Practice environments of community health centres in South Africa

Rabie, Tinda

Monday, 18 November 2013: 3:55 PM

Tinda Rabie Jr., PhD (c), M.Cur, RN, RM
School of Nursing Science, North-West University, Potchefstroom, South Africa
Hester C. Klopper, PhD, MBA, RN, RM, FANSA
FUNDISA, University of the Western Cape and North-West University, Pretoria, South Africa
Siedine Coetzee, PhD, RN, RM
School of Nursing Science, North West University, Potchefstroom, South Africa

Learning Objective 1: describe the Primary Health Care context of the South African public health care sector

Learning Objective 2: describe the practice environments of Community Health Centres of the Primary Health Care context of the South African public health care sector

BACKGROUND: The National Department of Health has recommitted themselves through the "revitalization of PHC" that the South African (SA) public health sector will be a Primary Health Care (PHC) approach focusing on accessible and equitable health care for all. In the PHC context nurses are the front line healthcare providers who must first assess patients, before they can be referred to the secondary level of care (hospital). The nurses within the PHC context are greatly affected by nursing shortages, heavy workloads and limited resources. The practice environment within the PHC context of the SA public health sector has not yet been explored.

OBJECTIVE: To explore and describe the practice environment of community health centres (CHC) in the North West Province of SA

METHODS: This study was an extension of the Nurse Forecasting (RN4CAST) study. Data was collected using the Practice Environment Scale of the Nursing Work Index (PES-NWI). The PES-NWI was revised for the PHC context. 195 questionnaires (response rate = 67%) were completed by professional nurses from 26 CHCs in two districts of the North-West Province in SA.

RESULTS: The confirmatory factor analysis and reliability testing revealed that the revised PES-NWI was valid and reliable. The sub-scales staffing and resource adequacy and nurse participation in CHC affairs had means below 2.5, indicating that nurses were not in agreement that these sub-scales were present in their practice environment. However, nurse manager ability, leadership and support; collegial nurse-physician relationships and nursing foundations for quality of care were regarded positively in their practice environment.

CONCLUSIONS: CHC nurses experience their practice environment as positive, except for staffing and resource adequacy and nurse participation in CHC affairs. Therefore strategies must focus on improving each of these factors in the PHC context of the public health care sector of SA.

See more of: Enhancing the Workforce in Rural and Community Health
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