Barriers to quality patient care in rural district hospitals

Eygelaar, Johanna Elizabeth; Stellenberg, Ethelwynn L.

doi:10.4102/curationis.v35i1.36

Cited by 20 publications

(36 citation statements)

References 2 publications

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“…Six of these studies considered employee outcomes, two of which found a positive association with job satisfaction and retention [ 166 , 172 ]. Four other studies (from South Africa, Tanzania, and Nigeria) [ 94 , 102 , 146 , 148 ] found negative relationships between training and employee outcomes. Two of these studies also reported improved team performance as a result of team-training, but their evidence was qualified as weak [ 146 , 172 ].…”

Section: Resultsmentioning

confidence: 98%

“…Ten studies presented evidence on the relationship between training and outcomes [ 75 , 94 , 100 , 102 , 148 , 150 , 155 , 146 , 166 , 172 ]. Six of these studies considered employee outcomes, two of which found a positive association with job satisfaction and retention [ 166 , 172 ].…”

Section: Resultsmentioning

confidence: 99%

“…Two of these studies also reported improved team performance as a result of team-training, but their evidence was qualified as weak [ 146 , 172 ]. Three of the four studies focusing on organizational outcomes reported improvements in the quality of care [ 94 , 150 , 166 ]. The two studies reporting on patient outcomes found non-significant reductions in (maternal) mortality rates [ 155 , 172 ].…”

Section: Resultsmentioning

confidence: 99%

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The effect of human resource management on performance in hospitals in Sub-Saharan Africa: a systematic literature review

2018

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Hospitals in Sub-Saharan Africa (SSA) face major workforce challenges while having to deal with extraordinary high burdens of disease. The effectiveness of human resource management (HRM) is therefore of particular interest for these SSA hospitals. While, in general, the relationship between HRM and hospital performance is extensively investigated, most of the underlying empirical evidence is from western countries and may have limited validity in SSA. Evidence on this relationship for SSA hospitals is scarce and scattered. We present a systematic review of empirical studies investigating the relationship between HRM and performance in SSA hospitals.Following the PRISMA protocol, searching in seven databases (i.e., Embase, MEDLINE, Web of Science, Cochrane, PubMed, CINAHL, Google Scholar) yielded 2252 hits and a total of 111 included studies that represent 19 out of 48 SSA countries.From a HRM perspective, most studies researched HRM bundles that combined practices from motivation-enhancing, skills-enhancing, and empowerment-enhancing domains. Motivation-enhancing practices were most frequently researched, followed by skills-enhancing practices and empowerment-enhancing practices. Few studies focused on single HRM practices (instead of bundles). Training and education were the most researched single practices, followed by task shifting.From a performance perspective, our review reveals that employee outcomes and organizational outcomes are frequently researched, whereas team outcomes and patient outcomes are significantly less researched. Most studies report HRM interventions to have positively impacted performance in one way or another. As researchers have studied a wide variety of (bundled) interventions and outcomes, our analysis does not allow to present a structured set of effective one-to-one relationships between specific HRM interventions and performance measures. Instead, we find that specific outcome improvements can be accomplished by different HRM interventions and conversely that similar HRM interventions are reported to affect different outcome measures.In view of the high burden of disease, our review identified remarkable little evidence on the relationship between HRM and patient outcomes. Moreover, the presented evidence often fails to provide contextual characteristics which are likely to induce variety in the performance effects of HRM interventions. Coordinated research efforts to advance the evidence base are called for.Electronic supplementary materialThe online version of this article (10.1186/s12960-018-0298-4) contains supplementary material, which is available to authorized users.

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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The effect of human resource management on performance in hospitals in Sub-Saharan Africa: a systematic literature review

2018

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“…Public hospitals in South Africa experience varying shortages of medical equipment and in general the country scored below 50% in a national health care facilities baseline audit conducted in 2012 [ 13 , 14 ]. The shortage is higher in rural hospitals than in urban hospitals like in other countries [ 15 - 17 ]. Poor maintenance and repair as well as limited financial resources are responsible for the shortages.…”

Section: Discussionmentioning

confidence: 99%

Experiences of nurses on the critical shortage of medical equipment at a rural district hospital in South Africa: a qualitative study

Moyimane

Kekana

2017

Pan Afr Med J

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IntroductionMedical equipment is an essential health intervention tool used by nurses for prevention, diagnosis and treatment of disease and for rehabilitation of patients. However, access to functioning medical equipment is a challenge in low- and middle-income countries. The World Health Organization estimated that 50 to 80 percent of medical equipment in developing countries is not working, creating a barrier to the ability of the health system to deliver health services to patients. This study explored and described the lived experiences of nurses working at a district hospital with a critical shortage of medical equipment.MethodsA qualitative, exploratory, phenomenological and descriptive study design was used. A purposive sampling was used to select participants and due to saturation of data 14 nurses participated in the study. Research ethics were observed. Data was collected through semi-structured interviews using an interview guide. Interviews were audio-taped and field notes were taken. Voice recordings were transcribed verbatim and Tesch’s open coding method was used for data analysis. Findings were confirmed by an independent coder.ResultsCritical shortage of medical equipment at the hospital occurred in the form of unavailability of equipment, low quality and poor maintenance of the few that were available. Shortage impacted negatively on nursing care, nursing profession and the hospital.ConclusionNurses should be provided with functional medical equipment in order to provide quality nursing care. Management, leadership and governance structures should be strengthened to ensure that procurement and maintenance plans for medical equipment are developed and implemented.

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“…11 While access to primary health care has reportedly increased in recent decades, especially in rural areas, quality of care has not always kept pace. 12 In addition, South Africa faces a quadruple burden of disease and a mix of health system challenges. 13 These conditions, in a context of widespread poverty and extreme inequality, limit the chances of optimal adaptation to climate change, but also of implementing a National Health Insurance (NHI) scheme in a cost-effective manner.…”

Section: Introductionmentioning

confidence: 99%

National Health Insurance and climate change: Planning for South Africa’s future

Wright¹,

Chersich²,

Mathee³

2019

S. Afr. J. Sci.

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Barriers to quality patient care in rural district hospitals

Cited by 20 publications

References 2 publications

The effect of human resource management on performance in hospitals in Sub-Saharan Africa: a systematic literature review

The effect of human resource management on performance in hospitals in Sub-Saharan Africa: a systematic literature review

Experiences of nurses on the critical shortage of medical equipment at a rural district hospital in South Africa: a qualitative study

National Health Insurance and climate change: Planning for South Africa’s future

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