Challenges of quality improvement in the healthcare of South Africa post-apartheid: A critical review.
Winnie T Maphumulo, Busisiwe R Bhengu
PMID 31170800WHAT IT FOUND
South African public facilities are described as failing basic care standards, with long waits, denied access, infection risk, missing records, and equipment shortages.
This reports system problems, not tested interventions.
Key findings
01The review identifies seven recurring problems in South African public healthcare: prolonged waiting because of staff shortages, adverse events, poor hygiene and infection control, litigation from avoidable errors, shortage of medicine and equipment, and poor record-keeping.
02About one in seven patients entering South African hospitals is described as at risk of acquiring a healthcare-associated infection.
03Poor record-keeping can cause unnecessary delays, and in worst cases lost medical history can contribute to incorrect diagnosis or death.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
It is a review of published reports and documents, not a primary clinical study of patients or therapists. It does not test an intervention or report measured clinical outcomes, so it cannot show that a specific practice change improves care. It includes newspaper and media reports, which are not appraised like clinical evidence. It focuses on South Africa’s public health system, so the details may not apply to another setting.
The easy way to misread this
Do not read this review as proof that a specific quality improvement programme works. It describes reported system failures and existing policies, not measured clinical outcomes from an intervention.