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A healthcare system in any country is rarely the product of one logical policy-making experience, but rather a manifestation of many years of historical development. The purpose of this paper is to examine the characteristics, components, and variables of South Africa’s healthcare system in the context of global patterns. It leverages a dynamic period in South Africa since 1994, and applies a comparative health systems analysis to explain where the country’s healthcare system is, and where it is potentially going.

This paper reviews literature related to South Africa’s healthcare system, outlines its historical development, and discusses three fundamental challenges experienced in the country. This paper also reviews the literature on healthcare system typologies and identifies three framework models that have been used to categorise national healthcare systems since the 1970s. This paper then discusses the categorisation of South Africa’s healthcare system in these models, in comparison to Canada and the USA.

This paper finds that the framework models are useful tools for comparative analysis of healthcare systems. However, any use of such typologies should be done with the awareness that national healthcare systems are not isolated entities because they function within a larger context. They are not static, since they are constantly evolving with many nuances, even with very similar healthcare system categorisations.

This paper charts the trajectory of change in the South African healthcare system, and demonstrates that the change process must keep internal conditions in mind if the outcome is to be successful. Imitating policies of countries with well-functioning systems, without regard to local realities, may not work, as the government attempts to usher in changes within a short span of time.

This paper examines the contested value of healthy life and wellbeing in a context of severe austerity, exploring how the value of “Public Health” is constructed through and with material-discursive practices and accounting representations. It seeks to explore the political and ethical implications of constructing the valuable through a shared consensus over the “facts” when addressing complex, multi-agency problems with long time horizons and outcomes that are not always easily quantifiable.

The theorisation, drawing on science and technology studies (STS) scholars and Karen Barad's (2007) agential realism, opens up the analysis to the performativity of both material and discursive practices in the period following a major re-organisation of activity. The study investigates two case authorities in England and the national regulator through interviews, observations and documentary analysis.

The paper demonstrates the deeply ethical and political entanglements of accounting representations as objectivity, consensus and collective action are constructed and resisted in practice. It goes on to demonstrate the practical challenges of constructing “alternative accounts” and “intelligent accountabilities” through times of austerity towards a shared sense of public value and suggests austerity measures make such aims both more challenging and all the more essential.

Few studies in the accounting literature have explored the full complexity of valuation practices in non-market settings, particularly in a public sector context; this paper, therefore, extends familiar conceptual vocabulary of STS inspired research to further explore how value(s), ethics and identity all play a crucial role in making things valuable.

The purpose of this paper is to determine whether some aspects of the distinctive Mayo Clinic care model could be translated into English National Health Service (NHS) hospital settings, to overcome the fragmented and episodic nature of non-emergency patient care.

The authors used a rapid review to assess the literature on integrated clinical care in hospital settings and critical analysis of links between Mayo Clinic’s care model and the organisation’s performance and associated patient outcomes.

The literature directly concerned with Mayo Clinic’s distinctive ethos and approach to patient care is limited in scope and largely confined to “grey” sources or to authors and institutions with links to Mayo Clinic. The authors found only two peer-reviewed articles which offer critical analysis of the contribution of the Mayo model to the performance of the organisation.

Mayo Clinic is not the only organisation to practice integrated, in-hospital clinical care; however, it is widely regarded as an exemplar.

There are barriers to implementing a Mayo-style model in English NHS hospitals, but they are not insurmountable and could lead to much better coordination of care for some patients.

The study shows that there is an appetite among NHS patients and staff for better coordinated, multi-specialty care within NHS hospitals.

In the English NHS integrated care generally aims to improve coordination between primary, community and secondary care, but problems remain of fragmented care for non-emergency hospital patients. Use of a Mayo-type care model, within hospital settings, could offer significant benefits to this patient group, particularly for multi-morbid patients.

This paper is based on research addressing quality of construction schedules. The paper aims to structure a Schedule Health Assessment method and present it as a means to carry out the evaluation of construction schedules.

