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PubMed2005

The neonatal resuscitation training project in rural South Africa.

A paediatrician trainer from Australia (JT) spent 3 months in South Africa to assist with the development of neonatal resuscitation training in rural areas, particularly in district hospitals. The project was initiated by the Rural Health Unit at the University of the Witwatersrand and coordinated through the Family Medicine Education Consortium (FaMEC). The Rural Workforce Agency of Victoria together with General Practice and Primary Health Care Northern Territory covered the salary and international travel costs of the trainer, while local costs were funded by provincial departments of health, participants and a Belgian funded FaMEC project. The trainer developed an appropriate one-day skills training course in neonatal resuscitation (NNR), using the South African Paediatric Association Manual of Resuscitation of the Newborn as pre-reading, and a course to train trainers in neonatal resuscitation. From July to October 2004 he moved around the country running the neonatal resuscitation course, and, more importantly, training and accrediting trainers to run their own courses on an ongoing basis. The neonatal resuscitation course involved pre- and post-course multiple-choice question tests to assess knowledge and application, and, later, pre- and post-course skills tests to assess competence. A total of 415 people, including 215 nurses and 192 doctors, attended the neonatal resuscitation courses in 28 different sites in eight provinces. In addition, 97 trainers were trained, in nine sites. The participants rated the course highly. Pre- and post-course tests showed a high level of learning and improved confidence. The logistical arrangements, through the departments of family medicine, worked well, but the programme was very demanding of the trainer. Lessons and experiences were not shared between provinces, leading to repetition of some problems. A clear issue around the country was a lack of adequate equipment in hospitals for neonatal resuscitation, which needs to be addressed by health authorities. A process of ongoing training has been established, with provincial coordinators taking responsibility for standards and the roll-out of training. A formal evaluation of the project is planned. The project serves as a model for skills training in rural areas in South Africa, and for collaboration between organisations. A number of specific recommendations are made for the future of this NNR training project, which offer lessons for similar programmes.

Allied Health Personnel↗

PubMed2005

The most rural conference?

Explore the source record for details and available documents.

Africa, Southern↗

PubMed2004

Reframing the HIV/AIDS debate in developing countries I: setting the scene.

In 2001, it was estimated that 4.7 million South Africans were living with HIV/AIDS. Prevalence figures have risen steadily over the past 10 years in most African countries, and in only a few, like Uganda, does the epidemic show signs of waning. In Africa, the status of the obese has risen enormously. If you're fat, you don't have AIDS. The epidemic is fuelled by many factors. These include: a lack of basic education about HIV risk; migrant labour disrupting family stability; polygamous marriages; patriarchal practices; and a lack of basic human rights, including being able to refuse intercourse, for women. Health care systems struggle and fail to cope with overwhelming demands, and the scale of the human loss risks dehumanising carers and health workers. Doctors evolve coping strategies, as do health systems and governments. Aid from the Western world has, until recently, been tokenistic in scale. HIV/AIDS in Africa is substantially a result of the socioeconomic and political realities of the past and present, and is related to the continued exploitation of developing countries by developed nations. This article was the introductory paper in the 'HIV/AIDS in the Developing World workshop' of the 2003 WONCA World Rural Health Congress, Santiago de Compostela, Spain. The concluding 'Santiago de Compostela Statement on HIV/AIDS' was adopted at the congress, and is offered here as a suggested way forward.

Journal Article↗

PubMed2004

Seeking quality: some experiences in South Africa.

Although definitions of quality in healthcare may vary, it is accepted that there are standards towards which we should be aiming. Thus quality improvement is an important part of developing rural health services. At the same time rural settings provide unique challenges to this process. The quality improvement cycle provides a tool to assist rural practitioners wishing to work towards better quality health care. The cycle starts with identifying the problems that need to be addressed and thereafter forming a team to deal with the issues identified. The team together sets standards, which provide targets appropriate to the context and towards which the service should aim. They then gather data to assess how the healthcare service is currently performing in terms of those standards. On the basis of this information, an analysis is made of the problems and their causes, which then allows the team to develop a specific plan to address the important limiting factors in the context. Implementation of the plan continues on an ongoing basis, repeating the steps as needed, with evaluation occurring as part of each cycle to assess whether quality is indeed improving. The process is described as a cycle because it needs to be ongoing, in various ways, as part of continuous quality improvement. Examples of each of the stages of the cycle are given from the South African context as illustrations of the tasks inherent in quality improvement.

Journal Article↗

PubMed2003

Rural health focus: organising CPD for rural hospitals.

Rural and Remote Health is committed to the task of providing a freely accessible, international, peer-reviewed evidence base for rural and remote health practice. Inherent in this aim is a recognition of the universal nature of rural health issues that transcends both regional interests and local culture. While RRH is already publishing peer-reviewed material, the Editorial Board believes many articles of potential worth are largely inaccessible due to their primary publication in small-circulation, paper-based journals whose readership is geographically limited. In order to augment our already comprehensive, international evidence base, the RRH Editorial Board has decided to republish, with permission, selected articles from such journals. This will also give worthwhile small-circulation articles the wide audience only a web-based journal can offer. The RRH editorial team encourages journal users to nominate similar, suitable articles from their own world region.

