Jane Goudge
Dados Biográficos
| ID | 144926 |
|---|---|
| NOME | Jane Goudge |
| PRENOMES | Jane |
| SOBRENOME | Goudge |
| ASSINATURA | GOUDGE J |
| AFILIAÇÕES | University of the Witwatersrand |
| ORCID | 0000-0001-6555-7510 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 42 |
| TOTAL DE CITAÇÕES | 58 |
| TOTAL COMO AUTOR | 42 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 2005 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2025 |
| ÍNDICE H | 4 |
Using a cash transfer plus SMS nudge package to improve the wellbeing among caregivers of adolescents living with HIV during the Covid-19 epidemic in South Africa
Caregivers of adolescents living with HIV encounter multiple economic and psycho-social challenges which impair their wellbeing and provision of optimal care. Cash transfers combined with short message service (SMS) nudges may address the financial and mental barriers to caregiver wellbeing in sub-Saharan Africa. We examined the preliminary effectiveness and feasibility outcomes of this multipronged approach for improving caregiver wellbeing. We …
“ They need to feel at home not in a home. ” Experiences of residents and carers in mental health residential facilities
Smaller residential homes offer more autonomy and integration than large dormitory-style facilities. Policies and funding should support smaller, community-based supported accommodation for people with serious mental illness
Community-based Collaborative Care for Serious Mental Illness
Community-based collaborative care (CBCC) is an effective approach for addressing the needs of people with mental health conditions. However, even with the established components of CBCC in place, CBCCs effectiveness for serious mental illnesses (SMIs) remains unknown. This review aims to synthesize qualitative evidence of health care providers’ experiences of CBCC in order to identify key factors that facilitate or hinder collaboration in the sp…
Healthcare providers’ experiences of community-based collaborative care for serious mental illness
Community-based collaborative care (CBCC) is an internationally recognised model of integrated care that emphasises multidisciplinary teamwork and care coordination. In South Africa, community psychiatry has been integrated into some primary healthcare (PHC) facilities. This study examines healthcare providers’ perceptions of collaboration and its challenges in various integrated care settings. Three main components of CBCC (multidisciplinary tea…
Mobilisation towards formal employment in the healthcare system
In low and middle-income countries, community health workers (CHWs) play a critical role in delivering primary healthcare (PHC) services. However, they often receive low stipends, function without resources and have little bargaining power with which to demand better working conditions. Using a qualitative case study methodology, we studied CHWs’ conditions of employment, their struggle for recognition as health workers, and their activities to e…
Citizen engagement in national health insurance in rural western Kenya
Effective citizen engagement is crucial for the success of social health insurance, yet little is known about the mechanisms used to involve citizens in low- and middle-income countries. This paper explores citizen engagement efforts by the National Health Insurance Fund (NHIF) and their impact on health insurance coverage within rural informal worker households in western Kenya. Our study employed a mixed methods design, including a cross-sectio…
Do Integrated Community Psychiatry Services in Primary Health Care Settings Improve Continuity of Care? A Mixed-methods Study of Health Care Users’ Experiences in South Africa
Coordination and continuity of care were constrained in both clinics, regardless of the organisational integration approaches used. As low- and middle-income countries work towards integrating mental health care into PHC, the implementation of organisational integration approaches should consider physical space, caseload, HCU need, and the inclusion of dedicated providers to coordinate care
Service Users’ and Providers’ Experiences and Perceptions of Mental Health Accommodation Services
Background . There is a high prevalence of homeless people with psychotic disorders and supported housing is often required. However, there is little evidence about supported housing services, especially in low‐middle income countries. This rapid review synthesizes evidence about the experiences of users and providers of community‐based accommodation services for people living with serious mental illness internationally to understand priorities f…
Community health workers’ quality of comprehensive care
Background Community healthcare worker (CHW) training programs are becoming increasingly comprehensive (an expanded range of diseases). However, the CHWs that the program relies on have limited training. Since CHWs’ activities occur largely during household visits, which often go unsupervised and unassessed, long-term, ongoing assessment is needed to identify gaps in CHW competency, and improve any such gaps. We observed CHWs during household vis…
Community-orientated primary health care
Due to insufficient number of health workers and the evidence of the benefits of community health workers (CHWs), CHWs are being deployed to provide health care services to under-served communities. In this article, we explore to what extent the South African CHW programmes introduced between 2009 and 2011 are attuned to community needs, integrated into the healthcare system and community structures, and also implemented in accordance with commun…
It is like an umbrella covering you, yet it does not protect you from the rain”
Countries in Sub-Saharan Africa are increasingly adopting mandatory social health insurance programs. In Kenya, mandatory social health insurance is being implemented through the national health insurer, the National Hospital Insurance Fund (NHIF), but the level of coverage, affordability and financial risk protection provided by health insurance, especially for rural informal households, is unclear. This study provides as assessment of affordabi…
