Challenges experienced by health care professionals working in resource-poor intensive care settings in the Limpopo province of South Africa

Malelelo-Ndou, Hulisani; Ramathuba, Dorah U.; Netshisaulu, Khathutshelo Grace

doi:10.4102/curationis.v42i1.1921

Cited by 31 publications

(24 citation statements)

References 28 publications

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“…[ 30 ] Even if the ICU beds are abundant, there will be a significant shortage of supplies such as ventilators and oxygen, and all of the other supplies required for severe respiratory failure patients’ care. [ 28 ]…”

Section: Discussionmentioning

confidence: 99%

Endoscopic endonasal skull base surgery during the COVID-19 pandemic: A developing country perspective

Soliman

Elbaroody

Elsamman

et al. 2020

Surgical Neurology International

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Background: Although primarily a respiratory disorder, the coronavirus pandemic has paralyzed almost all aspects of health-care delivery. Emergency procedures are likely continuing in most countries, however, some of them raises certain concerns to the surgeons such as the endoscopic endonasal skull base surgeries. The aim of this study is to present the current situation from a developing country perspective in dealing with such cases at the time of the COVID-19 pandemic. Methods: A cross-sectional analytical survey was distributed among neurosurgeons who performed emergency surgeries during the COVID-19 pandemic in Cairo, Egypt, between May 8, 2020, and June 7, 2020. The survey entailed patients’ information (demographics, preoperative screening, and postoperative COVID-19 symptoms), surgical team information (demographics and postoperative COVID-19 symptoms), and operative information (personal protective equipment [PPE] utilization and basal craniectomy). Results: Our survey was completed on June 7, 2020 (16 completed, 100% response rate). The patients were screened for COVID-19 preoperatively through complete blood cell (CBC) (100%), computed tomography (CT) chest (68.8%), chest examination (50%), C-reactive protein (CRP) (50%), and serological testing (6.3%). Only 18.8% of the surgical team utilized N95 mask and goggles, 12.5% utilized face shield, and none used PAPRs. Regarding the basal craniectomy, 81.3% used Kerrison Rongeur and chisel, 25% used a high-speed drill, and 6.3% used a mucosal shaver. None of the patients developed any COVID-19 symptoms during the first 3 weeks postsurgery and one of the surgeons developed high fever with negative nasopharyngeal swabs. Conclusion: In developing countries with limited resources, preoperative screening using chest examination, CBC, and CT chest might be sufficient to replace Reverse transcription polymerase chain reaction. Developing countries require adequate support with screening tests, PPE, and critical care equipment such as ventilators.

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Section: Discussionmentioning

confidence: 99%

Endoscopic endonasal skull base surgery during the COVID-19 pandemic: A developing country perspective

Soliman

Elbaroody

Elsamman

et al. 2020

Surgical Neurology International

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show abstract

“…5 Numerous cost-saving exercises have been implemented over the past 5 years, included the freezing of posts, prioritisation of core items over the less essential and reducing infrastructure spending. 8 In this paper, we compare the responses to austerity in the three hospitals in a poor rural province in South Africa, contrasting absorptive strategies that expect more effort from fewer staff, adaptive strategies that draw resources from elsewhere and transformative strategies that improve the way actors engage with each other, so enable resilience.…”

Section: Introductionmentioning

confidence: 99%

Austerity, resilience and the management of actors in public hospitals: a qualitative study from South Africa

Fana

Goudge

2021

BMJ Glob Health

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BackgroundGlobal economic recession coupled with internal inefficiencies and corruption has led to a period of austerity in the South African healthcare system.This paper examines the strategies used by management in response to austerity in the three public hospitals and their effect on organisational functioning.MethodsWe used a comparative qualitative case study approach, collecting data using a combination of in-depth interviews with managers, and focus group discussion and interviews with shop stewards and staff.ResultsAusterity, imposed by the introduction of a provincial cost containment committee, has led to a reduction in staff, benefits, shortages of equipment and delayed procurement and recruitment processes. Managers in the first hospital maintained training on labour relations for staff and managers, they jointly planned how to cope with reduced staff and initiated a new forum for HR and finance staff. These strategies improved the way actors engaged, enabling them to resolve problems. Good communication ensured that staff understood what was within the hospitals control and what was not. A second hospital relied on absorptive strategies, such as asking staff to do more with less. The result was resistance, and greater use of sick leave. Some staff gave their own money to help feed patients but were angry at management for putting them in this difficult position. Leadership in the third hospital did not manage actors well either; help from the Government’s Expanded Public Works Programme was rejected by the unions, managers did not attend meetings as they felt their contributions were not listened to. Poor communication meant that the managers and staff did not understand what was within the hospital’s control and what was not; a misunderstanding led to a physical fight between managers.ConclusionOrganisational resilience in the face of austerity requires leaders to manage different stakeholders well. Hospital managers who promote democratic or participatory leadership and management, open communication, teamwork and trust among all stakeholders will lead better functioning organisations. A special focus should be placed on such practices to develop the resilience of health systems’ organisations.

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“…Low- and middle-income countries (LMICs) are broadly affected by the same basic epidemiological and population characteristics as high-income countries, however varying transmission dynamics, influenced by factors such as population density, under-funded surveillance and fewer health facilities, can exacerbate transmission (7). That said, LMICs have both greater experience in managing infectious disease outbreaks, and younger populations, which can alter the shape of epidemics.…”

Section: Introductionmentioning

confidence: 99%

Rapid Systematic Review Exploring Historical and Present Day National and International Governance during Pandemics

Lowry

Taddese

Bowman

2020

Preprint

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Introduction Pandemics have plagued mankind since records began, and while non-communicable disease pandemics are more common in high-income nations, infectious disease pandemics continue to affect all countries worldwide. To mitigate impact, national pandemic preparedness and response policies remain crucial. And in response to emerging pathogens of pandemic potential, public health policies must be both dynamic and adaptive. Yet, this process of policy change and adaptation remains opaque. Accordingly, this rapid systematic review will synthesise and analyse evaluative policy literature to develop a roadmap of policy changes that have occurred after each pandemic event, throughout both the 20th and 21st Century, in order to better inform future policy development. Methods and Analysis A rapid systematic review will be conducted to assimilate and synthesise both peer-reviewed articles and grey literature that document the then current pandemic preparedness policy, and the subsequent changes to that policy, across high-, middle- and low-income countries. The rapid review will follow the PRISMA guidelines, and the literature search will be performed across five relevant databases, as well as various government websites to scan for grey literature. Articles will be screen against pre-agreed inclusion/ exclusion criteria, and data will be extracted using a pre-defined charting table. Ethics and Dissemination All data rely on secondary, publicly available data sources; therefore no ethical clearance is required. Upon completion, the results of this study will be disseminated via the Imperial College London Community and published in an open access, peer-reviewed journal.

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Challenges experienced by health care professionals working in resource-poor intensive care settings in the Limpopo province of South Africa

Cited by 31 publications

References 28 publications

Endoscopic endonasal skull base surgery during the COVID-19 pandemic: A developing country perspective

Endoscopic endonasal skull base surgery during the COVID-19 pandemic: A developing country perspective

Austerity, resilience and the management of actors in public hospitals: a qualitative study from South Africa

Rapid Systematic Review Exploring Historical and Present Day National and International Governance during Pandemics

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