The development of the Schedule Health assessment method can be characterised as constructive research. The structuring of the method is based on analysis of factors forming the overall quality of construction schedules. The method has been tested in a proof of concept study. This comprised a case study in which four master schedules developed by junior production managers were evaluated using the Schedule Health assessment method.

It is possible to construct a method for the quality evaluation of construction schedules.

The completed testing is still rather limited since it is based merely on experiences of junior production managers with a single case.

The Schedule Health assessment method can in a useful manner make the quality evaluation of construction schedules easy to approach and effective process.

This research has produced a novel method for the quality evaluation of construction schedules.

Overheating is considered a modifiable risk factor for sudden infant death syndrome (SIDS). The purpose of this paper is to explore differences in infant thermal care beliefs between mothers of South Asian and white British origin in Bradford, UK.

This study employed face-to-face interviews with semi-structured and structured questions with 51 white British and 51 South-Asian mothers in the Bradford District, UK.

White British mothers were more concerned about overheating causing SIDS whereas South-Asian mothers were more concerned about cold causing respiratory infections. However concerns around hypothermia and chills causing colds were expressed in both groups. White British mothers were significantly more likely to be concerned about their infant getting too hot than too cold and South-Asian mothers about both heat and cold (p0.001), but white British mothers on lower incomes and with poorer education expressed concern about cold more so than their better off, better educated peers indicating a possible link to fuel poverty.

It was not possible to observe actual night-time practices and that South Asian as a cultural category is limited because could be regarded as too broad.

Whilst there guidance available to prevent infants overheating to prevent SIDS there is little or none about infants getting cold and how temperature affects other conditions.

Thermal care behaviours and beliefs differ between ethnic groups. SIDS and overheating is only one concern for mothers in providing thermal care for their infants. More policy and research is needed to explore the wider impact of thermal care on infant health and survival.

This topic is rarely addressed despite the wide ranging implications of heat and cold to infant well-being.

Peer support is increasingly being introduced into mainstream mental health services internationally. The distinctiveness of peer support, compared to other mental health support, has been linked to values underpinning peer support. Evidence suggests that there are challenges to maintaining those values in the context of highly standardised organisational environments. The purpose of this paper is to describe a “principles-based” approach to developing and evaluating a new peer worker role in mental health services.

A set of peer support values was generated through systematic review of research about one-to-one peer support, and a second set produced by a UK National Expert Panel of people sharing, leading or researching peer support from a lived experience perspective. Value sets were integrated by the research team – including researchers working from a lived experience perspective – to produce a principles framework for developing and evaluating new peer worker roles.

Five principles referred in detail to: relationships based on shared lived experience; reciprocity and mutuality; validating experiential knowledge; leadership, choice and control; discovering strengths and making connections. Supporting the diversity of lived experience that people bring to peer support applied across principles.

The principles framework underpinned development of a handbook for a new peer worker role, and informed a fidelity index designed to measure the extent to which peer support values are maintained in practice. Given the diversity of peer support, the authors caution against prescriptive frameworks that might “codify” peer support and note that lived experience should be central to shaping and leading evaluation of peer support.

This paper adds to the literature on peer support in mental health by describing a systematic approach to understanding how principles and values underpin peer worker roles in the context of mental health services. This paper informs an innovative, principles-based approach to developing a handbook and fidelity index for a randomised controlled trial. Lived experiences of mental distress brought to the research by members of the research team and the expert advisors shaped the way this research was undertaken.

This case study paper aims to explore the complexities and challenges of epidemic response and public health surveillance in Native American and Indigenous American communities in the United States and find viable solutions. This paper explores these topics through the emergence and impact of the hantavirus pulmonary syndrome (HPS) within the Navajo Nation in the United States using critical incident analysis and best practices.

