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Lalla-Edward ST, Mosam A, Hove J, Erzse A, Rwafa-Ponela T, Price J, Nyatela A, Nqakala S, Kahn K, Tollman S, Hofman K, Goldstein S. Essential health services delivery in South Africa during COVID-19: Community and healthcare worker perspectives. Front Public Health 2022; 10:992481. [PMID: 36568767 PMCID: PMC9773136 DOI: 10.3389/fpubh.2022.992481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 11/21/2022] [Indexed: 12/13/2022] Open
Abstract
Background Between May 2020 and February 2022, South Africa's health system bore strain as it battled mitigating the coronavirus pandemic. The country's pandemic response was scrutinized. This period also brought into focus pre-existing shortcomings in the healthcare system and its governing bodies. Contextually, there is a paucity in literature on the experiences of healthcare providers and users. This study aimed to contribute information on COVID-19, with the intention of providing guidance on preparing for future infectious disease outbreaks. Methods Cross sectional exploratory qualitative methodology was employed using semi-structured interviews and focus group discussions with community members (CM) and healthcare workers (HCW) from two South African study sites: (a) rural Bushbuckridge (run by Agincourt Health and Socio-Demographic Surveillance Site) and (b), Regions D and F in Johannesburg Metropole. Results After interviewing 42 CMs and 43 HCWs, it emerged that mandated process changes while minimizing COVID-19 exposure, necessitated healthcare personnel focusing on critical care treatment at the expense of less acute ones. COVID-19 isolation protocols, extensive absenteeism and HCWs with advanced skills being perceived as more adept to treat COVID-19 patients contributed to HCWs experiencing higher workloads. Fears regarding contracting and transmitting COVID-19, suffering financial losses, and not being able to provide adequate advice to patients were recurrent themes. Dissemination of relevant information among healthcare facility personnel and communities suffered due to breakdowns in communication. Conclusion Concessions and novel strategies to avail medication to patients had to be created. Since providence was lacking, government needs to formulate health intervention strategies that embrace health literacy, alternate methods of chronic medication dispensation, improved communication across health care platforms and the use of telehealth, to circumvent the threats of possible further infectious disease outbreaks.
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Affiliation(s)
- Samanta T. Lalla-Edward
- Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Atiya Mosam
- South African Medical Research Council (SAMRC)/Wits Centre for Health Economics and Decision Science – PRICELESS South Africa (SA), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jennifer Hove
- Medical Research Council (MRC)/Wits Rural Public and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Agnes Erzse
- South African Medical Research Council (SAMRC)/Wits Centre for Health Economics and Decision Science – PRICELESS South Africa (SA), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Teurai Rwafa-Ponela
- South African Medical Research Council (SAMRC)/Wits Centre for Health Economics and Decision Science – PRICELESS South Africa (SA), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jessica Price
- Medical Research Council (MRC)/Wits Rural Public and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Athini Nyatela
- Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Sizwe Nqakala
- Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Kathleen Kahn
- Medical Research Council (MRC)/Wits Rural Public and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Stephen Tollman
- Medical Research Council (MRC)/Wits Rural Public and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Karen Hofman
- South African Medical Research Council (SAMRC)/Wits Centre for Health Economics and Decision Science – PRICELESS South Africa (SA), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Susan Goldstein
- South African Medical Research Council (SAMRC)/Wits Centre for Health Economics and Decision Science – PRICELESS South Africa (SA), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Boissier R, Savoie PH, Long JA. [Epidemiology of urological emergencies in France]. Prog Urol 2021; 31:945-955. [PMID: 34420876 DOI: 10.1016/j.purol.2021.07.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 07/21/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION To report the epidemiology and the care pathway for urological emergencies in France for the official report of the 115th Congres Francais d'Urologie. METHODS We made a request to the Institut de Veille Sanitaire and its network Surveillance Sanitaire des Urgences et des Décès (SurSaUD®). Within this system, the OSCOUR® network (Organisation de la surveillance coordonnée des urgences) centralizes in real time the data of emergency visits from more than 720 emergency departments throughout the national territory (>93% of the national territory covered by the OSCOUR® network). For each emergency defined by its CIM-10 code, the following data were collected from 2014 to 2019: age, gender, length of stay and post-emergency status (hospitalization vs. return home). RESULTS From 2014 to 2019, urological emergencies represented on average 4.2% of all emergencies, with an average 591,080±66,782 passages/year including 25% that resulted in hospitalization. Infectious disease represented 35% of all urological emergencies. The 3 most common urologic emergencies were: renal colic, acute urine retention and hematuria for men; acute cystitis, pyelonephritis and renal colic for women. CONCLUSION In an analysis of the OSCOUR® (Organisation de la surveillance coordonnée des urgences) registry, we determined the epidemiological profiles of the main urological emergencies with contemporary data.
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Affiliation(s)
- R Boissier
- Université Aix-Marseille, Service d'Urologie et de transplantation Rénale, CHU La Conception, AP-HM, Marseille, France.
| | - P H Savoie
- Service d'urologie, Hôpital d'Instruction des Armées Sainte Anne, BP 600, 83800 Toulon cedex 09, France
| | - J-A Long
- Service d'urologie et de la transplantation rénale, CHU Grenoble, France; TIMC-IMAG CNRS 5525, France
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