Exploring the role of district clinical specialist teams in maternal health outcomes in a South African district: A mixed method study from 2012 to 2020
Background. High maternal and child mortality in South Africa (SA) necessitated the establishment of district clinical specialist teams (DCSTs) in all health districts in 2012, mandated to work in collaboration with district managers and health professionals to achieve joint goals of improved m...
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South African Medical Association
2024-11-01
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| Series: | South African Medical Journal |
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| Online Access: | https://samajournals.co.za/index.php/samj/article/view/2205 |
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| author | J Basu A Stewart D Basu J Wing U Feucht |
| author_facet | J Basu A Stewart D Basu J Wing U Feucht |
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Background. High maternal and child mortality in South Africa (SA) necessitated the establishment of district clinical specialist teams (DCSTs) in all health districts in 2012, mandated to work in collaboration with district managers and health professionals to achieve joint goals of improved maternal and child health services and outcomes.
Objectives. Within the context of SA district health services, to explore the various obstetric intervention measures undertaken by a DCST over an 8-year period (July 2012 - February 2020), as aligned to the national DCST policy framework, and to document the knowledge and perceptions among managers and health professionals on the work done by the DCST in the district health service.
Methods. A review of DCST reports and documents was conducted along with in-person structured interviews among health professionals and district health managers in the Ekurhuleni Health District in SA. Health professionals who had a working relationship with the DCST and relevant managers of health, including CEOs, clinical managers, community health centre managers, maternal and child health co-ordinators and municipal managers were selected for the interview. Interviews were conducted by the interviewer using a data collection tool focused on the scope of work and acceptance of the DCST in improving maternal health services in a geographically defined district health system. Data collection tools were completed by the interviewer upon questioning the participants. Data were analysed by documenting the activities of the DCST, and thematic analysis was performed for the interviews.
Results. Analysis of DCST reports and documents revealed the broad range of activities, including clinical training and mentoring, clinical work, supervision, audit, research, monitoring and evaluation and clinical risk management. Thematic analysis extracted seven themes, namely clinical effectiveness, clinical risk management, professional development, accountability for maternal and child health, clinical work, monitoring and evaluation, and leadership and governance. All (n=20) participants acknowledged the positive impact of the DCST on the improvement in maternal health services.
Conclusion. The DCST was perceived by local peers as a successful strategy to improve maternal health services in a district health service. This success is likely rooted in its focused intervention measures, within a supportive environment of district managers and health professionals. Such district-based clinical teams are a potential strategy to improve maternal health services within primary healthcare services.
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| format | Article |
| id | doaj-art-7c3a849692214db59b334d94c252f88f |
| institution | Kabale University |
| issn | 0256-9574 2078-5135 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | South African Medical Association |
| record_format | Article |
| series | South African Medical Journal |
| spelling | doaj-art-7c3a849692214db59b334d94c252f88f2025-02-10T12:25:29ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352024-11-011141210.7196/SAMJ.2024.v114i11.2205Exploring the role of district clinical specialist teams in maternal health outcomes in a South African district: A mixed method study from 2012 to 2020J Basu0https://orcid.org/0000-0002-1523-2555A Stewart1D Basu2J Wing3U Feucht4Obstetrics and Gynaecology, Ekurhuleni district clinical specialist team, Ekurhuleni Health District, Germiston, South Africa, and Department of Obstetrics and Gynaecology, University of the Witwatersrand, Johannesburg, South Africa; Maternal and Infant Health Care Strategies Research Unit, South African Medical Research Council, University of Pretoria, South Africa; Ekurhuleni Clinical Research Centre, University of Adelaide, Australia, and University of Pretoria, South Africa; Physiotherapy Department, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaPhysiotherapy Department, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaEkurhuleni Clinical Research Centre, University of Adelaide, Australia, and University of Pretoria, South Africa; Department of Public Health Medicine, Steve Biko Academic Hospital, University of Pretoria, South Africa; Community Orientated Primary Care Research Unit, University of Pretoria, South Africa; WHO Collaborating Centre, University of Pretoria, South AfricaDepartment of Internal Medicine, Charlotte Maxeke Johannesburg Academic Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South AfricaMaternal and Infant Health Care Strategies Research Unit, South African Medical Research Council, University of Pretoria, South Africa; Ekurhuleni Clinical Research Centre, University of Adelaide, Australia, and University of Pretoria, South Africa; Department of Paediatrics and Child Health, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa; Research Centre for Maternal, Fetal, Newborn and Child Health Care Strategies, University of Pretoria, South Africa Background. High maternal and child mortality in South Africa (SA) necessitated the establishment of district clinical specialist teams (DCSTs) in all health districts in 2012, mandated to work in collaboration with district managers and health professionals to achieve joint goals of improved maternal and child health services and outcomes. Objectives. Within the context of SA district health services, to explore the various obstetric intervention measures undertaken by a DCST over an 8-year period (July 2012 - February 2020), as aligned to the national DCST policy framework, and to document the knowledge and perceptions among managers and health professionals on the work done by the DCST in the district health service. Methods. A review of DCST reports and documents was conducted along with in-person structured interviews among health professionals and district health managers in the Ekurhuleni Health District in SA. Health professionals who had a working relationship with the DCST and relevant managers of health, including CEOs, clinical managers, community health centre managers, maternal and child health co-ordinators and municipal managers were selected for the interview. Interviews were conducted by the interviewer using a data collection tool focused on the scope of work and acceptance of the DCST in improving maternal health services in a geographically defined district health system. Data collection tools were completed by the interviewer upon questioning the participants. Data were analysed by documenting the activities of the DCST, and thematic analysis was performed for the interviews. Results. Analysis of DCST reports and documents revealed the broad range of activities, including clinical training and mentoring, clinical work, supervision, audit, research, monitoring and evaluation and clinical risk management. Thematic analysis extracted seven themes, namely clinical effectiveness, clinical risk management, professional development, accountability for maternal and child health, clinical work, monitoring and evaluation, and leadership and governance. All (n=20) participants acknowledged the positive impact of the DCST on the improvement in maternal health services. Conclusion. The DCST was perceived by local peers as a successful strategy to improve maternal health services in a district health service. This success is likely rooted in its focused intervention measures, within a supportive environment of district managers and health professionals. Such district-based clinical teams are a potential strategy to improve maternal health services within primary healthcare services. https://samajournals.co.za/index.php/samj/article/view/2205DCST; Maternal health; district health services; outcomes |
| spellingShingle | J Basu A Stewart D Basu J Wing U Feucht Exploring the role of district clinical specialist teams in maternal health outcomes in a South African district: A mixed method study from 2012 to 2020 South African Medical Journal DCST; Maternal health; district health services; outcomes |
| title | Exploring the role of district clinical specialist teams in maternal health outcomes in a South African district: A mixed method study from 2012 to 2020 |
| title_full | Exploring the role of district clinical specialist teams in maternal health outcomes in a South African district: A mixed method study from 2012 to 2020 |
| title_fullStr | Exploring the role of district clinical specialist teams in maternal health outcomes in a South African district: A mixed method study from 2012 to 2020 |
| title_full_unstemmed | Exploring the role of district clinical specialist teams in maternal health outcomes in a South African district: A mixed method study from 2012 to 2020 |
| title_short | Exploring the role of district clinical specialist teams in maternal health outcomes in a South African district: A mixed method study from 2012 to 2020 |
| title_sort | exploring the role of district clinical specialist teams in maternal health outcomes in a south african district a mixed method study from 2012 to 2020 |
| topic | DCST; Maternal health; district health services; outcomes |
| url | https://samajournals.co.za/index.php/samj/article/view/2205 |
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