Original Research

Perceptions of private specialist outreach services at a rural district hospital, South Africa

Hayden L. Poulter, Louis S. Jenkins, Paul A. Kapp
South African Family Practice | Vol 65, No 1 : Part 1| a5641 | DOI: https://doi.org/10.4102/safp.v65i1.5641 | © 2023 Hayden L. Poulter, Louis S. Jenkins, Paul A. Kapp | This work is licensed under CC Attribution 4.0
Submitted: 26 September 2022 | Published: 23 January 2023

About the author(s)

Hayden L. Poulter, Department of Family and Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; and, Department of Family and Emergency Medicine, Knysna Provincial Hospital, Western Cape Department of Health, Knysna, South Africa
Louis S. Jenkins, Department of Family and Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; and, Primary Health Care Directorate, Department of Family, Emergency and Community Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa; and, Department of Family and Emergency Medicine, George Hospital, Western Cape Department of Health, George, South Africa
Paul A. Kapp, Department of Family and Emergency Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; and, Department of Family and Emergency Medicine, Knysna Provincial Hospital, Western Cape Department of Health, Knysna, South Africa

Abstract

Background: A major disparity exists in access to specialised healthcare between rural and urban areas. Specialist outreach programmes are one of the ways in which rural specialist healthcare inequality is being addressed. A number of rural district hospitals (RDH) employ local, private specialists (LPS) to supplement public specialist outreach. Limited research exists on private specialist outreach and support (PSOS) in sub-Saharan Africa or South Africa.

Methods: This was a descriptive, exploratory, qualitative study using thematic analysis of semi-structured interviews. Non-probability, purposive sampling was used to obtain a sample size of 16 participants. The audio recordings were transcribed verbatim and analysed with the framework method and ATLAS.ti version 8© software.

Results: Four major themes emerged, namely roles of LPS, effects, sustainability and feasibility of PSOS. Overall PSOS was considered sustainable, feasible and had positive effects in and beyond the sub-districts. The value of PSOS was supported by improved access and timeliness of services, improved competency of RDH medical practitioners, improved coordination, comprehensiveness and continuity of care. Private specialist outreach and support was, however, associated with increased burden on the RDH resources and required a basic level of RDH infrastructure to function effectively.

Conclusion: The perceived contribution of private specialist outreach services was positive overall. Implementation in RDHs is feasible, but should involve consideration of factors in the hospital, town, sub-district and district prior to implementation.

Contribution: This paper provides evidence that private specialist outreach and support services are feasible in the state health sector, provided that certain considerations are taken into account.


Keywords

ivate specialists; outreach; rural; district hospital; perceptions

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