A model to strengthen Ward Based Outreach Teams (WBOTs) within the PHC Re-engineering programme in Vhembe district, Limpopo Province

Background: After the Alma Ata Declaration in 1978, many countries especially the developing regions of the world, began to establish or strengthen their Community Health Worker (CHW) programmes due to the need for “a shift in attitude from a focus on ill health and hospitals, to a focus on communities and families controlling their own health” Purpose: The purpose of this study was to develop a model to strengthen the performance of Ward Based Outreach Teams within the re-engineering programme in Vhembe district, Limpopo Province. Methods: The study followed parallel convergent mixed method approach was used in data collection, analysing and merging data of both qualitative and quantitative design simultaneously, in order to give the general picture of the problem. Convergent design take place when the researcher collects and analyses both qualitative and quantitative data during the same phase of the research process and merges the two sets of results into inclusive interpretation Phase 1(a) Qualitative objectives were to explore the perceptions, experiences, and challenges of WBOTs on PHC re-engineering programme. The qualitative strand followed the exploratory descriptive approach. The target population were the WBOTs involved in PHC re-engineering programme (CHWs, team leaders (professional nurses) and coordinators of the programme. Non-probability purposive convenient sampling method was used to sample the participants. In-depth unstructured interviews were used to collect to the focus group discussions (FGDs). 9 FGDs were involved. An audiotape and field notes was used to supplement data. Measures of trustworthiness were also observed. Data was analysed using Tesch’s thematic analysis. Phase 1(b) Quantitative objectives were to assess thee knowledge of professional nurses on PHC re-engineering and to assess the impact of PHC re-engineering in the health system. The target population were the professional nurses at PHC facilities whose facilities are attached to PHC re-engineering programme and having consistency in submitting monthly statistics for 6 months on the activities of the CHWs. Probability sampling method was. Simple random used to sample the respondents. Structured questionnaire was used to collect data from the respondents. SPPSS Version 27 was used to analyse data. Phase 2, Chin & Kramer’s concept analysis steps was utilized to analyse findings. Phase 3, development of a model was based on Dickoff theoretical framework of context, agent, recipient, dynamics, procedure and outcome. Ethical considerations were ensured, and measures to ensure validity and reliability was applied. Findings: Both team leaders and professional nurses acknowledged the ineffective coordination of PHC re-engineering programme due to the multiple roles that they are expected to perfume on daily basis. Lack of support, supervision, mentoring, coaching, communication, monitoring and evaluation came out as the key stumbling blocks between team leaders, professional nurses and community health care workers. Lack of support from the district management team was also identified. Negative attitude of some facility staff members towards the CHWs tend to cause poor relationship and lack of trust in health providers. Recommendations: The study recommends that all professional nurses at PHC facilities should have sufficient knowledge on PHC re-engineering programme, they should understand the impact of PHC re-engineering programme in the community and the health system in order to work harmoniously with the CHWs. They should also understand the diversity of the health system towards attaining a status of health for all. Team leaders should ensure that PHC re-engineering receive priority in all PHC facilities. Again, team leaders should know PHC re-engineering targets and be linked to service delivery targets. They should provide proper support, supervision, mentoring, coaching, monitoring and evaluating the activities of the CHWs. District management team should be visible and provide supportive to the WBOTs.

Author dc:creator

• Machavana, Monica Mavuti

Advisors dc:contributor.advisor

• Ramathuba, D. U.
• Lebese, T. R.

• Community health worker
• MEDICINE::Social medicine::Public health medicine research areas::Community medicine
• Ward based Outreach teamss
• Professional nurses
• Primary health care
• Performance
• Reengineering
• Strengthening

Statement dc:rights

• University of Venda

Language dc:language.iso

en

Repository record dc:identifier.uri

http://univendspace.univen.ac.za/handle/123456789/2782

OAI record oai:identifier

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