilled infection prevention and control (IPC) practitioners with limited opportunities for IPC training, especially in rural areas. Methods: This quality improvement research-based case study surveyed healthcare workers’ IPC training needs and measured the impact of a targeted IPC training intervention at four healthcare facilities in a rural sub-district in the Western Cape Province of SA. Transfer and implementation of IPC knowledge and best practice were evaluated at the participating facilities, both pre and post intervention. Results: Most survey respondents (239/271; 88.2%) practised in rural districts and reportedly received infrequent (either annual or no) in-service training in IPC (138/271; 51%). The IPC education intervention (five short courses) was attended by almost one-third of clinical staff (129/422; 30.6%) at the four rural healthcare facilities. The pre-intervention IPC assessment identified the following: poor knowledge and implementation of tuberculosis-IPC measures; limited knowledge of medical device decontamination; high rates of needle-stick injuries; low hand-hygiene compliance rates and poor compliance with personal protective equipment use. At the post-intervention assessment, IPC knowledge scores and hand-hygiene compliance rates improved significantly but some IPC practices were unchanged. Conclusion: A structured IPC training programme in rural healthcare facilities can improve healthcare workers’ IPC knowledge, but has limited impact on clinical practice.
  • Thumbnail Image
    Item
    Understanding the current discourse of rehabilitation : with reference to disability models and rehabilitation policies for evaluation research in the South African setting
    (AOSIS Publishing, 2013-12-11) Mji, G.; Chappell, P.; Statham, S.; Mlenzana, N.; Goliath, C.; De Wet, C.; Rhoda, A.
    Evaluation of rehabilitation programmes is essential in order to monitor its effectiveness and relevance. There is however a need to consider policies when conducting evaluation research in rehabilitation. The aim of this paper is to present the theoretical and legislative underpinnings of rehabilitation in South Africa.A narrative review of national and international disability legislation and empirical research in context of rehabilitation was conducted.The findings of this review reveals that as a fluid construct, the discourse of rehabilitation has been underpinned by the changing theoretical and socio-political understandings of disability. This inturn has influenced various international and national health and disability policies and legislations that oversee the implementation of rehabilitation practice. Despite this, there has been little evaluation of public health rehabilitation services in context of these policies and legislations in South Africa. The fluidity of rehabilitation need to be considered when conducting evaluation research in rehabilitation.