Factors impacting on organisational learning in three rural health districts
South African Family Practice
Centre for Rural Health, University of KwaZulu-Natal, KwaZulu-Natal, South Africa
Background: Access to quality health care in rural areas may be compromised not only by the inadequate numbers of skilled professional staff, but also by the lack of skills of the health professionals who are employed in rural facilities, due to inadequate continual professional learning and staff development. The objective of this paper is to examine the factors impacting on professional staff attendance of informal learning sessions in rural district hospitals and primary healthcare clinics. Methods: Structured, self-administered surveys, adapted from the Dimensions of a Learning Organization Questionnaire, were completed by professional staff on duty during data collection in 18 rural hospitals and their associated primary healthcare services facilities in three rural districts. The impacts of characteristics of staff, such as age, gender, professional experience and length of service, staffing levels, and the dimensions of a learning organisation, viz leadership, culture of change and teamwork, on attendance of learning sessions were considered. Results: Among professional nurses, attendance of learning sessions was significantly associated with the number of years of professional experience, length of service at the health facility, and scores on the teamwork dimension. While in the case of professional nurses attendance was not correlated with the staffing levels, the percentage of posts filled at the respective facilities and the assessment of hospital leadership as being supportive of learning were significant predictors of attendance among doctors. Conclusions: Despite severe staff shortages in these rural districts, at facilities where there was a perception of leadership and teamwork the professional staff generally attended learning sessions.
adult; article; female; health care access; health care facility; health care organization; health care personnel; health care quality; health service; health survey; human; learning; male; medical staff; physician; professional practice; public hospital; questionnaire; rural health care; skill; teamwork