Experiences of community care givers caring for clients suffering from tuberculosis in eThekwini district, KwaZulu-Natal

Abstract

Introduction Tuberculosis is still a leading cause of deaths in low and middle income countries especially those of Sub-Saharan Africa. The successful implementation of strategies to improve TB outcomes remains critical for South Africa as the country is faced with the burden of many TB related deaths. South Africa has included TB management as a priority programme for the country in its strategies to the achieve millennium development goals. The National Department of Health introduced the CCG programme to assist professional health workers in the control and management of various health conditions including TB. The competent management of the CCGs is central to meeting service delivery objectives. Aim of the study The aim of the study was to explore and describe the experiences of community care givers caring for TB clients. Methodology A qualitative, exploratory, descriptive design was used to conduct the study. Purposive sampling was used to recruit 24 community care givers that were employed by Department of Health receiving a stipend and had been working as community care givers for at least two years. Data was collected using semi structured interviews and was subsequently analysed using Tesch’s method of data analysis Results The themes that emerged from the interviews included: accessibility of kits and protective clothing to the CCGs, their safety and security, training and development, ii including financing of the CCG programme. The following sub-themes emerged as part of the themes: Insufficient supply of kits, alternative means of making kits available to the CCG’s, promotion and supply of uniforms for the CCGs, procurement and supply of protective clothing, alternative ways of getting protective clothes, vaccination against communicable diseases, safety allowance, transparency on criteria for further training and development, age limits regarding the selection of the CCGs, lack of career pathing, stipend received by the CCGs and employment benefits for the CCGs. Recommendations Recommendations were made with regards to institutional management and practice, policy development and implementation, and further research. These included establishing processes for: supply of kits, protective clothes and vaccines, pre and periodical medicals, criteria for further training and development, and issuing of stipend. A broader study involving all the CCGs affiliated to all PHC clinics in eThekwini district on the required support and supervision was also recommended.

Accountability to Build School and System Improvement Capacity

“…For accountability standards to be able to align these actors' efforts towards improvement around a similar set of criteria and norms, they need to accept the standards as valid indicators of high-quality education and incorporate them in their daily practices and in how they support schools in implementing feedback from inspections and assessments. An example of where this was not working comes from Mazibuko (2009) who found that in South Africa (KwaZulu-Natal) there was a lack of clarity in the roles of support offices, districts and inspectors, which hampered the support of schools in using inspection recommendations to improve. Other stakeholders, such as resource centres or school support services, rarely followed up on the inspector's recommendations, which made the inspection a one-off activity with few consequences.…”