This project is a case study paper based on a topical review of the literature. A topical review of the literature is a comprehensive exploration of the current body of knowledge within a particular research field. It is an important tool used by scholars and practitioners to further the development of existing knowledge as well as to identify potential directions for future research (Fourie, 2020). Such a paper can provide a useful insight into the various aspects of the process that the researcher may have overlooked, as well as highlighting potential areas of improvement (Gall et al., 2020). It can also provide a useful source of ideas and inspiration for the researcher as it can provide an overview of the various approaches used by other researchers in the field (Göpferich, 2009). Case study papers using a topical review of the literature have been used to help frame and inform research topics, problems and best practices for some time. They are typically used to explore a topic in greater depth and to provide an overview of the literature to improve the world of practice to provide a foundation for future comprehensive empirical research. Case study papers can provide research value by helping to identify gaps in the literature and by providing a general direction for further research. They can also be used to provide a starting point for research questions and hypotheses and to help identify potential areas of inquiry.

This study explores best practices in public health surveillance and epidemic response that can help strengthen public health infrastructure by informing the development of effective surveillance systems and emergency response plans, as well as improving data collection and analysis capabilities within Native American and Indigenous American communities in the United States that also have the option to include new technologies like artificial intelligence (AI) with similar outbreaks in the future.

The literature review did not include any primary data collection, so the existing available research may have limited the findings. The scope of the study was limited to published literature, which may not have reported all relevant findings. For example, unpublished studies, field studies and industry reports may have provided additional insights not included in the literature review. This research has significant value based on the limited amount of studies on how infectious diseases can severely impact Native American communities in the United States, leading to unnecessary and preventable suffering and death. As a result, research on viable best practices is needed on the best practices in public health surveillance and epidemic response in Native American and Indigenous American communities through historical events and critical incident analysis.

Research on public health surveillance and epidemic response in Native American communities can provide insights into the challenges faced by these communities and help identify potential solutions to improve their capacity to detect, respond to and prevent infectious diseases using innovative approaches and new technologies like AI.

More research on public health surveillance and epidemic response can inform policies and interventions to improve access to healthcare for Native American populations, such as increasing availability of healthcare services, providing culturally appropriate health education and improving communication between providers and patients. By providing better public health surveillance and response capacity, research can help reduce the burden of infectious diseases in Native American communities and ultimately lead to improved public health outcomes.

The COVID-19 pandemic has caused severe challenges to ethnic minorities in the UK. While the experiences of migrants are both complex and varied depending on individuals' social class, race, cultural proximity to the host country and acculturation levels, more in-depth studies are necessary to fully understand how COVID-19 affects specific migrant groups and their health. Taiwanese migrants were selected because they are an understudied group. Also, there were widespread differences in pandemic management between the UK and Taiwan, making this group an ideal case for understanding how their acculturation journey can be disrupted by a crisis.

Qualitative data were collected at two different time points, at the start of the UK pandemic (March/April 2020) and six months on (October/November 2020), to explore migrant coping experiences over time. Theoretically, the authors apply acculturation theory through the lens of coping, while discussing health-consumption practices, as empirical evidence.

Before the outbreak of the pandemic, participants worked hard to achieve high levels of integration in the UK. The pandemic changed this; participants faced unexpected changes in the UK’s sociocultural structures. They were forced to exercise the layered and complex “coping with coping” in a hostile host environment that signalled their new marginalised status. They faced impossible choices, from catching a life-threatening disease to being seen as overly cautious. Such experience, over time, challenged their integration to the host country, resulting in a loss of faith in the UK’s health system, consequently increasing separation from the host culture and society.

It is important to note that the Taiwanese sample recruited through Facebook community groups is biased and has a high level of homogeneity. These participants were well-integrated, middle-class migrants who were highly educated, relatively resourceful and active on social media. More studies are needed to fully understand the impact on well-being and acculturation of migrants from different cultural, contextual and social backgrounds. This being the case, the authors can speculate that migrants with less resource are likely to have found the pandemic experience even more challenging. More studies are needed to fully understand migrant experience from different backgrounds.

