4 research outputs found
The Interactions of Public Health Organisational Leadership with its Environment: A Case Study of the Sally Mugabe Central Hospital in Harare, Zimbabwe
No full textIntroduction and Background: This paper presents a case study from Sally Mugabe Central Hospital; that examines the interactions of public health organisational leadership with its environment, within the context of Zimbabwe's unique social, economic and political circumstances.
Objective: To investigate how the local context and local environment of Zimbabwe's unique social, economic and political situation have interacted with the leadership of Sally Mugabe Central Hospital as a Zimbabwean public health institution.
Methods: A combination of semi-structured interviews and document analysis were used to conduct the research. Purposive sampling and expert sampling were used to select respondents for interviews. Content analysis of relevant administrative and management documents kept at the participating institution was carried out. This research is located within the theoretical framework of Health Policy and Systems Research (HPSR); and examines the institutional level or meso-level of the healthcare system.
Results and Discussion: Research findings are discussed under subheadings that correspond to the interactions of social, economic and political factors with public health institutional leadership.
Recommendations: Based on the research findings of this case study, recommendations are made on relevant and effective changes to practice, for the leadership of Zimbabwean public health institutions, recommendations that may have some applicability elsewhere as well, on the basis of lessons learnt.
Conclusion: The problem of chronic underfunding; as well as the social, economic and political challenges that have been experienced at the institutional level in the Zimbabwean public health system; require innovative and adaptive public health leadership that can confront adversity in a complex environment
Reflections on support design in geotechnically challenging group conditions: a case of Zimbabwean great Dyk platinum mining
No full textA dissertation submitted to the Faculty of Engineering and the Built Environment, University of the Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Master of Science in Engineering, Johannesburg, 2018Falls of ground pose costly hazards to personnel and equipment and thus measures should be taken to prevent them. The stability of excavations is ensured by good support design and sound mining practices. This research endeavours to analyse and improve the support systems used in geotechnically challenging ground conditions for Great Dyke platinum mines by analysing the current support systems and recommending effective support system thereof. Various techniques were used to determine the quality of ground conditions, predict the rock mass behaviour and to identify the appropriate support system. An analysis of the current ground control methods and their limitations was also undertaken. The reflections showed that the current support system and mining practices in geotechnically poor grounds need to be modified to improve safety and productivity. Stoping overbreak is influenced by poor ground conditions and the explosives currently used. The use of emulsion is recommended to replace ANFO. Redesigning of pillars through a reviewed design rock mass strength is also recommended taking into cognisance the current rock mass data. Pillar staggering was also seen as the best practice in geotechnically poor ground conditions in a bid to limit exposure. An evaluation of the current tendon system indicated an opportunity for improvement following comprehensive empirical and analytical design techniques. A new support system was recommended, taking into consideration cost-benefit analysis to clamp overlying layers as well as the catastrophic wedges. Barring down using pinch bars in poor ground was seen as a risky and time-consuming exercise, hence the use of mechanical scalers is recommended to achieve zero harm and to meet production targets. Smoothwall blasting is recommended in poor ground to minimize hangingwall damage. The results gathered and analysed showed that, technically, emulsion explosives are beneficial but the increase of operational cost down-weighs them. However, in solution to the problem which prompted this research, the author suggests the mines to take up emulsion as it promotes safety at higher productivity in terms of tonnage output. Other recommendations include the use of hydrological surveys to determine groundwater levels and implement corrective measures. Both empirical and numerical modelling approaches need to be utilized in determining the optimum support. Additional support is also recommended where there is pillar robbing and pillar scaling to increase the pillar strength. Poor support design and poor mining practices pose danger to employees, resulting in loss of profitable reserves and entrapment of expensive mining machinery thereby culminating in additional capital costs and reduced life of mine.XL201
Opioid use and HIV treatment services experiences among male criminal justice‑involved persons in South Africa : a qualitative study
No full textAVAILABILITY OF DATA AND MATERIALS : The datasets used and/or analyzed in the current study are available from the
corresponding author on reasonable request. The qualitative datasets are not
publicly available in order to protect the participants’ privacy and confidentiality,
particularly given the small sample size and the study’s geographic
specificity. Study participants with stigmatized traits disclosed rich, detailed,
and sensitive information that may unintentionally reveal their identities.BACKGROUND : Opioid use disorder (OUD) is overrepresented among people with criminal justice involvement; HIV
is a common comorbidity in this population. This study aimed to examine how formerly incarcerated men living
with HIV and OUD in South Africa experienced HIV and OUD services in correctional facilities and the community.
METHODS : Three focus group discussions were conducted with 16 formerly incarcerated men living with HIV and OUD
in Gauteng, South Africa. Discussions explored available healthcare services in correctional facilities and the community
and procedural and practice differences in health care between the two types of settings. Data were analyzed
thematically, using a comparative lens to explore the relationships between themes.
RESULTS : Participants described an absence of medical services for OUD in correctional facilities and the harms caused
by opioid withdrawal without medical support during incarceration. They reported that there were limited OUD services
in the community and that what was available was not connected with public HIV clinics. Participants perceived
correctional and community HIV care systems as readily accessible but suggested that a formal system did not exist
to ensure care continuity post-release.
CONCLUSIONS : OUD was perceived to be medically unaddressed in correctional facilities and marginally attended
to in the community. In contrast, HIV treatment was widely available within the two settings. The current model
of OUD care in South Africa leaves many of the needs of re-entrants unmet. Integrating harm reduction into all
primary care medical services may address some of these needs. Successful HIV care models provide examples
of approaches that can be applied to developing and expanding OUD services in South Africa.The US National Institutes of Health Fogarty International Center.http://www.harmreductionjournal.com/am2024Family MedicineSDG-03:Good heatlh and well-bein
Implementation and evaluation of the Y-Check comprehensive adolescent health check-up intervention in Zimbabwe: a pre-post mixed-methods study.
No full textRoutine adolescent health check-ups can support healthy development and well-being, but evidence on the feasibility, acceptability and effectiveness of contextually relevant comprehensive check-ups in low- and middle-income settings is limited. We conducted a hybrid implementation-effectiveness study incorporating a mixed-methods pre-post design of Y-Check, a comprehensive health check-up intervention in Zimbabwe, as part of a multicountry study developed and coordinated by the World Health Organization. Eligible participants were 10-19-year-old adolescents attending school or community venues. We used self-administered digital questionnaires, provider-led clinical tests and nurse reviews to screen for 25 conditions/behaviors. We provided health promotion, on-site care and referral to relevant providers. From October 2022 to September 2023, 2,097 adolescents were enrolled, of whom 1,843 (87.9%) were seen at 6 months. The primary outcome of appropriate care and/or referral(s) for all identified issues was achieved for 70.8% (95% confidence interval: 68.7-72.9%) of 1,865 participants with at least one issue. At follow-up, there were improvements in nutrition, health-related quality of life, self-esteem, behaviors and educational outcomes. The intervention was feasible and largely acceptable. Uptake of referral services varied by issue. Y-Check cost US$47 per participant. Through Y-Check, we identified untreated conditions and risk behaviors and successfully treated and linked adolescents to services. Here we provide evidence on the potential of the intervention to positively impact health and well-being
