RESUMEN
Community-led monitoring (CLM) of health services is a mechanism of community participation and accountability that is increasingly advocated across the globe. In South Africa (SA), a large-scale community-led monitoring initiative called Ritshidze ('saving our lives') was established in 2019. Steered by a coalition of civil society organisations representing people living with HIV, Ritshidze monitors just over 400 primary healthcare (PHC) facilities in 8 provinces on a quarterly basis. In this piece we describe the purposes and design features and the five-step approach to CLM of the Ritshidze model. We also highlight some of the positive changes achieved, and reflect on possible reasons for successes. In doing so, we aim to draw attention to this significant national initiative and its potential as a mechanism of social accountability in SA.
Asunto(s)
Infecciones por VIH , Atención Primaria de Salud , Sudáfrica , Atención Primaria de Salud/normas , Atención Primaria de Salud/organización & administración , Humanos , Participación de la Comunidad/métodos , Mejoramiento de la Calidad , Responsabilidad Social , Calidad de la Atención de SaludRESUMEN
Absenteeism results in an increased workload for nurses who stand in for colleagues and can lead to situations in which a lack of motivation among nurses and a lowering of the quality of patient care may occur. The researcher observed that certain conditions, such as inflexible working schedules, were given as reasons for the absenteeism in units in a provincial hospital. A non-experimental, descriptive, quantitative study was undertaken. The purpose of the article was to describe the working conditions that contribute to absenteeism among the professional and sub-professional nurses at a provincial hospital in the Limpopo province of South Africa. The sample included 107 professional nurses and 163 sub-professional nurses who voluntarily agreed to participate in the study. A questionnaire was used to collect data, which was analysed by using descriptive and inferential statistics. The findings of this study indicated that personal and managerial characteristics, and organisational and working conditions may lead to absenteeism in the workplace. This article focuses on the working conditions that are constraints, namely inadequate group cohesion, inadequate delegation of autonomy, role ambiguity, ineffective routinisation and the effect of the workload in the workplace. Recommendations are made for improving working conditions to combat absenteeism among nurses. The limitations of this study are highlighted.
Asunto(s)
Absentismo , Actitud del Personal de Salud , Personal de Enfermería en Hospital , Lugar de Trabajo , Adulto , Agotamiento Profesional/etiología , Agotamiento Profesional/psicología , Distribución de Chi-Cuadrado , Conducta Cooperativa , Femenino , Humanos , Relaciones Interprofesionales , Satisfacción en el Trabajo , Masculino , Moral , Motivación , Enfermeras Administradoras/organización & administración , Enfermeras Administradoras/psicología , Rol de la Enfermera/psicología , Investigación Metodológica en Enfermería , Personal de Enfermería en Hospital/organización & administración , Personal de Enfermería en Hospital/psicología , Autonomía Profesional , Factores de Riesgo , Apoyo Social , Sudáfrica , Encuestas y Cuestionarios , Carga de Trabajo/psicología , Lugar de Trabajo/organización & administración , Lugar de Trabajo/psicologíaRESUMEN
An outbreak of dysentery in Zimbabwe was associated with a high mortality, especially in children who developed hemolytic uremic syndrome (HUS). To examine the causes of high mortality from HUS and to suggest measures that could reduce the case fatality rate, clinical and laboratory features of 91 children with dysentery were reviewed. Of these, 14 developed HUS; their findings were compared with age-matched controls with dysentery only. Persistent alteration of consciousness after rehydration, pallor, and oliguria were early clinical indicators of HUS. Leukocytosis and leukemoid reaction, microhematuria, and non-resolving hyponatremia distinguished children with HUS from those with dysentery. While Shigella dysenteriae type I was responsible for the dysentery outbreak in the community, most stool cultures of children with HUS were negative. Mortality from HUS was high. Late recognition of HUS and a lack of peritoneal dialysis could have contributed to the fatal outcome in some cases. Early recognition of HUS through close observation of children with dysentery and appropriate laboratory investigations with referral to a hospital, where peritoneal dialysis is available, should improve the outcome.