Nursing

This issue of the HST Update examines the information plays a pivotal role in the health care industry and questions if the needs of the health care workers are being met.

The concept of doctors visiting clinics to support primary health care is well established but the role that these doctors should play is not clear, and varies from area to area.

The district STI Clinic Assessment tool or DISCA is a quality improvement instrument for use in Primary Health Care clinics (Appendix 1). It was developed after extensive consultation with nurses, public health professionals and health service managers and measures key input, process and output indicators related to care for Sexually Transmitted Infections (STI).

The education, training and provision of professional nurses in South Africa have evolved in an ad hoc manner predominantly due to historical and socio-political forces. The training and educational components were not linked to personnel provision plans in the health system, recommended by WHO (1996).

As the wheels of health care reform move, so should the training curricula for health workers. Various authors have a number of times stated that the nurse is the single most important frontline health worker in a clinic setting. Without the nurses intervention the health care centre/clinic cannot function adequately. It is therefore critical that nurse education and the supply of nurses form an integral part of teh transformation of health services in South Africa. This months issue is dedicated to nurse training with particular focus on the district health system (DHS). In a nutshell the DHS is the best vehicle for delivering primary health care (PHC) since it promotes collaboration between all sectors and reduces fragmentation and duplication of services. Questions such as, are nurses adequately prepared for current health care reforms? are considered in this Update. The current gaps in training, suggestions and recommendations to address these are revisited. Selected key participants in nurse education from the level of the South African Nursing Council (SANC) to nurses themselves, share their views and experiences in this Update.

Health promotion first entered the South African health system 10 years ago. At that time old style health education and family planning advisers and others were deployed into new health promotion services. The result of this deployment was that many people entered this new service without any formal training in health promotion and without even a clear picture of what health promotion could offer South Africa and how it was different from its predecessor, health education.

Practical approaches to health promotion within a district.