Browsing by Author "McGrath, Robyn Lesley"
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Item The effects of COVID-19 on paediatric therapeutic services at Chris Hani Baragwanath Academic Hospital(University of the Witwatersrand, Johannesburg, 2024) McGrath, Robyn Lesley; Slemming, WiedaadBackground: The COVID-19 pandemic has affected child health services worldwide, including in South Africa, where prioritisation of paediatric therapeutic services was lacking despite their vital role in health promotion and disease management. Aim: This study aimed to assess the impact of the COVID-19 pandemic on paediatric therapeutic services at a tertiary level hospital in Johannesburg, South Africa, focusing on service outputs, challenges, and innovations during 2020 and 2021. Methods: This study used a concurrent triangulation mixed methods approach. Quantitative analysis of service output data was combined with qualitative analysis of healthcare worker interviews. Integration was facilitated through a convergent design joint display during interpretation. Results: In 2020, patient contact sessions significantly decreased, particularly during lockdown phases, leading to missed diagnoses and adverse patient outcomes. Ineffective hospital management contributed to a lack of communication and direction for managers and clinicians which was worsened by the absence of national guidelines. Persistent trends of low service utilisation during the pandemic drove healthcare worker innovation, forcing healthcare workers to adopt a systems approach to decision making. Innovations centred on inter-professional communication and coordination, service re-evaluation and restructuring, new service delivery models, technology use, patient education and prioritisation, and adapting the duration and frequency of care. Conclusion: Paediatric services healthcare workers responded innovatively to pandemic challenges, with some solutions improving long-term service delivery efficiency. Insights from this study can enhance health system preparedness and inform planning for paediatric therapeutic services in South Africa, especially in anticipation of future events and the National Health Insurance scheme