ABSTRACT
Background: Several studies have been carried out on procedural skills of doctors in district hospitals in rural South Africa. However, there is insufficient information about skills of doctors in peri-urban district hospitals. This paper attempts to supplement this vital information. Aim: The aim of the study was to determine self-reported levels of competence in procedural skills of doctors in peri-urban district hospitals and to assess factors influencing this. Setting: The study was undertaken in three district hospitals in two health districts of Gauteng Province. Methods: A cross-sectional descriptive study using a self-administered questionnaire was undertaken in three district hospitals in two health districts of Gauteng Province. The questionnaire assessed procedural skills based on district health service delivery requirements for doctors in district hospitals using a modified skill set developed for family medicine training in South Africa. Results: There was a wide range of self-reported competence and experience among doctors for various skill sets. Doctors were generally more competent for procedures in general surgery, medicine, orthopaedics, obstetrics and gynaecology and paediatrics than anaesthesia, ear, nose and throat and ophthalmology. There were statistically significant associations between age and overall anaesthetic competence (p= 0.03); gender and overall competence in surgery (p= 0.03), orthopaedics (p= 0.02) and urology (p= 0.005); years of experience and overall competence in dermatology skills; current hospital and overall competence in anaesthesia (p= 0.01), obstetrics and gynaecology (p= 0.015) and dermatology skills (p= 0.01). Conclusion: This was one of the first studies to look at self-reported procedural competence of doctors in a peri-urban setting in South Africa. The results highlight the need for regular skills audits, standardised training and updating of skills of doctors in district hospitals
Subject(s)
Hospitals, District , Physicians , Self Report , South AfricaABSTRACT
Background. Handwashing is a recognised cost-effective intervention for the prevention of common childhoodinfections, including pneumonia and diarrhoeal disease. Globally, handwashing practices may be poor and little is known about handwashing practices in South Africa.Objectives. To describe and compare handwashing practises of caregivers whose infants are admitted with acute gastroenteritis and acute lower respiratory tract infection with those of healthy infants who are attending primary healthcare clinics for routine immunisation.Methods. A cross-sectional study of self-reported handwashing practices was conducted among caregivers of infants from the Vulindlela area,Pietermaritzburg. Respondents were interviewed regarding household structure, services and handwashing practices.Results. During the 3-month study period, 137 respondents were interviewed. Of these, 41 (30%) had infants with pneumonia, 41 (30%) with diarrhoea and 55 (40%) had healthy infants. A high rate of handwashing with soap and water (81.8%) was found in this study, with 58.4% of the respondents using running rather than stagnant water. Logistic regression identified some variables associated with higher odds of having a healthy infant, namely: a monthlyhousehold income >ZAR2 000 (odds ratio (OR) 4.74; 95% confidence interval (CI)1.99 - 11.25); washing hands with soap and running water (OR 3.88; 95% CI 1.55 - 9.76); washing hands before eating (OR 7.41; 95% CI 0.79 - 68.76), and washing hands after household chores (OR 9.24; 95% CI 1.85 - 46.25).Conclusion. A higher than anticipated number of participants washed their hands with soap and running water and at critical moments