Acceptability of prepayment, social solidarity and cross-subsidies in national health insurance
Introduction: Many low- and middle-income countries are attempting to finance healthcare through voluntary membership of insurance schemes. This study examined willingness to prepay for health care, social solidarity as well as the acceptability of subsidies for the poor as factors that determine enrolment in western Kenya. Methods: = 11) with policy makers and implementers in a single county in western Kenya. Social solidarity was defined by wil…
Assessing the Utility of a Quality-of-Care Assessment Tool Used in Assessing Comprehensive Care Services Provided by Community Health Workers in South Africa
Background: Few studies exist on the tools for assessing quality-of-care of community health worker (CHW) who provide comprehensive care, and for available tools, evidence on the utility is scanty. We aimed to assess the utility components of a previously-reported quality-of-care assessment tool developed for summative assessment in South Africa. Methods: In two provinces, we used ratings by 21 CHWs and three team leaders in two primary health ca…
Dietary diversity, food insecurity and the double burden of malnutrition among children, adolescents and adults in South Africa
Childhood stunting remains a global public health problem. Many stunted children live in the same household as overweight or obese adults (the so-called double burden of malnutrition), evidence that quality as well as quantity of food is important. In recent years, food security measurement has shifted away from anthropometry (e.g., stunting) to experiential measures (e.g., self-reported hunger). However, given the continued problem of stunting, …
Strengthening public financial management in the health sector
INTRODUCTION: Effective public financial management (PFM) ensures public health funds are used to deliver services in the best way possible. Given the global call for universal health coverage, and concerns about the management of public funds in many low-income and middle-income countries, PFM has become an important area of research. South Africa has a robust PFM framework, that is generally adhered to, and yet financial outcomes have remained …
Austerity, resilience and the management of actors in public hospitals
BACKGROUND: Global economic recession coupled with internal inefficiencies and corruption has led to a period of austerity in the South African healthcare system.This paper examines the strategies used by management in response to austerity in the three public hospitals and their effect on organisational functioning. METHODS: We used a comparative qualitative case study approach, collecting data using a combination of in-depth interviews with man…
Organizational structure and human agency within the South African health system
Despite international recognition of health promotion (HP) as a cost-effective way to improve population health, it is not highly regarded nor is it sufficiently institutionalized in many health systems. This diminishes its ability to deliver on its public health promises. This paper examined the role of organizational structure and human agency within the South African health system (drawing on Giddens’s structuration theory) in determining the …
Impact of financial management centralisation in a health system under austerity
INTRODUCTION: International calls for universal health coverage (UHC) have led many countries to implement health sector reforms, however, since the 2008 global recession, economic growth has slowed in many lower-income and middle-income countries. In a renewed interest in public financial management (PFM), international organisations have emphasised the importance of giving spending control to those responsible for healthcare. However, centralis…
Towards a framework for multisector and multilevel collaboration
The framework does not suggest that multisector collaboration is a panacea, but that MSA remains critical to address complex health and development issues. Focus should be on finding innovative ways to inform and strengthen its implementation in practice. The framework can be used by practitioners and policy makers to inform design, implementation, and evaluation of multisector collaborations. It reflects on complexities of MSA, and brings to the…
The state of enrollment on the National Health Insurance Scheme in rural Ghana after eight years of implementation
Despite the introduction of policy exemptions as an equity measure, the poorest of the poor were rarely identified for exemption. The government must urgently resource the Department of Social Welfare to identify the poor for NHIS enrollment
Process evaluation in the field
This research demonstrates the important role of process evaluation in understanding implementation process of complex interventions. This can help to highlight a broad range of system requirements such as new policies and capacity building to support implementation. Process evaluation is crucial in understanding contextual factors that may impact intervention implementation which is important in considering whether or not the intervention can be…
How to do (or not to do)… Measuring health worker motivation in surveys in low- and middle-income countries
A health system’s ability to deliver quality health care depends on the availability of motivated health workers, which are insufficient in many low income settings. Increasing policy and researcher attention is directed towards understanding what drives health worker motivation and how different policy interventions affect motivation, as motivation is key to performance and quality of care outcomes. As a result, there is growing interest among r…
Multisectoral (in)action
Whilst progress has been made, evidence of effective approaches to improve action on addressing the social and structural drivers of the HIV epidemic remains a priority, to meet the 2030 sustainable development agenda, and to achieve key HIV targets, including the 90-90-90 target and the Treatment as Prevention (TasP) intervention. With a focus on the public sector in South Africa, we critically reflect on the HIV mainstreaming approach, assessin…
