Day 3 :
Insearch Management Consulting, South Africa
James Arens currently works as an independent consultant in the healthcare industry in South Africa. He has vast experience in both the public and private healthcare systems both as clinician and executive manager. Whilst working as a lecturer at the University of Cape Town, Pharmacology department, he published 6 academic papers in local and international reputable journals - including the Cochrane Review. The last twelve years has been spent in the private healthcare sector at senior and executive management levels as well as consulting. His focus is on conceptualizing sustainable strategies and operations in the healthcare sector.
Statement of the Problem: The increase in the burden of disease and associated costs are unbaiting globally. The current healthcare systems and financing models of most countries are unable to deal with this crisis. The increasing healthcare problems require a new breed of leaders from all sectors and stakeholders in healthcare. The purpose of this presentation is to illustrate how the community nursing fraternity should take up the challenge of providing leadership in an ever changing and transitioning healthcare system.
Methodology & Theoretical Orientation: The study highlights trends in the global healthcare delivery systems that are moving towards a community health approach. The disease burden and escalating costs are illustrated – using South African data as examples. The current South African National Health Insurance Bill is summarized into a framework to identify areas requiring Community Nursing skills and leadership. The shortcomings in healthcare delivery systems are discussed with a view to community nursing leadership qualities and skills required to meet the current challenges. Examples from UK NHS experience are shared illustrating how significant legislative changes were made over time to enhance the role of nursing in general to meet the prevailing challenges of healthcare.
Conclusion: The healthcare delivery challenges experienced globally require that nurses; particularly the community nursing fraternity steps up to the challenges and provide leadership by influencing events and policy to ensure that healthcare is improved or reformed to meet the healthcare needs of most of their country populations; particularly the most poor and vulnerable.
Nelson Mandela Metropolitan University, South Africa
Margaret Williams, as an associate professor in the Department of Nursing Science, works to ensure an optimal learning experience for post graduate students attending the Advanced Primary Healthcare course which she coordinates and teaches. She also supervises Honours, Masters and PHD candidates in their research journey which culminates in them attaining a higher qualification. Prof Williams has extensive experience in teaching and learning, research and academic administration. Her primary research area resides in an overall goal to optimise health for all in line with the WHO premise. She focuses on children’s health and in this regard partners with UNICEF SA in various projects focusing on malnutrition in its innumerable forms. Another focal area is HIV and Tuberculosis with which she has numerous research partners, and has published several articles.
Despite the fact that breastfeeding is an accepted cultural norm in South Africa, the latest South African Demographic and Health Survey (SADHS) shows that only 32% of infants are exclusively breastfed. Breastfeeding initiation rates of breastfeeding in South Africa remain high at around 88% but the exclusive breastfeeding rate is only 44% from 0-1 month and drops to 23.7% in infants aged 4-5 months. A breastfeeding awareness campaign was launched at the world breastfeeding conference in Johannesburg in December 2016. The aim of the campaign was to engage with communities and families in an effort to raise awareness about the importance of breastfeeding and to influence attitudes and behaviors in supporting mothers to breastfeed. The aim was to explore and describe how primary and secondary caregivers including Early Childhood Development (ECD) practitioners, parents, grandparents and their families/community and healthcare workers, respond to the breastfeeding awareness campaign in order to determine the relevance and appropriateness of the campaign for the target audience. The review was conducted using a qualitative approach by a team from the Nelson Mandela University and Department of Health. An expert panel from UNICEF SA together with researchers experienced in qualitative research methods developed the methodology. The research population comprised of adult caregivers, including mothers, grandmothers, fathers, plus ECD practitioners and healthcare workers. Purposive sampling was used to include adult participants who were willing to engage with the campaign tools. Focus groups were conducted using a semi-structured interview instrument. Responses from various participants were grouped together in the different themes that emerged, using the Tesch method of data analysis. An independent coder was used to verify the identified themes. The findings confirmed that despite awareness about the benefits of breastfeeding, the practical challenges and lack of support result in poor compliance in terms of breastfeeding messages. Strong cultural beliefs were identified that played a role in poor support together with a lack of trust in breast-milk quality and in the ability of especially young mothers to abstain from drinking alcohol or adhere to PMTCT in terms of drug adherence. Participants suggested several improvements for the campaign, with pertinent questions reflecting the perceived need to improve healthcare workers roles in championing breastfeeding at primary healthcare level. The results further highlighted requests for more information about breast-milk content and disease prevention, support for breastfeeding with a focus on examples of practical support.