Monitoring the implementation of community service
Monitoring the implementation of community service
Monitoring the implementation of community service
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❖ Personal development for <strong>community</strong> <strong>service</strong> doctors. Some gains may be:<br />
Growth in terms <strong>of</strong> knowledge, skills, pr<strong>of</strong>essional values and confidence. Critical thinking in<br />
terms <strong>of</strong> decision making, dealing with emergencies, and using available resources. Sensitivity to<br />
<strong>the</strong> needs <strong>of</strong> this country as a result <strong>of</strong> this experience and exposure.<br />
❖ Health indicators<br />
Take into consideration <strong>the</strong> impact <strong>of</strong> HIV/AIDS.<br />
Long term goal is to improve <strong>the</strong> health status <strong>of</strong> all South Africans.<br />
Compare this year’s health indicators with 5 years later.<br />
❖ Emigration rates<br />
Improvement on <strong>the</strong> emigration rates: more doctors deciding to remain in SA.<br />
Methodology<br />
A formal study monitoring compulsory <strong>community</strong> <strong>service</strong> for doctors in its first year <strong>of</strong> <strong>implementation</strong><br />
is currently under way. The results <strong>of</strong> <strong>the</strong> first part, which is qualitative, are presented here. Two basic issues<br />
were investigated: <strong>the</strong> experiences <strong>of</strong> <strong>the</strong> doctors <strong>the</strong>mselves, and <strong>the</strong> effect <strong>of</strong> <strong>the</strong> scheme on <strong>the</strong> hospitals<br />
and <strong>the</strong> health <strong>service</strong> as a whole.<br />
Interviews with key informants and focus group discussions were held with managers and <strong>community</strong><br />
<strong>service</strong> doctors in 3 provinces: KwaZulu-Natal, <strong>the</strong> Eastern Cape and <strong>the</strong> Nor<strong>the</strong>rn Province. These provinces<br />
were chosen as <strong>the</strong>y contain <strong>the</strong> largest proportions <strong>of</strong> <strong>the</strong>ir populations in rural areas, which was <strong>the</strong> initial<br />
focus <strong>of</strong> <strong>the</strong> scheme. District, regional and central hospitals were chosen in each province for this study.<br />
Hospital managers and senior nurses were interviewed in addition to <strong>the</strong> <strong>community</strong> <strong>service</strong> doctors<br />
<strong>the</strong>mselves and <strong>the</strong>ir colleagues, in order to gain as comprehensive a picture <strong>of</strong> <strong>the</strong> situation in each<br />
hospital as possible.<br />
Table 1: Hospitals visited<br />
Name <strong>of</strong> hospital Number <strong>of</strong> beds MO posts CS posts<br />
KwaZulu-Natal<br />
Emmaus hospital 141 6 2<br />
Ladysmith hospital 591 12 7<br />
Madadeni hospital 608 33 8<br />
Eastern Cape<br />
Holy Cross 352 9 3<br />
Nessie Knight<br />
Nor<strong>the</strong>rn Province<br />
180 2 2<br />
Botlokwa 40 2 2<br />
WF Knobel 259 5 4<br />
Pietersburg/Mankweng complex 970 95 20<br />
Note: MD = Medical Officer<br />
CS = Community <strong>service</strong>
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