- Title
- An ergonomics approach to understanding perceived barriers to the provision of high-quality healthcare: a Sarah Baartman District clinics case study
- Creator
- Card, Jason
- ThesisAdvisor
- Davy, Jonathan Patrick
- ThesisAdvisor
- Todd, Andrew I
- Subject
- Medical care -- South Africa -- Eastern Cape
- Subject
- Public health -- South Africa -- Eastern Cape
- Date
- 2020
- Type
- text
- Type
- Thesis
- Type
- Masters
- Type
- MSc
- Identifier
- http://hdl.handle.net/10962/170536
- Identifier
- vital:41933
- Description
- Background:The complex nature of healthcare systemsoftenresultsinthe emergence of context-specific barriers that limit the ability for healthcare stakeholders to ensure safe and effective care delivery. In low-to middle-income (LMIC) countries, such as South Africa (SA), limited financial, material and human resources coupled withpoor infrastructure and poor public health determinants, includingpoverty andpoor education, affectthe ability to maintain andimprove on quality care outcomes.Understanding what different stakeholders perceive as barriers, and if these barriers are understood at different levels, is therefore important when attempting to mitigate the risk for unsafe or inefficient care delivery. Human Factors and Ergonomics (HFE) adoptssystems and participatory approaches for the exploration, analysis, and design of socio-technical systems to optimize both human wellbeing and system performance.The barriers to safe and effective healthcare delivery, from an HFE perspective, are not known in the South African context, particularly in parts of the Eastern Cape Province. Elucidatingthesebarriers, even if self-reported,may guidefuture efforts aimed at mitigating risks.The purpose of this study, therefore,wasto explore and highlight the perceived systemic barriers to local and national healthcare delivery, within the Sarah Baartman District in the Eastern Cape Province of South Africa.Methods: Ashort discussion aimed at introducing HFE and components of the Work Systems Model, followed by a survey that captured participant demographics, job characteristics, the perceived national and local systemic barriers, and proposed solutions, was administered withhealthcare stakeholders from 14 primary healthcare facilities and 1 department office within the Sarah Baartman District.Participants (n=120) included management, pharmacy, administration, maintenance, community-and home-based care and nursing staff.Data from the surveys were thematically analysed and categorised according to components of the work system model (Carayon, 2009) and respective workgroup.Results: The findings revealed many overlapping,systemic barriersthat includedshortages of staff, poor management and leadership, a lack of equipmentand basic necessities, poor infrastructure, patient complexity,and high workloads. The results further indicate that the way in which the reported barriers affect worksystem interactionsand performance are unique to different workgroups. Stakeholders iiproposedthat,among others, the absorption of contract workers, the provision of training and adequate human and medical resources and the maintenance of facilities may mitigate the barriers and improve healthcare delivery.Conclusion: The findings highlight a myriad of perceived systemic barriers perceived in the Sarah Baartman district, some of which were fundamental for the effective function of any healthcare system. These barriers may have wide-spread implications for stakeholders at all levels, ultimately affecting the performance, satisfaction and safety and the quality of care. It is especially important to consider these barriers in light of the COVID-19 epidemic, which emerged throughout this study and the major threat it presents to South African healthcare systems. Future research should aim to explore how these barriers interact to contribute to processes and outcomes, as well as explore the perceptions at provincial and national levels in order to better identify areas and strategies for improvement.
- Format
- 211 pages, pdf
- Publisher
- Rhodes University, Faculty of Science, Human Kinetics and Ergonomics
- Language
- English
- Rights
- Card, Jason
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