Browsing by Subject "Service providers"

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    Child and adolescent mental health services in the Western Cape Province of South Africa: the perspectives of service providers
    (2022-07-14) Mokitimi, Stella; Jonas, Kim; Schneider, Marguerite; de Vries, Petrus J
    Background Current work in the field point to the need to strengthen child and adolescent mental health services (CAMHS) globally, and especially in low- and middle-income countries (LMICs). Policy development, planning and service provision must be relevant to the needs of stakeholders at grassroots level, and should include their perspectives. This study set out to explore the perspectives and lived experiences of service providers, including their recommendations to strengthen CAMHS in South Africa. Methods Using focus group discussions (FGDs) and semi-structured individual interviews (SSIIs), qualitative data were collected from 46 purposefully selected multidisciplinary health service providers across the Western Cape, one of the nine provinces of South Africa. Audio-recorded data were entered into NVivo 11 (QSR), and thematic analysis was performed by two independent raters. Results Results highlighted a significant lack of CAMH resources, poor intersectoral collaboration, limited access to training, absence of consistency and uniformity in service delivery, weak support for staff, and high rates of negative attitudes of staff. External factors contributing to poor CAMHS identified by service providers included poor socioeconomic circumstances, high rates of HIV/AIDS, substance use and stigma. The eight recommendations to strengthen CAMHS included a need to (1) increase CAMH staffing, (2) provide dedicated CAMHS at secondary care and child-friendly infrastructure at primary care, (3) review current service focus on number of patients seen versus quality of care provided to children, (4) formalise intersectoral collaborations, (5) increase learning opportunities for trainees, (6) employ a lead professional for CAMHS in the province, (7) increase support for staff, and (8) acknowledge staff initiatives. Conclusions Findings underlined the need for quality improvement, standardisation and scale-up of mental health services for children and adolescents in South Africa. Whilst we used the Western Cape as a ‘case study’, we propose that our findings may also be relevant to other LMICs. We recommend that the perspectives of service users, including children and adolescents, be sought to inform service transformation.
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    Open Access
    Exploring the perceptions of service providers regarding the need for and availability of services that affect the well-being of LGBTQIA+ individuals living with intellectual and developmental disability in Cape Town, South Africa
    (2025) Poswa, Nathi; Kleintjes, Sharon
    Background: Limited studies have focused on the service providers' perspective regarding the need for and availability of services for people with intellectual and developmental disability (IDD) who identify as lesbian, gay, bisexual, transgender, queer, questioning, intersex, and asexual (LGBTQIA+) (Stoffelen, Kok, Hospers, et al., 2013). The purpose for the study was to promote a better understanding of what service-providing organisations, policymakers, researchers, advocacy groups, and the government should focus on to advocate for and meet the needs of LGBTQIA+ people with IDD. Method: The study design was qualitative. A scoping review of the literature was undertaken, and semi-structured interviews were conducted with 13 service providers who work with people who have IDD, people from the LGBTQIA+ community, and individuals with both identities. Results: The results indicated that, for people with IDD who are LGBTQIA+, service availability and access is dependent, in part, on service providers' core beliefs rather than policy guidance. The results indicate that there is a need for sexuality education that focuses on different sexual orientations for people with IDD and their service providers. Study implications: More research is needed to explore the perceptions of transgender individuals with IDD regarding the availability of and access to gender affirming healthcare, as well as research to inform the development or adaptation of LGBTQIA+ inclusive educational programmes for service providers, users and their caregivers. Future research should include LGBTQIA+ service users' primary accounts, to inform decision-making for service developments and educational resource developments regarding all aspects of their sexual health and well-being.