TThe perceptions of clinical nurse practitioners on service delivery in primary health care facilities in Eden District, Western Cape

[摘要] ENGLISH SUMMARY : Background: South Africa is facing many challenges in the process of changing the health care system to satisfy society as well as meeting international requirements. Programs were gradually expanded at Primary Health Care (PHC) level, in order to improve the quality of service delivery and patient access to care. Since the implementation of decentralized and integrated models of care, patients were redirected to clinics closer to their residence. Clinical Nurse Practitioners (CNPs) are directly involved in providing care in the expanded programs on a PHC level, since they have authorization under the Nursing Act (No. 33 of 2005) to prescribe drugs. The aim of the study is to explore the perceptions of CNPs regarding factors that influence service delivery in expanded programs in PHC facilities, specifically in the Eden District in the Western Cape.Methods: A qualitative approach with a descriptive design was utilized to explore and describe the perceptions of CNPs regarding service delivery in expanded programs. The study applied purposive sampling to select participants from four clinics in George sub-district, Western Cape. Permission was obtained from the Health Research Ethics Committee of Stellenbosch University and the Department of Health, Western Cape. Nine semi-structured interviews were conducted, transcribed and analyzed using the five stages described by Denscombe. Sub-themes emerged from six major themes.Results: The themes that emerged included: expansions in duties/roles, impact of extended duties and the challenges to comply with the changes. Factors that influenced participants' perception of the services rendered at PHC facilities include, for example, the increased workload and the shortage of staff to cope with the constant changes. Conclusion: The factors that affect service delivery in a PHC setting are interrelated and have an impact on quality of care. Recommendations were made to contribute positively to the morale of staff and the provision of quality service delivery. Opportunities for further research are recommended.

[发布机构] Stellenbosch University