Challenges and solutions to nurse-delivered integrated primary health care in Nelson Mandela Bay.

IF 1.7 Q4 PRIMARY HEALTH CARE
Zubrina Baartman, Cornelle Young, Justine C Baron
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Abstract

Background:  Delivery of a comprehensive and integrated primary health care service to increase healthcare access, quality, equity and efficiency requires an effective working environment.

Aim:  To explore perceptions of primary health care nurses in the Eastern Cape, South Africa, regarding the adequacy of their working environment for integrated primary health care service delivery.

Setting:  Selected public primary health care clinics in a subdistrict of the Nelson Mandela Bay metropole, Eastern Cape, South Africa.

Methods:  A qualitative descriptive explorative design was used. Semi-structured interviews were conducted with nine nurses working in the selected facilities. Data were thematically analysed.

Results:  Availability of members of the multidisciplinary primary health care team, nurse competency, responsiveness and productivity levels compromise integrated primary health care. Service delivery is further negatively impacted by a lack of resources and non-optimal collaboration among members of the primary health care team.

Conclusion:  Challenges to rendering an effective integrated primary health care service exist within the primary health care working environment. To significantly increase comprehensive and integrated primary health care service delivery as a quality component of South African healthcare, these challenges need to be addressed.Contribution: An evidence-based description of aspects of primary health care workspaces that compromise integrated primary health care delivery is provided. This information can be used to improve integrated primary health care services. Integrated services are a prerequisite for the Ideal Clinic Initiative, which is a foundation of the implementation of the National Health Insurance (NHI) scheme for South Africa.

Abstract Image

Abstract Image

纳尔逊·曼德拉湾护士提供综合初级保健的挑战和解决办法。
背景:提供全面和综合的初级卫生保健服务,以增加获得卫生保健的机会、质量、公平和效率,需要一个有效的工作环境。目的:探讨南非东开普省初级卫生保健护士对其综合初级卫生保健服务提供的工作环境是否充足的看法。环境:南非东开普省纳尔逊·曼德拉湾都会区的选定公共初级保健诊所。方法:采用定性描述性探索性设计。对在选定机构工作的9名护士进行了半结构化访谈。对数据进行主题分析。结果:多学科初级卫生保健团队成员的可用性、护士的能力、反应能力和生产力水平损害了综合初级卫生保健。缺乏资源和初级卫生保健团队成员之间的非最佳协作进一步对服务的提供产生负面影响。结论:在初级卫生保健工作环境中存在着提供有效的综合初级卫生保健服务的挑战。要大幅度增加提供全面和综合初级保健服务,使之成为南非保健的一个高质量组成部分,就必须解决这些挑战。贡献:对初级卫生保健工作场所影响综合初级卫生保健提供的各个方面进行了基于证据的描述。这些信息可用于改善综合初级保健服务。综合服务是理想诊所倡议的先决条件,而理想诊所倡议是实施南非国民健康保险计划的基础。
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来源期刊
CiteScore
3.30
自引率
10.00%
发文量
81
审稿时长
15 weeks
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