Public health policymakers are advised to dedicate more resources to understand migrants' experiences in the host country. In particular, this paper has shown how separation, especially if embraced temporarily, is not necessarily a negative outcome to be corrected with specific policies. It can be strategically adopted by migrants as a way of defending their health and well-being from an increasingly hostile environment. Migrants' home country experience provides vicarious learning opportunities to acquire good practices. Their voices should be encouraged rather than in favour of a surprising orthodox and rather singular approach in the discussion of public health management.

The paper has clear public health policy implications. Firstly, public health policymakers are advised to dedicate more resources to understand migrants' experiences in the host country. Acknowledging migrants' voice is a critical first step to contribute to the development of a fair and inclusive society. Secondly, to retain skilful migrants and avoid a future brain-drain, policymakers are advised to advance existing infrastructure to provide more incentives to support and retain migrant talents in the post-pandemic recovery phase.

This paper reveals how a group of previously well-integrated migrants had to exercise “coping with coping” during the COVID crisis. This experience, over time, challenged their integration to the host country, resulting in a loss of faith in the UK’s health system, consequently increasing separation from the host culture and society. It contributes to the understanding of acculturation by showing how a such crisis can significantly disrupt migrants' acculturation journey, challenging them to re-acculturate and reconsider their identity stance. It shows how separation was indeed a good option for migrants for protecting their well-being from a newly hostile host environment.

With global migration, the number of ethnic minority and migrant women receiving maternity health care in dominantly Anglo-European societies has increased significantly but they consistently have among the worst pregnancy and maternal outcomes. This paper aims to analyse gaps in structural (migration-related inequalities) and cultural (responsiveness to ethno-cultural practices) competencies among maternal health practitioners in Aotearoa New Zealand (NZ).

Using a semi-structured interview guide, in-depth interviews were conducted with 13 maternal health practitioners in NZ. Data were analysed using a thematic analysis framework.

The results highlight significant barriers around language and communication, cultural stereotyping by professionals, ethnic women’s own constraints around family and cultural expectations and their lack of knowledge about reproductive health. In addition, practitioners’ own ethnic differences are inseparable from their approach to structural and cultural competencies; there were instances of ‘over-’ or ‘under-’ reading of culture, practitioner constructions of ideal pregnancies and anti-racism concerns that shaped maternal care practices that were sensitive to, but also marginalised, ethnic migrant women who attended maternity services.

To the best of the authors’ knowledge, this is the only study in NZ that examines the impact of complex dynamics of migration and culture on knowledge, beliefs and values of practitioners, in context of their own personal biographies. Identifying strategies to improve the way diversity is practiced in hospital settings can be transformational in improving maternal outcomes for ethnic migrant women in NZ.

This paper aims to investigate three promotional publications produced by the Postum Cereal Company – A Trip Through Postumville (1920), How I Make Postum (1924) and The Wonderful Lunch Boxes (1925) – with the aim of understanding how language and other semiotic resources are used to promote its products as good and healthy choices.

The three publications were collected from the HathiTrust Digital Library and University of South Florida Tampa Special Collections. They were subjected to multimodal critical discourse analysis to tease out their subtle characteristics and how a combination of language, image, colour, typography and composition are used to represent certain ideas and values related to health and well-being.

The publications subscribe to three distinct genres – “inside the factory”, “friendly spokesperson” and “fictional world” – each of which are aimed at different target audiences. The first seeks to promote Postum as an open and transparent company; the second to promote Postum as a company that cares about its consumers; and the third to promote the health benefits of Postum in a fun and accessible manner. Nonetheless, they are united in their overall objective to link the regular consumption of Postum as essential for good health.

To date, few studies have been conducted on the Postum Cereal Company, while the limited research conducted on promotional publications has tended to overlook discourses of health and well-being. The three genres outlined in this study, thus, have the potential to foster a reappraisal of promotional publications and showcase their ability to offer new understandings on historical approaches to marketing, particularly the link with health and science.