South African primary health care allied health clinical practice guidelines : the big picture

dc.contributor.authorDizon, J. M.en_ZA
dc.contributor.authorGrimmer, K. A.en_ZA
dc.contributor.authorMachingaidze, S.en_ZA
dc.contributor.authorLouw, Q. A.en_ZA
dc.contributor.authorParker, H.en_ZA
dc.date.accessioned2018-02-05T05:34:27Z
dc.date.available2018-02-05T05:34:27Z
dc.date.issued2018-01-29
dc.date.updated2018-02-04T04:20:32Z
dc.descriptionCITATION: Dizon, J. M., et al. 2018. South African primary health care allied health clinical practice guidelines : the big picture. BMC Health Services Research, 18:48, doi:10.1186/s12913-018-2837-z.
dc.descriptionThe original publication is available at https://bmchealthservres.biomedcentral.com
dc.description.abstractBackground: Good quality clinical practice guidelines (CPGs) are a vehicle to implementing evidence into allied health (AH) care. This paper reports on the current ‘state of play’ of CPGs in a lower-to-middle-income country (South Africa), where primary healthcare (PHC) AH activities face significant challenges in terms of ensuring quality service delivery in the face of huge PHC need. Methods: A qualitative study was conducted, using semi-structured interviews with purposively-sampled individuals involved in AH PHC CPGs in South Africa. They included national and state government policy-makers, academics and educators, service managers, clinicians, representatives of professional associations, technical writers, and members of informal professional networks. The interview data was transcribed and de-identified, and analysed descriptively by hand-coding. The COREQ statement guided study conduct and reporting. A framework to guide research in other countries into perspectives of AH PHC CPG activities was established. Results: Of the 32 invited, 29 people participated: of these 25 were interviewed and four provided meeting notes. Most participants had multiple professional roles, being engaged concurrently in clinical practice, academia, professional associations and / or government. Key themes comprised Players (sub-themes of sampling frame, participants, advice, role players and collaboration); Guidance (sub-themes of nomenclature, drivers, purpose, evidence sources) and Role of AH in PHC (sub-themes of discipline groupings, disability and rehabilitation, AH recognition). Conclusion: There was consistently-expressed desire for quality guidance to support better quality AH PHC activities around the country. However no international CPGs were used, and there were no South African CPGs specific to local PHC AH practice. The guidance gap was filled by non-evidence-based documents produced often without training, to deal with specific clinical situations. This led to frustration, duplication and fragmentation of effort, confusing nomenclature, and an urgent need for standardised and agreed guidance. We provided a standardised framework to capture perspectives on CPGs activities in other AH PHC settings.
dc.description.sponsorshipSouth African Medical Research Council (SAMRC)
dc.description.urihttps://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-018-2837-z
dc.description.versionPublisher's version
dc.format.extent13 pages
dc.identifier.citationDizon, J. M., et al. 2018. South African primary health care allied health clinical practice guidelines : the big picture. BMC Health Services Research, 18:48, doi:10.1186/s12913-018-2837-z
dc.identifier.issn1472-6963 (online)
dc.identifier.otherdoi:10.1186/s12913-018-2837-z
dc.identifier.urihttp://hdl.handle.net/10019.1/103099
dc.language.isoen_ZAen_ZA
dc.publisherBioMed Central
dc.rights.holderAuthors retain copyright
dc.subjectMedicine -- Practice -- Standards -- South Africaen_ZA
dc.subjectPrimary health care -- South Africaen_ZA
dc.titleSouth African primary health care allied health clinical practice guidelines : the big pictureen_ZA
dc.typeArticleen_ZA
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