Social health insurance contributes to universal coverage in South Africa, but generates inequities
By introducing the scheme, the government chose to prioritise access to private sector care for government employees, over improving the availability and quality of public sector services available to all. Government has recently regained its focus on achieving UHC through the public system, but is unlikely to discontinue GEMS, which is now firmly established. The inequities generated by the scheme have thus been institutionalised within the coun…
Performance management in times of change
To strengthen district health services, there should be improvement of processes that enhance the performance of the health system. Implementation of the PA system relies on the extent of management skills at the local level. There is a need to develop managers who have the ability to manage in a transforming and complex environment. This means developing both hard skills such as planning, co-ordination and monitoring and soft skills where one is…
How can trust be investigated? Drawing lessons from past experience
Mobile phone use among patients and health workers to enhance primary healthcare
Mobile phones have the potential to improve access to healthcare information and services in low-resourced settings. This study investigated the use of mobile phones among patients with chronic diseases, pregnant women, and health workers to enhance primary healthcare in rural South Africa. Qualitative research was undertaken in Mpumalanga in 2014. Semi structured in-depth interviews were conducted with 113 patients and 43 health workers from sev…
Stigma, identity and resistance among people living with HIV in South Africa
AIDS-related stigma can cause delays in testing, poor treatment adherence, and greater numbers of new infections. Existing studies from low- and middle-income countries focus on the negative experiences of stigma, and few document resistance strategies. In this article we document the diverse journeys of people living with HIV in South Africa, through ill health, testing, disclosure, and treatment, and their responses to stigma. The research ques…
Progress towards universal coverage
A desire to enhance protection against health care costs and improve equity of access to health care lies at the core of many health sector financing initiatives. Until recently, international debates about financing and health equity have focused primarily on mechanisms to promote equity in relation to very specific elements of health systems. However, in recent years there has been growing interest in considering these equity challenges from a …
Ways of Doing
In this article, we consider the conduct of post-apartheid health care in a policy context directed toward entrenching democracy, ensuring treatment-adherent patients, and creating a healthy populace actively responsible for their own health. We ask how tuberculosis treatment, antiretroviral therapy, and maternal services are delivered within South Africa's health system, an institutional site of colonial and apartheid injustice, and democratic r…
Bringing Justice to Unacceptable Health Care Services? Street-Level Reflections from Urban South Africa
Transforming repressive institutions into respected instruments of justice is necessary for the social reconstruction of fragile and postconflict states. Yet, little attention has been given to the role of health systems in facilitating such change. We situate South Africa’s right to access health care as part of a broader sociopolitical endeavour to ‘bring justice’ in the aftermath of apartheid and argue that street-level bureaucrats tasked with…
Social solidarity and willingness to tolerate risk- and income-related cross-subsidies within health insurance
The importance of ill-health in perpetuating poverty is well recognized. In order to prevent the damaging downward spiral of poverty and illness, there is a need for a greater level of social protection, with greater cross-subsidization between the poor and wealthy, and the healthy and those with ill-health. The aim of this paper is to examine individual preferences for willingness to pre-pay for health care and willingness to cross-subsidize the…
Community-based Collaborative Care for Serious Mental Illness
Community-based collaborative care (CBCC) is an effective approach for addressing the needs of people with mental health conditions. However, even with the established components of CBCC in place, CBCCs effectiveness for serious mental illnesses (SMIs) remains unknown. This review aims to synthesize qualitative evidence of health care providers’ experiences of CBCC in order to identify key factors that facilitate or hinder collaboration in the sp…
Do Integrated Community Psychiatry Services in Primary Health Care Settings Improve Continuity of Care? A Mixed-methods Study of Health Care Users’ Experiences in South Africa
Coordination and continuity of care were constrained in both clinics, regardless of the organisational integration approaches used. As low- and middle-income countries work towards integrating mental health care into PHC, the implementation of organisational integration approaches should consider physical space, caseload, HCU need, and the inclusion of dedicated providers to coordinate care
Service Users’ and Providers’ Experiences and Perceptions of Mental Health Accommodation Services
Background . There is a high prevalence of homeless people with psychotic disorders and supported housing is often required. However, there is little evidence about supported housing services, especially in low‐middle income countries. This rapid review synthesizes evidence about the experiences of users and providers of community‐based accommodation services for people living with serious mental illness internationally to understand priorities f…