Journal Article↗

PubMed2003

Rural hospital focus: defining rural.

Rural and Remote Health is committed to the task of providing a freely accessible, international, peer-reviewed evidence base for rural and remote health practice. Inherent in this aim is a recognition of the universal nature of rural health issues that transcends both regional interests and local culture. While RRH is already publishing peer-reviewed material, the Editorial Board believes many articles of potential worth are largely inaccessible due to their primary publication in small-circulation, paper-based journals whose readership is geographically limited. In order to augment our already comprehensive, international evidence base, the RRH Editorial Board has decided to republish, with permission, selected articles from such journals. This will also give worthwhile small-circulation articles the wide audience only a web-based journal can offer. The RRH editorial team encourages journal users to nominate similar, suitable articles from their own world region.

Journal Article↗

PubMed2003

Rural hospital focus: students.

Rural and Remote Health is committed to the task of providing a freely accessible, international, peer-reviewed evidence base for rural and remote health practice. Inherent in this aim is a recognition of the universal nature of rural health issues that transcends both regional interests and local culture. While RRH is already publishing peer-reviewed material, the Editorial Board believes many articles of potential worth are largely inaccessible due to their primary publication in small-circulation, paper-based journals whose readership is geographically limited. In order to augment our already comprehensive, international evidence base, the RRH Editorial Board has decided to republish, with permission, selected articles from such journals. This will also give worthwhile small-circulation articles the wide audience only a web-based journal can offer. The RRH editorial team encourages journal users to nominate similar, suitable articles from their own world region.

Journal Article↗

PubMed2003

Rural hospital focus: accommodation.

Rural and Remote Health is committed to the task of providing a freely accessible, international, peer-reviewed evidence base for rural and remote health practice. Inherent in this aim is a recognition of the universal nature of rural health issues that transcends both regional interests and local culture. While RRH is already publishing peer-reviewed material, the Editorial Board believes many articles of potential worth are largely inaccessible due to their primary publication in small-circulation, paper-based journals whose readership is geographically limited. In order to augment our already comprehensive, international evidence base, the RRH Editorial Board has decided to republish, with permission, selected articles from such journals. This will also give worthwhile small-circulation articles the wide audience only a web-based journal can offer. The RRH editorial team encourages journal users to nominate similar, suitable articles from their own world region. This article 'Rural hospital focus: accommodation', is third in our series. It first appeared in South African Family Practice 2000; 22 (7), and is reproduced here in its original form, with kind permission of both publisher and author, prominent South African rural doctor, Professor Ian Couper. 'Rural hospital focus' was the title of the SAFP column which presented this article.

Journal Article↗

PubMed2003

Recruiting foreign doctors to South Africa: difficulties and dilemmas.

In 2003, the Medical and Dental Professional Board of the Health Professions Council of South Africa again made it possible for foreign-qualified doctors to obtain registration without sitting an examination. This eased the way for eligible non-South African doctors to work in South Africa in order to assist with the current staffing crisis in rural hospitals. This personal view examines the issues and difficulties related to foreign-trained doctors practising in South Africa, such as short-term practice vs long-term commitment; strategies to promote preparation of local doctors for rural hospital practice; the loss of recruited doctors to third-party countries; the principle of distributive justice in international medical training; and defining acceptable standards of training. The conclusions reached are that while doctors from developing countries, especially from neighbouring African nations, have historically brought a wealth of practical experience to South Africa's rural hospitals, there are also mutual benefits in recruiting from doctors trained in developed countries. The guiding principle is to obtain well-trained and experienced doctors who are able to function in a rural hospital until there are sufficient local-trained doctors. While the article focuses specifically on medical staffing in rural South Africa, the principles discussed apply equally to other health-care professionals and other, similar countries.

Journal Article↗

PubMed2003

Rural hospital focus: no transport, no primary health care.

Rural and Remote Health is committed to the task of providing a freely accessible, international, peer-reviewed evidence base for rural and remote health practice. Inherent in this aim is a recognition of the universal nature of rural health issues that transcends local culture and regional interests. While RRH is already publishing such peer-reviewed material, the Editorial Board believes many articles of potential worth are largely inaccessible due to their primary publication in small-circulation, paper-based journals whose readership is geographically limited. In order to generate and make available a comprehensive, international evidence base, the RRH Editorial Board has decided to republish, with permission, selected articles from such journals. This will also give worthwhile small-circulation articles the wide audience only a web-based journal can offer. The RRH RRH editorial team encourages journal users to nominate similar, suitable articles from their own world region. This article 'Rural hospital focus: No transport, no primary health care', is second in our series. It first appeared in South African Family Practice 2000; 22 (6), and is reproduced here in its original form, with kind permission of both publisher and author, prominent South African rural doctor, Professor Ian Couper. 'Rural hospital focus' was the title of the SAFP column which presented this article.

Journal Article↗

PubMed2000