Promoting Awareness of the Role of the District Clinical Specialist Team in the Amathole District, South Africa: A Valuable Specialty in Improving Healthcare Access and Quality
Abstract
:1. Introduction
2. Methods
Ethical Consideration
3. Findings
3.1. Capacity Building
“The DCST assist in conducting workshops and in-service training on PMTCT related topics. In my clinic, we were trained on proper management of mother and childcare. They support us to implement PMTCT protocol and make sure that we are practising and adhering to the guidelines.”(Professional Nurse)
“I see the role of the DCST in mentoring and coaching us to make sure we implement PMTCT guidelines.”(District Health Team Member)
“In my clinic, we call the DCST anytime when we need support, and they assist us to manage cases that are complicated. They are ready to help us, and they support us”(Professional Nurse)
“My clinic has challenges …. some of them (the staff) are new on the job because many staff leave for better jobs. The DCST assisted by training the staff when we called them.”(Professional Nurse)
“I think the DCST supported us to conduct clinical audits and to identify areas of weakness in our clinic. They know the nurses that need help, and they support them to perform their work better.”(District Health Team Member)
3.2. Programme Performance Oversight and Monitoring
“They assist us a lot. They help us to see where we are not doing well in terms of our indicators. They also monitor the use of guidelines and see that we manage our patients properly. When we encounter any challenge with our patients, we reach out to them by calling them on phone, and they provide more information and education on how to handle them”(Professional Nurse)
“In my sub-district, the DCST check and cross-check our data when they do their support visits. When there is a reoccurring problem, they assist us and help the staff to understand the issues for not performing well. I know that the DCST organise meetings to analyse data. They also help to review strategies to track patients that are lost to follow-up. For example, tracing of mothers and children who are HIV positive but missed their clinic appointments so that they can be managed according to the DoH protocol”(Quality Improvement Advisor)
“Another thing they assist us with is supporting us to manage cases that are complicated. They advise us whenever we call on them to help us and they support us to plan properly”(Operational Manager)
“We have seen improvement in early booking, monitoring and recording of viral load in pregnant women that are HIV positive in the clinics. This is as a result of the support we received to use the guidelines and make sure that the mothers were tested early, tested more than once during the antenatal period and ensuring that we start them on ARVs as soon we can. Also, we do not have any record of new infections in newborns because of the support we have received from the DCST. The teams come to our clinic to support us to do our work better …. by assisting us with any challenge we encounter. They also advise us on how we can do our work better.”(Professional Nurse)
3.3. Technical Support for Programme Implementation
“We (the facility team, DCST and Quality Improvement Advisor) develop a quality improvement plan together. They (DCST) join our monthly data clarification and data cleaning meeting to follow up with the change ideas we have from the S2S quarterly learning sessions, where we also learn about the best practice from other clinics”.(Quality Improvement Advisor)
“Here in my facility, the DCST helps us every time we call.… they help in tracing children who became HIV positive. Even if the child was not delivered here or the child was delivered in a nearby facility, the DCST assist in tracing the child and therefore we are able to initiate the children on ARVs [Antiretroviral therapy] as soon as possible. In my opinion, the DCST assist us to track those that are lost to follow up which is important in our work.”(Professional Nurse)
“I see that the DCST assist us to analyse different clinic PMTCT data. The DCST provide support and guidance to the managers on different challenges that they experience. They also help us to see where we are not doing well in terms of our indicators.”(District Health Team Member)
“The DCST guide us to comparing the previous month’s data with the current one to see if we are doing well or not. For example, we will be able to know how many newly positive pregnant women we have in the clinic so that we can compare with those that are already on ARVs and those that are pregnant. When the pregnant mother delivers, we will know the babies that are exposed to HIV and how many new babies or children are infected with HIV”.
“We work well with them (DCST), although we do not have all the positions filled in the district. They (DCST) are part of our data meeting and data review meeting every Tuesday and at the end of the month, where we identify gaps in our performance and work together to improve them.”(Operational Manager)
4. Discussion
4.1. Supporting Clinical Governance
4.2. Interrelationship of the DCST with the District Health Management Team (DHMT)
4.3. Use of Data to Monitor Programme Improvement
4.4. Study Limitations
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Acknowledgments
Conflicts of Interest
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Oyebanji, O.G.; Mathole, T.; Jackson, D. Promoting Awareness of the Role of the District Clinical Specialist Team in the Amathole District, South Africa: A Valuable Specialty in Improving Healthcare Access and Quality. Trop. Med. Infect. Dis. 2022, 7, 436. https://doi.org/10.3390/tropicalmed7120436
Oyebanji OG, Mathole T, Jackson D. Promoting Awareness of the Role of the District Clinical Specialist Team in the Amathole District, South Africa: A Valuable Specialty in Improving Healthcare Access and Quality. Tropical Medicine and Infectious Disease. 2022; 7(12):436. https://doi.org/10.3390/tropicalmed7120436
Chicago/Turabian StyleOyebanji, Oyebola G., Thubelihle Mathole, and Debra Jackson. 2022. "Promoting Awareness of the Role of the District Clinical Specialist Team in the Amathole District, South Africa: A Valuable Specialty in Improving Healthcare Access and Quality" Tropical Medicine and Infectious Disease 7, no. 12: 436. https://doi.org/10.3390/tropicalmed7120436