Action research-driven professional development : developing transformational health care managers and creating learning organisations

The Foundation for Professional Development (FPD) offers, inter alia, an advanced management development programme for health care managers in the public and private sector, sponsored by the United States Agency for International Development (USAID) and co-certified by Yale University in the United States (US). The focus is on professional development and transformational leadership. Authentic learning opportunities are created that focus on deep learning in the work context. Portfolio assessment is used. A developmental portfolio is compiled by the health care managers enrolled in the programme. The developmental process is underpinned by the principles of action research. Managers are self-empowered to take responsibility for investigating the transformation of their management practice as a measure of self-driven quality assurance. In most cases the action research process becomes educational to both the manager and his/her colleagues participating in the project. In this way a culture of professional organisational learning is created and maintained. This article reports on a number of case studies of health care managers who conducted action research in an array of health-related contexts, covering health science fields such as HIV/AIDS, tuberculosis and capacity building programmes to create learning organisations and community engagement projects. The lessons learned by the managers regarding the innovative ideas they experimented with in their specific contexts can be transferred to other managers and action research scholars. All these case studies provide evidence of knowledge being created in authentic contexts. These case studies are reported as scholarly endeavour to showcase the empowering and emancipating nature of action research and the contribution it makes to the existing body of knowledge in different fields in which health care managers have to operate.hj2014gv201

Challenges and constraints at district management level

Inadequate delegation of authority, defective budgeting processes, staffing issues, lack of managerial skills, vacancies in key managerial positions, and ineffective use or absence of quality management information systems to support decision-making were identified as challenges facing District Management Teamshttp://reference.sabinet.co.za/sa_epublication/healthram201

An exploratory survey measuring stigma and discrimination experienced by people living with HIV/AIDS in South Africa : the People Living with HIV Stigma Index

Background: The continued presence of stigma and its persistence even in areas where HIV prevalence is high makes it an extraordinarily important, yet difficult, issue to eradicate. The study aimed to assess current and emerging HIV/AIDS stigma and discrimination trends in South Africa as experienced by people living with HIV/AIDS (PLHIV). Methods: The PLHIV Stigma Index, a questionnaire that measures and detects changing trends in relation to stigma and discrimination experienced by PLHIV, was used as the survey tool. The study was conducted in 10 clinics in four provinces supported by the Foundation for Professional Development (FPD), with an interview total of 486 PLHIV. A cross-sectional design was implemented in the study, and both descriptive and inferential analysis was conducted on the data. Results: Findings suggest that PLHIV in this population experience significant levels of stigma and discrimination that negatively impact on their health, working and family life, as well as their access to health services. Internalised stigma was prominent, with many participants blaming themselves for their status. Conclusion: The findings can be used to develop and inform programmes and interventions to reduce stigma experienced by PLHIV. The current measures for dealing with stigma should be expanded to incorporate the issues related to health, education and discrimination experienced in the workplace, that were highlighted by the study.Psycholog

Action research-driven professional development: Developing transformational health care managers and creating learning organisations

The Foundation for Professional Development offers, inter alia, an advanced management development programme for health care managers in the public and private sector, sponsored by the USAID and co-certified by Yale University in the USA. The focus is on professional development and transformational leadership. Authentic learning opportunities are created that focus on deep learning in the work context. Portfolio assessment is used. A developmental portfolio is compiled by the health care managers enrolled in the programme. The developmental process is underpinned by the principles of action research. Managers are self-empowered to take responsibility for investigating the transformation of their management practice as a measure of self-driven quality assurance. In most cases the action research process becomes educational to both the manager and his/her colleagues participating in the project. In this way a culture of professional organisational learning is created and maintained. This paper reports a number of case studies of health care managers who conducted action research in an array of health-related contexts, covering health science fields such as HIV/AIDS, tuberculosis and capacity building programmes to create learning organisations and community engagement projects. The lessons learnt by the managers regarding the innovative ideas they experimented with in their specific contexts can be transferred to other managers and action research scholars. All these case studies provide evidence of knowledge being created in authentic contexts. These case studies are reported as scholarly endeavour to showcase the empowering and emancipating nature of action research and the contribution it makes to the existing body of knowledge in different fields in which health care managers have to operate. Keywords: Health care managers, learning organisation, action research, professional portfolios, quality assurance

Assessment of service quality of public antiretroviral treatment (ART) clinics in South Africa: a cross-sectional study

<p>Abstract</p> <p>Background</p> <p>In South Africa the ever increasing demand for antiretroviral treatment (ART) runs the risk of leading to sub-optimal care in public sector ART clinics that are overburdened and under resourced. This study assessed the quality of ART services to identify service areas that require improvement.</p> <p>Methods</p> <p>A cross-sectional study was carried out at 16 of 17 public ART clinics in the target area in greater Pretoria, South Africa. Trained participant observers presented as ART qualifying HIV positive patients that required a visit to assess <it>treatment readiness</it>. They evaluated each facility on five different occasions between June and November 2009, assessing the time it took to get an appointment, the services available and accessed, service quality and the duration of the visit. Services (reception area, clinician’s consultation, HIV counselling, pharmacy, nutrition counselling and social worker’s assessment) were assessed against performance standards that apply to all clinics. Service quality was expressed as scores for clinic performance (CPS) and service performance (SPS), defined as the percentage of performance standards met per clinic and service area.</p> <p>Results</p> <p>In most of the clinics (62.5%) participant observers were able to obtain an appointment within one week, although on the day of their visit essential services could not always be accessed. The median CPS of the assessed facilities was 68.5 with four clinics not meeting minimum standards (CPS > 60). The service areas that performed least well were the clinician’s consultation (SPS 67.3) and HIV counselling (SPS 70.7). Most notably, clinicians performed a physical examination in only 41.1% of the visits and rarely did a complete TB symptom screening. Counsellors frequently failed to address prevention of HIV transmission.</p> <p>Conclusions</p> <p>Overall public sector ART clinics in greater Pretoria were easily accessible and their services were of an acceptable quality. However, the time spent at the clinic to complete the services was found to be very long and there was considerable variation in adherence to performance standards within the services, particularly in respect of clinician’s consultation and counselling. Clinic management needs to ensure efficient clinic organisation and to improve adherence to performance standards in key service areas.</p