How can trust be investigated? Drawing lessons from past experience
Affordability, availability and acceptability barriers to health care for the chronically ill
BACKGROUND: There is an increasing burden of chronic illness in low and middle income countries, driven by TB/HIV, as well as non-communicable diseases. Few health systems are organized to meet the needs of chronically ill patients, and patients' perspectives on the difficulties of accessing care need to be better understood, particularly in poor resourced settings, to achieve this end. This paper describes the experience of poor households attem…
Stigma, identity and resistance among people living with HIV in South Africa
AIDS-related stigma can cause delays in testing, poor treatment adherence, and greater numbers of new infections. Existing studies from low- and middle-income countries focus on the negative experiences of stigma, and few document resistance strategies. In this article we document the diverse journeys of people living with HIV in South Africa, through ill health, testing, disclosure, and treatment, and their responses to stigma. The research ques…
Inequities in access to health care in South Africa
Progress towards universal coverage
A desire to enhance protection against health care costs and improve equity of access to health care lies at the core of many health sector financing initiatives. Until recently, international debates about financing and health equity have focused primarily on mechanisms to promote equity in relation to very specific elements of health systems. However, in recent years there has been growing interest in considering these equity challenges from a …
Social solidarity and willingness to tolerate risk- and income-related cross-subsidies within health insurance
The importance of ill-health in perpetuating poverty is well recognized. In order to prevent the damaging downward spiral of poverty and illness, there is a need for a greater level of social protection, with greater cross-subsidization between the poor and wealthy, and the healthy and those with ill-health. The aim of this paper is to examine individual preferences for willingness to pre-pay for health care and willingness to cross-subsidize the…
A rapid assessment of a community health worker pilot programme to improve the management of hypertension and diabetes in Emfuleni sub-district of Gauteng Province, South Africa
BACKGROUND: Non-communicable diseases (NCD) and infectious chronic illnesses are recognised as significant contributing factors to the burden of disease globally, specifically in South Africa, yet clinical management is often poor. The involvement of community health workers (CHWs) in TB and HIV care in South Africa, and other low- and middle-income settings, suggests that they could make an important contribution in the management of NCDs. OBJEC…
Moving towards universal coverage in South Africa? Lessons from a voluntary government insurance scheme
BACKGROUND: In 2005, the South African government introduced a voluntary, subsidised health insurance scheme for civil servants. In light of the global emphasis on universal coverage, empirical evidence is needed to understand the relationship between new health financing strategies and health care access thereby improving global understanding of these issues. OBJECTIVES: This study analysed coverage of the South African government health insuran…
Outreach services to improve access to health care in South Africa
INTRODUCTION: In South Africa, there are renewed efforts to strengthen primary health care and community health worker (CHW) programmes. This article examines three South African CHW programmes, a small local non-governmental organisation (NGO), a local satellite of a national NGO, and a government-initiated service, that provide a range of services from home-based care, childcare, and health promotion to assist clients in overcoming poverty-rela…
Bringing Justice to Unacceptable Health Care Services? Street-Level Reflections from Urban South Africa
Transforming repressive institutions into respected instruments of justice is necessary for the social reconstruction of fragile and postconflict states. Yet, little attention has been given to the role of health systems in facilitating such change. We situate South Africa’s right to access health care as part of a broader sociopolitical endeavour to ‘bring justice’ in the aftermath of apartheid and argue that street-level bureaucrats tasked with…
Adverse or acceptable
BACKGROUND: As in many fragile and post-conflict countries, South Africa's social contract has formally changed from authoritarianism to democracy, yet access to services, including health care, remains inequitable and contested. We examine access barriers to quality health services and draw on social contract theory to explore ways in which a post-apartheid health care contract is narrated, practiced and negotiated by patients and providers. We …
Community health workers, recipients’ experiences and constraints to care in South Africa – a pathway to trust
Community health workers (CHWs) affiliated with community-based organisations are central to the implementation of primary health care in district health services in South Africa. Here, we explore factors that affect the provision of and access to care in two provinces - Gauteng and Eastern Cape. Drawing on narratives of care recipients and the CHWs who support them, we illustrate the complex issues surrounding health maintenance and primary care…
Ways of Doing
In this article, we consider the conduct of post-apartheid health care in a policy context directed toward entrenching democracy, ensuring treatment-adherent patients, and creating a healthy populace actively responsible for their own health. We ask how tuberculosis treatment, antiretroviral therapy, and maternal services are delivered within South Africa's health system, an institutional site of colonial and apartheid injustice, and democratic r…
Everyday resilience in district health systems
