Browsing by Author "George, Gavin Lloyd."

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Cost-effectiveness analysis of an HIV-adapted training and continuous quality improvement supervisory intervention for community caregivers.
(2015) Mudzingwa, Takunda.; George, Gavin Lloyd.; Dobreva, Ralitza Vassileva.
Background It is argued that supportive supervision increases the performance of community health workers and this is evidenced by an increased uptake of interventions in health facilities located in the CHWs catchment area. Method A retrospective economic evaluation conducted from an implementer’s perspective of a two-arm cluster randomised control trial (RCT) that was implemented during the period May 2012 – November 2013 by the Centre for Rural Health at the University of KwaZulu-Natal (CRH-UKZN) in the Ugu Health District located in the province of KwaZulu-Natal. This RCT compared the cost-effectiveness of the training and supervision of community caregivers (CCGs) provided by the KwaZulu-Natal provincial Department of Health relative to the HIV-adapted community case management (CCM) training and continuous quality improvement (CQI) supervision of community care givers (CCGs) implemented by Centre for Rural Health at the University of KwaZulu-Natal (CRH-UKZN). The behavioural changes under consideration were (i) prevalence of antenatal booking before 20 weeks have lapsed in a woman’s pregnancy; (ii) prevalence of the number of women who present themselves for post-natal care within seven days of delivery; (iii) the prevalence of exclusive breast-feeding practice and the (iv) coverage of Human Immunodeficiency Virus Polymerase Chain Reaction (HIV PCR) testing of babies. Results The uptake of the target interventions were not statistically different between the control group and the intervention group; with the exception of the prevalence of exclusive breastfeeding. The intervention was more costly than the control in addition to being less cost-effective where the former was R19, 942 and the latter R8,389 per mothers practicing exclusive breast feeding., Conclusion The health outcomes achieved did not justify the additional costs of frequent supervision in the intervention, but rather the focus should be on quality and consistency of the supervision.
Early resumption of sex following voluntary medical male circumcision amongst school-going males.
(Public Library of Science., 2016) George, Gavin Lloyd.; Govender, Kaymarlin.; Beckett, Sean.; Montague, Carl.; Fröhlich, Janet Ann.
Abstract available in pdf.
Factors associated with the take-up of voluntary medical male circumcision amongst learners in rural KwaZulu-Natal.
(National Inquiry Services Centre., 2017) George, Gavin Lloyd.; Govender, Kaymarlin.; Beckett, Sean.; Montague, Carl.; Fröhlich, Janet Ann.
Abstract available in pdf.
Health expenditure, health outcomes and productivity in sub-Saharan Africa: sustainable thresholds, moderation and forecasting.
(2023) Adegoke, Yetunde Oluranti.; George, Gavin Lloyd.; Mbonigaba, Josue.
SSA is known to be confronting distinctive health problems and growth challenges, thereby, inadequate health expenditure, poor health outcomes and their implications for productivity require investigation. This situation persists despite evidence-related policy produced in the past, suggesting the need to investigate further the nature of the relationship between interrelated variables. This study aims to investigate the nonlinear effect of PHE on health outcomes and the moderating role of education on health outcomes, forecast the performance of different PHE scenarios in achieving the 2030 Sustainable Development Goals (SDGs), examine the effect of PHE and health outcomes on TFP and assess the moderating role of education in the relationship between PHE and TFP. The study utilizes various techniques including Panel spatial correlation consistent-ordinary least squares (PSCC-OLS and PSCC-FE) for Objective One, Feasible quasi-generalized least squares (FQGLS) for Objective Two. Fixed and random models, panel two-stage least squares (P2SLS), and panel threshold regression for Objective Three. System panel generalized method of moments (GMM) for Objective four. This study concludes a nonlinear relationship between PHE and health outcomes exists. Furthermore, the interaction of PHE and education would improve health outcomes. Second, an overall increase in PHE by 30% would achieve the SDG target of 70 maternal deaths in only Botswana, Namibia and South Africa. In addition, about 60% of the countries in SSA might be able to achieve the SDG target for child mortality by the year 2030. Third, including PHE and health outcomes into the TFP framework would guarantee a further increase in TFP growth in SSA, and a threshold level of PHE above 3.5% of the GNP could achieve better health outcomes and a further increase in TFP growth in SSA. Fourth, the interactive impact of PHE and education might cause an improvement in TFP in SSA. The study pioneers the investigation of nonlinear, threshold, moderating, forecasting and collaborative effect of PHE, the information is essential for optimizing, redistributing and utilization of resources, specifically, a minimum of 38 dollars per person will achieve better health and productivity in SSA.
