a University of Michigan Medical School, Ann Arbor, MI, USA b Ghana Health Service, Sekyere Kumawu District Health Directorate, Kumawu, Ghana c Department of Obstetrics and Gynecology, University of Science and Technology School of Medical Sciences, Kumasi, Ghana d Ghana Health Service, Bosomtwe District Health Directorate, Bosomtwe, Ghana e Department of Epidemiology, University of Michigan Sc...

BACKGROUND Communication between health workers and patients at Hottentots Holland Hospital (HHH) is hindered by staff and patients not speaking the same language. HHH is a district hospital in the Cape Town Metropolitan District of the Western Cape where staff mainly speak Afrikaans or English and a large number of patients mainly Xhosa. OBJECTIVES The study aimed to explore the effects of t...

BACKGROUND Understanding customers has become an urgent topic for increasing competitiveness. The purpopse of the study was to develop a qualitative dynamic attribute value model which provides insight into the customers' value for healthcare institute managers by conducting the initial open-ended questionnaire survey to select participants purposefully. METHODS A total number of 427 question...

BACKGROUND The Nursing Act 33 of 2005 holds nurse practitioners responsible for all acts and omissions in the delivery of quality patient care. But quality patient care is influenced by a number of factors beyond the control of nurse practitioners. Patient safety culture is one such factor and is seldom explored in hospitals in developing countries. This article describes the patient safety cul...

The role of the leader of a medical unit has evolved over time to expand from simply a medical role to a more managerial one. This study aimed to explore how the behavior of a hospital-based emergency department's (ED's) leader might be related to ED unit performance and ED employees' work satisfaction. One hundred and twelve hospital-based EDs in Taiwan were studied: 10 in medical centers, 32 ...

Small hospitals sit at the apex of the pyramid of primary care in the health systems of many low-income countries. If the Millennium Development Goal for child survival is to be achieved, hospital care for referred severely ill children will need to be improved considerably in parallel with primary care in many countries. Yet little is known about how to achieve this. This article describes the...

BACKGROUND The hierarchical pyramid inside Spanish public hospitals was radically changed by the Health Reform Law promulgated in 1986. According to it, the manpower of the hospitals was divided into three divisions (Medical, Nursing, General Services/Administration), which from then on occupied the same level, only subject to the general manager. Ten years after the implementation of the law, ...

I am a pediatric emergency physician in Calgary, Alta, and have been active in international health for more than 25 years. The last time I had been in Africa was in 1985 when I ran a district hospital in Lesotho in southern Africa. My husband and I had always wanted to return to the continent but career, children, and time got in the way. When those factors finally aligned, we were able to onc...

The diagnosis of Buruli ulcer should be considered in all painless undermined ulcers in the tropics. The diagnosis and treatment are a challenge in rural settings despite the well established tuberculosis programmes. Immediate commencement on rifampicin and streptomycin is essential to halt the progression of disease and to, hopefully, reverse it. Surgery is indicated in those with complex ulc...

Case detection, diagnosis and treatment of tuberculosis 1 B) in children are challenging issues vorldwide. This study in Afghanistan aimed to evaluate paediatric TB case management, including contact investigation, at health facilities where all diagnostic processes were available. In 7 out of 8 regions of the country 1 province was selected. Documents used for management of paediatric TB cases...