BACKGROUND Most sub-Saharan African countries struggle to make safe surgery accessible to rural populations due to a shortage of qualified surgeons and the unlikelihood of retaining them in district hospitals. In 2002, Zambia introduced a new cadre of non-physician clinicians (NPCs), medical licentiates (MLs), trained initially to the level of a higher diploma and from 2013 up to a BSc degree. ...

South Africa made a decision in 2002 to develop so-called mid-level medical workers, now known as clinical associates. This article describes the background to this decision, and the national process of developing the profession and its scope of practice, which was aligned with the needs of the health service, particularly those of rural district hospitals. A common national curriculum was then...

BACKGROUND Much has been written about the patient-centred approach in doctor-patient consultations. Little is known about interactions and communication processes regarding healthcare providers' and patients' perspectives on expectations and experiences of diagnostic imaging investigations within the medical encounter. Patients journey through the health system from the point of referral to th...

The German Research Network On Schizophrenia (GRNS) is a nationwide network currently comprising 16 psychiatric university departments and 14 state and district hospitals, as well as six local networks of psychiatric practices and general practitioners collaborating on about 25 interrelated, multicenter projects on schizophrenia research. The GRNS aims to intensify collaboration and knowledge e...

BACKGROUND In most countries of the sub-Saharan Africa, health care needs have been increasing due to emerging and re-emerging health problems. However, the supply of health care resources to address the problems has been continuously declining, thus jeopardizing the progress towards achieving the health-related Millennium Development Goals. Namibia is no exception to this. It is therefore nece...

OBJECTIVES We examined findings from a randomized controlled intervention trial designed to improve the quality of life of people living with HIV in Thailand. METHODS A total of 507 people living with HIV were recruited from 4 district hospitals in northern and northeastern Thailand and were randomized to an intervention group (n = 260) or a standard care group (n = 247). Computer-assisted pe...

In response to increasing high school graduation requirements along with emerging skills in the workforce, the focus of career academies has evolved from one of keeping students enrolled in high school through graduation to a more robust preparation for college and careers for all students. This new focus may have resulted in a demographic shift in the students participating in career academies...

BACKGROUND Mid-level medical workers play an important role in health systems and hold great potential for addressing the human resource shortage, especially in low- and middle-income countries. South Africa began the production of its first mid-level medical workers - known as clinical associates - in small numbers in 2008. OBJECTIVE We describe the way in which scopes of practice and course...

BACKGROUND Achieving high rates of adherence to antiretroviral therapy (ART) in resource-poor settings comprises serious, but different, challenges in both the first months of treatment and during the life-long maintenance phase. We measured the impact of a health system-oriented, facility-based intervention to improve clinic attendance and patient adherence. METHODS This was a quasi-experime...

Two hundred consecutive male cases of myocardial infarction have been treated along lines designed to provide a minimal time spent in bed, and in hospital, with early return to work. The method of treatment and the results are described. Rapid rehabilitation enabled 40 per cent to be discharged within a fortnight and 87 per cent within a month. Twenty-three per cent returned to work within 4 we...