Browsing by Author "Mayers, Pat"

Now showing 1 - 4 of 4
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    Factors determining the vulnerability of woman to sexually transmitted HIV : a literature review
    (AOSIS OpenJournals, 2008) Macleod-Downes, Leslie; Albertyn, Ruth M.; Mayers, Pat
    ENGLISH ABSTRACT: Gender-related vulnerability is described as a crucial factor contributing to increased susceptibility of women to HIV, accounting for more women than men being infected. At the same time, empowerment interventions are being promoted as effective strategies for increasing the ability of women to adopt protective behaviours. The aim of the review was to identify, collate and categorise the factors determining the gender-related vulnerability of women to sexually transmitted HIV. A review of literature from theoretical and empirical studies using diverse methodologies was undertaken. Reports included those identified through electronic and manual searching. Twenty factors, forming five clusters, were identified as influencing the ability of women to adopt protective behaviours. Each factor was analysed to describe its component parts and the relationship between a factor, gender-related vulnerability, HIV risk level and empowerment status. Further analysis provided a description of markers named predictors and indicators. The literature portrays markers that can be identified and used to describe gender equality status, HIV risk level and related empowerment. This provides the potential to identify factors in gender equality status and HIV risk level to address in programmes designed to empower women in order to lower their risk to sexually transmitted HIV.
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    Quality of asthma care : Western Cape Province, South Africa
    (Health and Medical Publishing Group (HMPG), 2009) Mash, Bob; Rhode, Hilary; Pather, Michael; Ainslie, Gillian; Irusen, Elvis; Bheekie, Angeni; Mayers, Pat
    Background. Asthma is the eighth leading contributor to the burden of disease in South Africa, but has received less attention than other chronic diseases. The Asthma Guidelines Implementation Project (AGIP) was established to improve the impact of the South African guidelines for chronic asthma in adults and adolescents in the Western Cape. One strategy was an audit tool to assist with assessing and improving the quality of care. Methods. The audit of asthma care targeted all primary care facilities that managed adult patients with chronic asthma within all six districts of the Western Cape province. The usual steps in the quality improvement cycle were followed. Results. Data were obtained from 957 patients from 46 primary care facilities. Only 80% of patients had a consistent diagnosis of asthma, 11.5% of visits assessed control and 23.2% recorded a peak expiratory flow (PEF), 14% of patients had their inhaler technique assessed and 11.2% were given a self-management plan; 81% of medication was in stock, and the controller/reliever dispensing ratio was 0.6. Only 31.5% of patients were well controlled, 16.3% of all visits were for exacerbations, and 17.6% of all patients had been hospitalised in the previous year. Conclusion. The availability of medication and prescription of inhaled steroids is reasonable, yet control is poor. Health workers do not adequately distinguish asthma from chronic obstructive pulmonary disease, do not assess control by questions or PEF, do not adequately demonstrate or assess the inhaler technique, and have no systematic approach to or resources for patient education. Ten recommendations are made to improve asthma care.
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    Task shifting and integration of HIV care into primary care in South Africa : the development and content of the streamlining tasks and roles to expand treatment and care for HIV (STRETCH) intervention
    (BioMed Central, 2011-08-02) Uebel, Kerry E.; Fairall, Lara R.; van Rensburg, Dingie H. C. J.; Mollentze, Willie F.; Bachmann, Max O.; Lewin, Simon; Zwarenstein, Merrick; Colvin, Christopher J.; Georgeu, Daniella; Mayers, Pat; Faris, Gill M.; Lombard, Carl; Bateman, Eric D.
    Abstract Background Task shifting and the integration of human immunodeficiency virus (HIV) care into primary care services have been identified as possible strategies for improving access to antiretroviral treatment (ART). This paper describes the development and content of an intervention involving these two strategies, as part of the Streamlining Tasks and Roles to Expand Treatment and Care for HIV (STRETCH) pragmatic randomised controlled trial. Methods: Developing the intervention The intervention was developed following discussions with senior management, clinicians, and clinic staff. These discussions revealed that the establishment of separate antiretroviral treatment services for HIV had resulted in problems in accessing care due to the large number of patients at ART clinics. The intervention developed therefore combined the shifting from doctors to nurses of prescriptions of antiretrovirals (ARVs) for uncomplicated patients and the stepwise integration of HIV care into primary care services. Results: Components of the intervention The intervention consisted of regulatory changes, training, and guidelines to support nurse ART prescription, local management teams, an implementation toolkit, and a flexible, phased introduction. Nurse supervisors were equipped to train intervention clinic nurses in ART prescription using outreach education and an integrated primary care guideline. Management teams were set up and a STRETCH coordinator was appointed to oversee the implementation process. Discussion Three important processes were used in developing and implementing this intervention: active participation of clinic staff and local and provincial management, educational outreach to train nurses in intervention sites, and an external facilitator to support all stages of the intervention rollout. The STRETCH trial is registered with Current Control Trials ISRCTN46836853.
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    Trends in task shifting in HIV treatment in Africa : effectiveness, challenges and acceptability to the health professions
    (AOSIS Publishing, 2015-07) Crowley, Talitha; Mayers, Pat
    Background: Task shifting has been suggested to meet the demand for initiating and managing more patients on antiretroviral therapy. Although the idea of task shifting is not new, it acquires new relevance in the context of current healthcare delivery. Aim: To appraise current trends in task shifting related to HIV treatment programmes in order to evaluate evidence related to the effectiveness of this strategy in addressing human resource constraints and improving patient outcomes, challenges identified in practice and the acceptability of this strategy to the health professions. Method: Electronic databases were searched for studies published in English between January 2009 and December 2014. Keywords such as ‘task shifting’, ‘HIV treatment’, ‘human resources’ and ‘health professions’ were used. Results: Evidence suggests that task shifting is an effective strategy for addressing human resource constraints in healthcare systems in many countries and provides a cost-effective approach without compromising patient outcomes. Challenges include inadequate supervision support and mentoring, absent regulatory frameworks, a lack of general health system strengthening and the need for monitoring and evaluation. The strategy generally seems to be accepted by the health professions although several arguments against task shifting as a long-term approach have been raised. Conclusion: Task shifting occurs in many settings other than HIV treatment programmes and is viewed as a key strategy for governing human resources for healthcare. It may be an opportune time to review current task shifting recommendations to include a wider range of programmes and incorporate initiatives to address current challenges.