Browsing by Author "Hatcher, Abigail M"

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    Evaluating the role of 'critical consciousness' in a rural South African development intervention : implications for structural approaches to HIV prevention
    (2006) Hatcher, Abigail M; De Wet, Jacques
    Traditional, information-giving approaches to HIV prevention have failed to curb the rapidly expanding HIV/AIDS epidemic in South Africa. Scholars and practitioners have looked to new interventions for HIV which centre upon structural changes, or the broader societal forces which shape HIV vulnerability. In recent years, Paulo Freire's notion of 'critical consciousness' has been cited as a way to involve communities in critical analysis and social change for HIV prevention. However, increasing calls for critical consciousness within HIV literature fail to recognise the complexities of integrating the notion at the ground-level. The Intervention with Microfinance for AIDS and Gender Equality (IMAGE) is a South African structural intervention for HIV which has been guided by critical consciousness. IMAGE aims to impact on poverty and gender-based violence by partnering a participatory gender curriculum with group-based microfinance. The research examines how IMAGE has translated the notion of critical consciousness into distinct processes, and evaluates the implementation of these processes by drawing from qualitative research with programme planners, facilitators and participants.
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    Placement, support, and retention of health professionals: national, cross-sectional findings from medical and dental community service officers in South Africa
    (BioMed Central, 2014-02-26) Hatcher, Abigail M; Onah, Michael; Kornik, Saul; Peacocke, Julia; Reid, Stephen
    Background: In South Africa, community service following medical training serves as a mechanism for equitable distribution of health professionals and their professional development. Community service officers are required to contribute a year towards serving in a public health facility while receiving supervision and remuneration. Although the South African community service programme has been in effect since 1998, little is known about how placement and practical support occur, or how community service may impact future retention of health professionals. Methods: National, cross-sectional data were collected from community service officers who served during 2009 using a structured self-report questionnaire. A Supervision Satisfaction Scale (SSS) was created by summing scores of five questions rated on a three-point Likert scale (orientation, clinical advising, ongoing mentorship, accessibility of clinic leadership, and handling of community service officers’ concerns). Research endpoints were guided by community service programmatic goals and analysed as dichotomous outcomes. Bivariate and multivariate logistical regressions were conducted using Stata 12. Results: The sample population comprised 685 doctors and dentists (response rate 44%). Rural placement was more likely among unmarried, male, and black practitioners. Rates of self-reported professional development were high (470 out of 539 responses; 87%). Participants with higher scores on the SSS were more likely to report professional development. Although few participants planned to continue work in rural, underserved communities (n = 171 out of 657 responses, 25%), those serving in a rural facility during the community service year had higher intentions of continuing rural work. Those reporting professional development during the community service year were twice as likely to report intentions to remain in rural, underserved communities. Conclusions: Despite challenges in equitable distribution of practitioners, participant satisfaction with the compulsory community service programme appears to be high among those who responded to a 2009 questionnaire. These data offer a starting point for designing programmes and policies that better meet the health needs of the South African population through more appropriate human resource management. An emphasis on professional development and supervision is crucial if South Africa is to build practitioner skills, equitably distribute health professionals, and retain the medical workforce in rural, underserved areas.