Original Research

Enabling factors for specialist outreach in western KwaZulu-Natal

Robert I. Caldwell, Merridy Grant, Bernard Gaede, Colleen Aldous
African Journal of Primary Health Care & Family Medicine | Vol 10, No 1 | a1690 | DOI: https://doi.org/10.4102/phcfm.v10i1.1690 | © 2018 Robert I. Caldwell, Merridy Grant, Bernard Gaede, Colleen Aldous | This work is licensed under CC Attribution 4.0
Submitted: 20 November 2017 | Published: 17 May 2018

About the author(s)

Robert I. Caldwell, School of Clinical Medicine, University of KwaZulu-Natal, South Africa
Merridy Grant, School of Nursing and Public Health, University of KwaZulu-Natal, South Africa
Bernard Gaede, School of Nursing and Public Health, University of KwaZulu-Natal, South Africa
Colleen Aldous, School of Clinical Medicine, University of KwaZulu-Natal, South Africa


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Abstract

Background: There exists a major disparity in access to specialist care between patients in urban and rural areas. Specialists are a scarce resource and are concentrated in urban areas. Specialist outreach attempts to fill the gap in service provision for patients situated remotely. While there is international evidence that multifaceted specialist outreach has achieved varying levels of success, factors that influence the effectiveness of outreach have not yet been fully elucidated in South Africa.

Aim: This study attempts to uncover some of the factors that enable good multifaceted specialist outreach.

Setting: The study was conducted in hospitals in western KwaZulu-Natal province. This health area is served by a tertiary hospital and 20 peripheral hospitals; three of these are regional level and the majority are district level hospitals. Specialist outreach emanates from the tertiary hospital.

Methods: Specialists providing outreach services from the tertiary hospital and medical officers at seven receiving hospitals were interviewed to explore perceptions regarding factors that might enable successful specialist outreach. Framework analysis on the transcribed interviews was carried out using NVivo version 11.

Results: A major positive finding concerns the relationships formed between outreach specialists and doctors at the recipient hospitals. The management of the programme with respect to structure, dependability, data management, transport provision, communication technology and public health systems was also seen as beneficial in specialist outreach.

Conclusion: Specialist outreach plays an essential role in providing equality in health care. To enable effectiveness, it is important to make full use of the multifaceted nature of this intervention.


Keywords

Specialist Outreach; Multifaceted; Rural Areas; Enabling Factors for Successful Outreach; Interviews with Participating Doctors

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