Community health workers play important roles in rural primary health care settings. They work within ward-based primary health care outreach teams yet their roles are not always clearly defined an...

Human resource for health (HRH) challenges jeopardise the South African health system, undermining the efforts made to curb the burden of disease. There is a demand for a category of health workers, which will meet the basic health needs of people at the grassroots level to ensure accessible, affordable health care using appropriate technologies acceptable to the recipients of care. The ward-based primary health care outreach teams are well placed to provide community-based primary health care services, which encompass activities in communities, households and referral networks with community-based providers. This study aims to elicit factors enabling or undermining the effectiveness of ward-based primary health care outreach teams in KwaZulu-Natal. The search strategy of this scoping review will be guided by Arksey and O’Malley’s scoping review methodology framework. The following electronic databases will be searched: PubMed, Google Scholar, Science Direct, Clinical key and from EBSCOhost platform and Dissertation via World Cat. The selection of study will involve three stages of screening. The principal author will conduct the title screen of articles from the databases and remove the duplicates. Two authors will independently conduct the abstract and full text screening, and articles that meet the eligibility criteria will be included for the study. Data will be extracted from the studies included, and the emerging themes will be analysed using NVIVO software. A quality assessment of the included studies will be determined through a mixed method appraisal tool (MMAT) version 2011. Ward-based primary health care outreach team (WBPHCOT) evidence, acceptability, preferences or practice effectiveness studies will be identified. Further expected results also include identification of knowledge gaps in primary health care practice as well as inform future research required. Findings will be disseminated electronically, in print and through peer presentation, conferences and congresses. Results from this scoping review will be useful to inform local and the South Africa National Health Insurance programme managers concerning the impact ward-based primary health care outreach teams have on the national health care system and on the health of the population.

Background: Reproductive health services are essential for everyone worldwide. In South Africa, the available literature does not address reproductive health as a full package for women refugees and their experiences. This study addressed women refugees in relation to reproductive healthcare services they receive from public healthcare facilities.Aim: The aim of the study was to document the day-to-day experiences of women refugees and uncover their challenges regarding utilisation of reproductive health services in public institutions of Durban, KwaZulu-Natal.Setting: The study was conducted in eThekwini district, Durban, KwaZulu-Natal, and did not consider participants who are located beyond the above-mentioned city’s borders.Methods: A qualitative, descriptive design was used. A semi-structured interview guide was used to collect data through face-to-face in-depth interviews with eight women refugees. Thematic content analysis guided the study.Results: Two major themes emerged: negative experiences or challenges, and positive experiences. The most dominant negative experiences included medical xenophobia and discrimination, language barrier, unprofessionalism, failure to obtain consent and lack of confidentiality, ill-treatment, financial challenges, internalised fear, religious and cultural hegemony, and the shortage of health personnel and overcrowding of public hospitals. The positive experiences included positive treatment and care and social support.Conclusion: The findings revealed that women refugees in Durban, KwaZulu-Natal, face many challenges such as medical xenophobia and discrimination in their attempt to seek reproductive health services in public healthcare facilities, making them even more vulnerable. Assisting women refugees with their reproductive health needs will remediate the challenges they face.

There is a rampant increase in diabetes prevalence globally. Sub-Saharan Africa (SSA) is projected to carry the largest burden of diabetes (34.2 million) by 2030. This will inevitably cause a parallel increase in diabetes-associated complications; with the predominant complications being blindness due to diabetic retinopathy and diabetic cataracts. Eye programs in developing countries remain inadequate, existing as stand-alone programs, focused on the provision of acute symptomatic care at secondary and tertiary health levels. Over 60% of people with undiagnosed diabetes report to eye care facilities with already advanced retinopathy. While vision loss due to cataracts is reversible, loss of vision from diabetic retinopathy is irreversible. Developing countries have in the last two decades been significantly impacted by infectious pandemics; with SSA countries committing over 80% of their health budgets towards infectious diseases. Consequently, non-communicable diseases and eye health have been neglected. This paper aimed to highlight the importance of strengthening primary health care services to prevent diabetes-related blindness. In SSA, where economies are strained by infectious disease, the projected rise in diabetes prevalence calls for an urgent need to reorganize health systems to focus on life-long preventative and integrated measures. However, research is critical in determining how best to integrate these without further weakening health systems.

Introduction: Evidence from many countries suggests that provision of home and community-based health services, linked to care at fixed primary health care facilities, is critical to good health outcomes. In South Africa, the Ward-Based Primary Health Care Outreach Teams are well placed to provide these services. The teams report to a primary health care facility through their outreach team leader. The facility manager/operational manager provides guidance and support to the outreach team leader. Aim: The aim of the study was to explore and describe the perceptions of facility managers regarding support and supervision of ward-based outreach teams in the National Health Insurance pilot sites in Kwa Zulu-Natal. Setting: The study was carried out in three National Health Insurance pilot districts in KwaZulu- Natal. Methods: An exploratory qualitative design was used to interview 12 primary health care facility managers at a sub-district (municipal) level. The researchers conducted thematic analysis of data. Findings: Some gaps in the supervisory and managerial relationships between ward based primary health care outreach teams and primary health care facility managers were identified. High workload at clinics may undermine the capacity of PHC facility managers to support and supervise the teams. Field supervision seems to take place only rarely and for those teams living far away from the clinic, communication with the clinic manager may be difficult. The study further highlights issues around the training and preparation of the teams. Conclusions: Ward based primary health care outreach teams have a positive impact in preventive and promotive health in rural communities. Furthermore, these teams have also made impact in improving facility indicators. However, their work does not happen without challenges.

Nigeria contributes the highest to the global burden of HIV/AIDS and also accounts for the largest proportion of new vertically transmitted HIV infections among children. The Mentor Mothers program in the Nigerian Department of Defense was introduced in accordance with the World Health Organization and its implementing partner guidelines to curb the high incidence of vertically acquired HIV infections. Understanding the experiences of participants could serve as a gateway to evaluating the effectiveness of the program to better provide quality services within targeted health facilities. This qualitative study employed key informant interviews with six healthcare workers as well as two focus group discussions with six mentor mothers and six prevention of mother-to-child transmission (PMTCT) patients in four selected hospitals in the Nigerian Department of Defense to explore their experiences of the Mentor Mothers program. A thematic analysis technique was used to analyze the collated data. As a result, four main themes emerged, with the program perceived by most participants as providing psychosocial support to the patients, a valuable educational resource for raising HIV awareness, a valuable resource for promoting exclusive breastfeeding and mitigating vertical transmission of the virus, and functioning as a link between patients and the healthcare system. The participants reported that the program had effectively decreased HIV infections in children, reduced child and maternal mortality, and supported the livelihood and development of women, families, and communities in and around the Nigerian Department of Defense health facilities.