Recent global crises have brought into sharp relief the absolute necessity of resilient health systems that can recognise and react to societal crises. While such crises focus the global mind, the real work lies, however, in being resilient in the face of routine, multiple challenges. But what are these challenges and what is the work of nurturing everyday resilience in health systems? This paper considers these questions, drawing on long-term, p…
Implementing a multi-sectoral response to HIV
BACKGROUND: A multi-sectoral response is advocated by international organisations as a good strategy to address the multiple drivers and impact of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), and was historically mandated as a condition of funding. In March 2017, the South African National AIDS Council (SANAC) launched the latest 5 year National Strategic Plan (NSP) to address HIV, sexually transmitted infections a…
How to do (or not to do)… Measuring health worker motivation in surveys in low- and middle-income countries
A health system’s ability to deliver quality health care depends on the availability of motivated health workers, which are insufficient in many low income settings. Increasing policy and researcher attention is directed towards understanding what drives health worker motivation and how different policy interventions affect motivation, as motivation is key to performance and quality of care outcomes. As a result, there is growing interest among r…
Multisectoral (in)action
Whilst progress has been made, evidence of effective approaches to improve action on addressing the social and structural drivers of the HIV epidemic remains a priority, to meet the 2030 sustainable development agenda, and to achieve key HIV targets, including the 90-90-90 target and the Treatment as Prevention (TasP) intervention. With a focus on the public sector in South Africa, we critically reflect on the HIV mainstreaming approach, assessin…
Social health insurance contributes to universal coverage in South Africa, but generates inequities
By introducing the scheme, the government chose to prioritise access to private sector care for government employees, over improving the availability and quality of public sector services available to all. Government has recently regained its focus on achieving UHC through the public system, but is unlikely to discontinue GEMS, which is now firmly established. The inequities generated by the scheme have thus been institutionalised within the coun…
Performance management in times of change
To strengthen district health services, there should be improvement of processes that enhance the performance of the health system. Implementation of the PA system relies on the extent of management skills at the local level. There is a need to develop managers who have the ability to manage in a transforming and complex environment. This means developing both hard skills such as planning, co-ordination and monitoring and soft skills where one is…
Something Happened
In 2014, something happened. Our colleague, AIDS activist and advocate of restorative justice, Harry Nyathela, was murdered. In the struggle to make sense of his senseless-seeming death, we reflect on the method of telling and listening to stories of violence in a ‘field’ that cannot be separated from everyday living (or dying). For researchers, there is little guidance on how to engage when something violent or traumatic happens. Suffering can n…
Mobile phone use among patients and health workers to enhance primary healthcare
Mobile phones have the potential to improve access to healthcare information and services in low-resourced settings. This study investigated the use of mobile phones among patients with chronic diseases, pregnant women, and health workers to enhance primary healthcare in rural South Africa. Qualitative research was undertaken in Mpumalanga in 2014. Semi structured in-depth interviews were conducted with 113 patients and 43 health workers from sev…
Towards a framework for multisector and multilevel collaboration
The framework does not suggest that multisector collaboration is a panacea, but that MSA remains critical to address complex health and development issues. Focus should be on finding innovative ways to inform and strengthen its implementation in practice. The framework can be used by practitioners and policy makers to inform design, implementation, and evaluation of multisector collaborations. It reflects on complexities of MSA, and brings to the…
The state of enrollment on the National Health Insurance Scheme in rural Ghana after eight years of implementation
Despite the introduction of policy exemptions as an equity measure, the poorest of the poor were rarely identified for exemption. The government must urgently resource the Department of Social Welfare to identify the poor for NHIS enrollment
Process evaluation in the field
This research demonstrates the important role of process evaluation in understanding implementation process of complex interventions. This can help to highlight a broad range of system requirements such as new policies and capacity building to support implementation. Process evaluation is crucial in understanding contextual factors that may impact intervention implementation which is important in considering whether or not the intervention can be…
Impact of financial management centralisation in a health system under austerity
INTRODUCTION: International calls for universal health coverage (UHC) have led many countries to implement health sector reforms, however, since the 2008 global recession, economic growth has slowed in many lower-income and middle-income countries. In a renewed interest in public financial management (PFM), international organisations have emphasised the importance of giving spending control to those responsible for healthcare. However, centralis…
Medicine (29 obras) · Political science (26 obras) · Economic growth (25 obras) · Health care (25 obras) · Nursing (21 obras) · Business (20 obras) · Economics (20 obras) · Global Maternal and Child Health (20 obras) · Sociology (18 obras) · Healthcare Systems and Reforms (16 obras)