The three-stage assessment to support hospital-home care coordination in Tshwane, South Africa.

Background: In complex health settings, care coordination is required to link patients to appropriate and effective care. Although articulated as system and professional values, coordination and cooperation are often absent within and across levels of service, between facilities and across sectors, with negative consequences for clinical outcomes as well as service load.

Aim: This article presents the results of an applied research initiative to facilitate the coordination of patient care.

Risks associated with communication delays in infants from underserved South African communities.

Background: For optimal development young children need warm, responsive, enriched and communicative environments for learning social, language, and other skills. Infants and toddlers exposed to psychosocial risk lack enriched environments and may present with communication delays.

Aim: To investigate the relationship between psychosocial risks and communication delays in infants from underserved communities in South Africa.

Addressing the shortage of health professionals in South Africa through the development of a new cadre of health worker: the creation of Clinical Associates.

South Africa made a decision in 2002 to develop so-called mid-level medical workers, now known as clinical associates. This article describes the background to this decision, and the national process of developing the profession and its scope of practice, which was aligned with the needs of the health service, particularly those of rural district hospitals. A common national curriculum was then developed, with implementation in three faculties.

Developing generalism in the South African context.

The largest impact on the South African burden of disease will be made in community-based and primary healthcare (PHC) settings and not in referral hospitals. Medical generalism is an approach to the delivery of healthcare that routinely applies a broad and holistic perspective to the patient's problems and is a feature of PHC. A multi-professional team of generalists, who share similar values and principles, is needed to make this a reality.

Management of district hospitals--exploring success.

Aim: The aim of the study was to explore and document what assists a rural district hospital to function well. The lessons learned may be applicable to similar hospitals all over the world.

Method: A cross-sectional exploratory study was carried out using in-depth interviews with 21 managers of well-functioning district hospitals in two districts in South Africa.