Browsing by Author "Pentz, Stephen"

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    African leaders’ views on critical human resource issues for the implementation of family medicine in Africa
    (2014-01-17) Moosa, Shabir; Downing, Raymond; Essuman, Akye; Pentz, Stephen; Reid, Stephen; Mash, Robert
    Abstract Background The World Health Organisation has advocated for comprehensive primary care teams, which include family physicians. However, despite (or because of) severe doctor shortages in Africa, there is insufficient clarity on the role of the family physician in the primary health care team. Instead there is a trend towards task shifting without thought for teamwork, which runs the risk of dangerous oversimplification. It is not clear how African leaders understand the challenges of implementing family medicine, especially in human resource terms. This study, therefore, sought to explore the views of academic and government leaders on critical human resource issues for implementation of family medicine in Africa. Method In this qualitative study, key academic and government leaders were purposively selected from sixteen African countries. In-depth interviews were conducted using an interview guide. All interviews were audio-recorded, transcribed and thematically analysed. Results There were 27 interviews conducted with 16 government and 11 academic leaders in nine Sub-Saharan African countries: Botswana, Democratic Republic of Congo, Ghana, Kenya, Malawi, Nigeria, Rwanda, South Africa and Uganda. Respondents spoke about: educating doctors in family medicine suited to Africa, including procedural skills and holistic care, to address the difficulty of recruiting and retaining doctors in rural and underserved areas; planning for primary health care teams, including family physicians; new supervisory models in primary health care; and general human resource management issues. Conclusions Important milestones in African health care fail to specifically address the human resource issues of integrated primary health care teamwork that includes family physicians. Leaders interviewed in this study, however, proposed organising the district health system with a strong embrace of family medicine in Africa, especially with regard to providing clinical leadership in team-based primary health care. Whilst these leaders focussed positively on entry and workforce issues, in terms of the 2006 World Health Report on human resources for health, they did not substantially address retention of family physicians. Family physicians need to respond to the challenge by respondents to articulate human resource policies appropriate to Africa, including the organisational development of the primary health care team with more sophisticated skills and teamwork.
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    Fragile yet unbreaking : an ethnographic exploration into young people's entangled experiences of traditional healing and HIV
    (2011) Pentz, Stephen; Levine, Susan
    The following study is an ethnographic exploration into young people’s entangled experiences of health and illness in relation to both HIV/AIDS and traditional forms of healing. The research employed a creative, didactic methodology based around a series of workshops conducted with two non-governmental organisations based in Grahamstown’s peri-urban townships: The first, Siyapumelela, maintains a focus on youth and HIV/AIDS; the second, Sakhuluntu, is a cultural group aimed at keeping young people off the streets. The argument begins by challenging the dichotomous relationship that is maintained between Modern Scientific Medicine and traditional forms of healing and calls for a dual standard system in which both epistemologies can be free to operate according to their own medical standards. The study explores young people’s therapeutic environments and tracks, in particular, how young people talk about and represent HIV/AIDS. HIV/AIDS is discussed as a concept metaphor; a domain term that orients a person towards areas of shared exchange and meaning. It is clear that most young people have a well-informed biomedical understanding of HIV/AIDS, yet metaphorically, they see it as a dangerous and destructive force; an uncertain threat in the world. The research poses the question as to why young people continue to put themselves at risk of contracting HIV by exploring the social environments which many young people are subject to – environments that are often characterised by extreme social structural violence. The argument examines the nature of social structural violence as it plays itself out in the everyday lives of the participants and identifies the kinds of challenges that many of them face on a day-to-day basis. Due to fragmented avenues of support and conditions of domestic fluidity, many young people from structurally violent communities are left with feelings of vulnerability and insecurity. Alongside experiences of social and structural insecurity, young people also harbour a sense of spiritual insecurity that stems from the dissolution of the ancestral cult as a result of the historical, yet persisting, fragmentation and reorganisation of the African family unit. The research discusses a form of spirit possession known as Amakhosi that young people engage in in order to (re)gain a sense of security and protection from forces beyond their control.