CHAPTER 5: CONCLUSIONS AND RECOMMENDATIONS
5.6 Recommendations
The study makes the following recommendations for improving the experiences and thus changing the attitudes of the community towards public health systems. The recommendations may be effected in Inanda and rolled out to other parts of the country in an effort to improve national patient experiences and attitudes. The recommendations are proposed with an aim to provide solutions to the research problem discussed and investigated in this study.
5.6.1 Marketing of services
The government as the service provider of public health needs to employ stratergies to advertise and market services available within the public health sector. Much of this has been seen in some of the department’s bigger programs, such as the HIV/AIDS program, which has made great strides and holds the title of largest HIV treatment programme in the world. The benefits have included a decline of 55% in AIDS related deaths since 2005 (UNAIDS, 2017). An approach of similar rigor needs to be adopted when communicating other services that are offered at the public health facilities. The prioritization of programs needs to be revisited to ensure that the programs of a lesser priority do not end up being completely eliminated from the awareness and promotion strategies. A big need was identified from the responses of the participants for a comprehensive marketing plan of all services offered at the facilities. These could be done in the form of audio promotions of radio stations, audio recordings of creating jingles and slogans to be played at the facility during the day, especially to target the youth, print media in the form of posters and pamphlets strategically placed and distributed at the patient reception points. The staff of the facility should at regular interval
creatively engage with the patients in an effort to present and promote certain programs and services.
Community engagements need to involve health slots where services are presented in plain language and communities encouraged utilizing them.
5.6.2 Marketing of available structures
A similar approach must be employed when marketing clinic structures. The community needs to be made aware of support structures available for their assistance in any issue they may encounter. As much as it is important to the community to know all the services offered, it is equally important for them to be empowered with the information of how issues they encounter may be addressed for their benefit. There needs to be clear communication in all facility spaces of how complaints are handled and how to report incidences. The contact numbers of key regulatory structures need to displayed at all patient reception areas including each consultation room as well as on patient clinic cards. This will enable to patients to anonymously present all complaints without the fear of victimization or intimidation. Marketing of such structures may be done through print media of banners, posters and pamphlets, through radios stations and also by the committee and clinic management frequently addressing the patients and encouraging engagements between the facility and the public served.
5.6.3 Implementation and enforcement of consequence management
Consequence management includes measures to protect the public’s health and safety, restore essential government services and provide relief to individuals affected by damage, loss hardship or suffering (CIPemia, 2020). It is recommended that all facilities implement a management strategy that will address all the misconduct report of the staff. Critical to consequence management strategy is the support that needs to be offered to the staff, to encourage ethical conduct when dealing with patients. The government has a constitutional mandate to strengthen the country’s democracy by enabling oversight, accountability and governance in the public sector, thereby building public confidence. It is thus recommended that the facilities implement a consequence management system based on; the setting and communication of clear expectations in relation to how they conduct their
duties, proactive observations to be conducted by management to monitor adherence to the communicated expectations and finally the implementation of appropriate consequences for any conduct not within the scope of what was agreed up. This will create positive attitude among the staff towards their work. It will also create patient confidence in the health sector and encourage consistency in utilization of the facilities.
5.6.4 Improved communication
It is recommended that communication between the facility and patients be enriched which will inform the attitudes of patients whilst at the facility. Important information such as a temporary shortage of staff due to absences for various reasons, maintenance of infrastructure causing certain services to be unavailable or delayed, daily expected waiting time need to be communicated to the patients on a daily basis. This will keep the patient informed about momentary challenges encountered by the facility, hence appeals for patient patience will be more likely to be heeded.
Improvements in the manner in which staff communicate with patients must be encouraged. They nurses need to practice effective communications strategies which include the cognizance of one’s body language, tone of voice, the words spoken and other factors which depict a means of communication to an individual. The nurses need to be friendlier to the patients, quick to listen and advise accordingly. All reasonable measures need to be taken to ensure the patients feel comfortable enough to present any challenges they might have encountered and strive to find a solution.
5.6.5 Improved resources and infrastructure
It is recommended that the state makes an effort to provide and maintain resources and infrastructure needed at the facilities for the benefit of the patients. The maintenance of equipment must be a priority, to ensure assets are kept in good working order and are therefore able to benefit the community. Budgetary adjustment need to be made in order to provide supplementation of resources, including appropriately qualified human resources when necessary. The regular training of health care professionals is an investment towards the improvement of human resource which stands to be
of great benefit to the patients.