Barriers to Health Care in Rural Mozambique: A Rapid Ethnographic Assessment of Planned Mobile Health Clinics for ART

Schwitters, Amee; Lederer, P; Zilversmit, Leah; Gudo, Paula Samo; Ramiro, Isaías; Cumba, Luisa; Mahagaja, Epifanio; Jobarteh, Kebba

doi:10.9745/ghsp-d-14-00145

Cited by 66 publications

(61 citation statements)

References 20 publications

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“…Findings from three studies were used to create or modify existing training programmes for clinicians 24 28 29. Schwitters et al 40 used the study to assist in the implementation of new health services (mobile health clinics), while Mullaney et al ,8 Choy et al ,37 Needle et al 36 and Chesluk et al 43 used the findings to reconfigure existing services.…”

Section: Resultsmentioning

confidence: 99%

Quick and dirty? A systematic review of the use of rapid ethnographies in healthcare organisation and delivery

2017

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Section: Resultsmentioning

confidence: 99%

Quick and dirty? A systematic review of the use of rapid ethnographies in healthcare organisation and delivery

2017

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“…This finding confirms the National Department of Health’s suggestion that traditional healers might be the first point of contact for patients living in rural areas 13. According to a recent study conducted on the feasibility of the use of mobile clinics in rural Mozambique, the need to recognize the role of traditional healers and for cooperation between Western and traditional medicine was also highlighted 18. In this specific study, patients with HIV often sought help from traditional healers initially because of an environmental barrier to access health care, but traditional healers referred these patients to hospital, since they were trained to recognize the symptoms of HIV 18.…”

Section: Findings and Discussionmentioning

confidence: 99%

“…According to a recent study conducted on the feasibility of the use of mobile clinics in rural Mozambique, the need to recognize the role of traditional healers and for cooperation between Western and traditional medicine was also highlighted 18. In this specific study, patients with HIV often sought help from traditional healers initially because of an environmental barrier to access health care, but traditional healers referred these patients to hospital, since they were trained to recognize the symptoms of HIV 18. In a study conducted in SA, the traditional healers did not have any training in the signs or complications of diabetes mellitus that could result in lower limb amputation and continued to treat their patients to the best of their ability.…”

Section: Findings and Discussionmentioning

confidence: 99%

Roles and challenges of the multidisciplinary team involved in prosthetic rehabilitation, in a rural district in South Africa

Ennion¹,

Rhoda²

2016

JMDH

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BackgroundMajor lower limb amputations result in a significant sense of loss, psychological stress, and decrease in function and overall quality of life for the amputee. The holistic, patient-centered prosthetic rehabilitation of an amputee requires input from a team of dedicated health professionals from different disciplines commonly referred to as a multidisciplinary team (MDT). MDT rehabilitation is considered crucial in the reintegration of the amputee into the community, as well as for providing psychological support after limb loss. Multidisciplinary and interdisciplinary rehabilitation has been proven to be more successful than therapy provided by individual therapists in a number of different populations, regardless of the population studied. However, in most developing countries, there is a significant lack of multidisciplinary rehabilitation.AimTo explore the roles and challenges of the members of the MDT involved in trans-tibial amputation rehabilitation in a rural community in South Africa (SA).DesignAn explorative sequential qualitative descriptive study.SettingA rural district in the KwaZulu Natal province in SA.ParticipantsNine prosthetic users, three surgeons, three traditional healers, 17 therapists, four prosthetists, and four community health workers.Instruments for data collectionSemistructured interviews and focus group discussions.ResultsThe roles of the members of the MDT were clarified, and various members of the MDT highlighted specific challenges relating to their experiences and roles in the rehabilitation team. Lack of interdisciplinary rehabilitation and communication among team members, as well as lack of resources, and patient education negatively impact the rehabilitation of trans-tibial amputees.ConclusionAiming to address the limited resources available to health care professionals, as well as improved communication and interdisciplinary rehabilitation, could potentially improve the overall rehabilitation of persons with a lower limb amputation in the rural setting.

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“…Health systems failures may be attributed to both quantitative and qualitative nursing shortages, including the lack of advanced skills to lead health initiatives, to conduct research and to educate other nurses. Health initiatives such as the roll-out of mobile health clinics to ensure equitable access to health care are an essential service to rural communities in Mozambique [2]. Mobile health services for the rollout of ARVs are only one example where a critical mass of midwives and neonatal nurses is needed to provide such leadership [3].…”

Section: Introductionmentioning

confidence: 99%

“…The devastating impact of mainly preventable conditions on its people has led to a life expectancy of 51 years and a human development index ranking of 178 out of 187 countries [2]. Among a range of factors, severe HRH constraints are cited as the main contributor to poor health outcomes [4].…”

Section: Introductionmentioning

confidence: 99%

Advancing nursing scholarship: the Mozambique model

Bruce

Dippenaar

Schmollgruber

et al. 2017

Global Health Action

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Background: Despite the importance of Human Resources for Health for the development and functioning of health systems worldwide, many countries continue to be plagued by poor health systems and a lack of adequate health care. Health systems failures may be attributed to both quantitative and qualitative nursing shortages including the lack of advanced skills to lead health initiatives, to conduct research and to educate other nurses. The response by development partners is usually framed around the production of skilled nurses through the processes of up-skilling and scaling-up. The outcome is expanded practice but with scant attention to the professional advancement of nurses. Objectives: In this paper we present a two-phased capacity development model that adopted professionalization strategies to advance nursing scholarship and consequent postgraduate specialization of the first cohort of nurses in Mozambique. The main objectives were to: develop and implement a clinical course work master’s degree in nursing; and ensure sustainability by capacitating the host institution to continue with the master’s programme following graduation. Methods: Rigorous processes for project discussions, negotiations and monitoring were necessary amid limited resources and a challenging political climate. Forging in-country partnerships, sustaining alliances and government investment are thus key to the success of the Mozambique model. Outcomes: Notwithstanding some difficulties, the process unfolded over a five-year period, graduating the first cohort of 11 senior nurses with a master’s degree, specializing either in critical care and trauma nursing, or maternal and neonatal health. Conclusions: Bridging the skills gap between generalist and specialist nurses is essential for them to manage complex and high acuity cases and to reverse associated morbidity and mortality. We conclude that this model serves as a professionalization strategy to advance nurses’ scholarship of clinical practice, research and teaching.

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Barriers to Health Care in Rural Mozambique: A Rapid Ethnographic Assessment of Planned Mobile Health Clinics for ART

Cited by 66 publications

References 20 publications

Quick and dirty? A systematic review of the use of rapid ethnographies in healthcare organisation and delivery

Quick and dirty? A systematic review of the use of rapid ethnographies in healthcare organisation and delivery

Roles and challenges of the multidisciplinary team involved in prosthetic rehabilitation, in a rural district in South Africa

Advancing nursing scholarship: the Mozambique model

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