HIV risk among adolescent girls and young women in age-disparate partnerships: evidence from KwaZulu-Natal, South Africa.
(Wolters Kluwer., 2018) Maughan-Brown, Brendan.; George, Gavin Lloyd.; Beckett, Sean.; Evans, Meredith.; Lewis, Lara.; Cawood, Cherie.; Khanyile, David.; Kharsany, Ayesha Bibi Mahomed.
Abstract available in pdf.
The impact of national strategies in addressing challenges faced by human resources for health in rural KwaZulu-Natal.
(2013) Mburu, Grace Wambui.; George, Gavin Lloyd.
The shortage of Human Resources for Health (HRH) is critical in developing countries. In South Africa, the capacity of HRH has reduced significantly since the 1990s, which can be attributed to e.g. emigration of health professionals to developed countries, increased disease burden, and insufficient production of HRH. This raises concerns as South Africa is home to the largest population of people living with HIV globally, estimated at 5.7 million. The distributions of HRH between urban and rural areas are notably uneven, largely due to problems of attracting and retaining workers to the rural areas. It is estimated that 46% of the population lived in rural areas but are only served by 12% of doctors and 19% of nurses. Furthermore, the shortage of HRH in the rural areas is as a result of the challenges faced by the HRH in the rural areas namely: poor working and living conditions, inadequate salaries and benefits, lack of training and career development opportunities among others. The Government has come up with several policy initiatives and National strategies aimed at addressing these challenges including community service, recruitment of foreign doctors to work in under-served areas, provision of rural allowance, and the Occupational Specific Dispensation (OSD). This study sought to determine the challenges faced by HRH in rural KwaZulu-Natal (KZN) and to review the impact of National strategies in addressing these challenges. The study is based on the talent management theoretical framework which emphasizes on adopting the right attraction, selection, engaging, developing, and retention strategies. The study was conducted in Hlabisa sub-district of Umkhanyakude located in northern KwaZulu-Natal. Cluster sampling was used to select 17 clinics into 3 groups. A random sampling was then used to select the two clinics from each cluster to be used in the study. Data was collected by conducting in-depth individual interviews among 25 HRH. A tape recorder was used to capture data, which was then analysed by highlighting the key statements which were used to identify themes. The themes for each interview were then compared to identify commonalities and differences in order to come up with overall themes which provided basis for writing up how these respective themes are interrelated. v The findings of the study provide evidence on the impact of policy interventions in addressing the challenges faced by HRH in rural areas. In line with previous studies, the study shows that national strategy initiatives aimed at addressing the challenges faced by HRH in the rural areas are working but only to a certain extent. For example the health professionals are happy with the implementation of OSD, which means the government has adequately addressed the issue of salaries. The community service and recruitment of foreign doctors to work in rural areas is partially addressing the problem of staff shortage. However, some of the specific challenges like the poor working and living conditions which greatly contribute to the HRH decision to leave the rural areas do not have specific strategies addressing them. Therefore, there is need for a more comprehensive approach in the formulation of these strategies to ensure that the challenges are addressed adequately. Our study highlights the need for a constant review of the impact of the Government strategies against the challenges they are designed to mitigate to ultimately address shortage of HRH in rural areas. Some of the study limitations include: limited literature on the topic since there are very few evidence based studies that have looked at how national strategies are impacting on the challenges of HRH in rural areas. the talent management theoretical framework was adopted in the absence of a more appropriate framework on management of scarce skills, and the study was conducted in one of the sub-districts in KZN which might limit its generalisability to other settings.
Strengthening HIV surveillance in the antiretroviral therapy era: rationale and design of a longitudinal study to monitor HIV prevalence and incidence in the uMgungundlovu District, KwaZulu-Natal, South Africa.
(BioMed Central., 2015) Kharsany, Ayesha Bibi Mahomed.; Cawood, Cherie.; Khanyile, David.; Grobler, Anna Christina.; McKinnon, Lyle R.; Samsunder, Natasha.; Fröhlich, Janet Ann.; Abdool Karim, Quarraisha.; Puren, Adrian.; Welte, Alex.; George, Gavin Lloyd.; Govender, Kaymarlin.; Toledo, Carlos.; Chipeta, Zawadi.; Zembe, Lycias.; Glenshaw, Mary T.; Madurai, Lorna.; Deyde, Varough M.; Bere, Alfred.
Abstract available in pdf.