Browsing by Author "Christian, Carmen S"

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    Home delivery of medication as part of reducing congestion in primary healthcare in Tshwane District Health Services
    (Medical Publishing Group, 2020) Louw, Jakobus Murray; Rantloane, B; Christian, Carmen S
    Congestion at health facilities poses the risk of extensive spread of the severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) to patients at high risk for severe illness and death due to this infection. During the lockdown to control the spread of the virus, many patients with chronic conditions are not visiting health facilities and not collecting their chronic medication. To improve adherence to medication, home delivery of medication was instituted for patients with chronic diseases who had been receiving care at the Skinner Street Clinic in Tshwane. To support patients with chronic diseases who were unable to collect their medication, by remotely consulting (telehealth) and delivering their medication during the lockdown due to the COVID-19 pandemic.
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    ‘The nurse did not even greet me’: how informed versus non-informed patients evaluate health systems responsiveness in South Africa
    (BMJ Global Health, 2021-04) Hompashe, Dumisani MacDonald; Gerdtham, Ulf-G; Christian, Carmen S
    Introduction Universal Health Coverage is not only about access to health services but also about access to high-quality care, since poor experiences may deter patients from accessing care. Evidence shows that quality of care drives health outcomes, yet little is known about non-clinical dimensions of care, and patients’ experience thereof relative to satisfaction with visits. This paper investigates the role of non-clinical dimensions of care in patient satisfaction. Methods Our study describes the interactions of informed and non-informed patients with primary healthcare workers at 39 public healthcare facilities in two metropolitan centres in two South African provinces. Our analysis included 1357 interactions using standardised patients (for informed patients) and patients’ exit interviews (for non-informed patients). The data were combined for three types of visits: contraception, hypertension and tuberculosis. We describe how satisfaction with care was related to patients’ experiences of non-clinical dimensions. Results We show that when real patients (RPs) reported being satisfied (vs dissatisfied) with a visit, it was associated with a 30% increase in the probability that a patient is greeted at the facilities. Likewise, when the RPs reported being satisfied (vs dissatisfied) with the visit, it was correlated with a 15% increase in the prospect that patients are pleased with healthcare workers’ explanations of health conditions. Conclusion Informed patients are better equipped to assess health-systems responsiveness in healthcare provision. Insights into responsiveness could guide broader efforts aimed at targeted education and empowerment of primary healthcare users to strengthen health systems and shape expectations for appropriate care and conduct.