Strengthening teamwork and respect (STAR) in maternity units: developing a health system intervention in South Africa
Disrespect and abuse in maternity services in South Africa has been described over several decades and are rooted in the country’s complex socio-political landscape and unequal health system which places strain on public sector health professionals. Strategies to improve the quality of health care t...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2025-12-01
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| Series: | Global Health Action |
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| Online Access: | http://dx.doi.org/10.1080/16549716.2024.2440982 |
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| author | Tanya Doherty Ruwayda Petrus Sandra Land Christiane Horwood Veronique Filippi Lyn Haskins Cleo Phewa Sphindile Mapumulo Silondile Luthuli Vaughn M. John |
| author_facet | Tanya Doherty Ruwayda Petrus Sandra Land Christiane Horwood Veronique Filippi Lyn Haskins Cleo Phewa Sphindile Mapumulo Silondile Luthuli Vaughn M. John |
| author_sort | Tanya Doherty |
| collection | DOAJ |
| description | Disrespect and abuse in maternity services in South Africa has been described over several decades and are rooted in the country’s complex socio-political landscape and unequal health system which places strain on public sector health professionals. Strategies to improve the quality of health care typically involve once-off didactic teaching or outside technical consultants focused on improving specific health programmes. These approaches fail to encourage self-reflection or to establish learning cultures. Participatory learning processes, embedded in routine service delivery, are a potentially powerful way to improve ownership and accountability for health system performance. We describe the process followed to develop the Strengthening Teamwork and Respect (STAR) intervention which is being implemented in nine district hospitals in two rural districts of KwaZulu-Natal. The intervention approach draws on a conceptual framework for learning health systems, with intervention strategies informed by participatory learning and action theory. The intervention design was an iterative process informed by literature reviews, formative data collection, consultation with provincial, district and hospital management stakeholders, expert reviewer inputs and piloting of proposed activities. This process produced the STAR intervention approach and toolkit, consisting of: identification and training of champions, creation of STAR teams, convening of learning sessions to work through STAR toolkit activities, identification, implementation and monitoring of change projects, and onsite and virtual mentorship from the STAR development team. Endline cross-sectional surveys and a parallel process evaluation will advance the evidence base for interventions to improve respectful care and cultures of teamwork and learning within maternity units in rural low- and middle-income settings. |
| format | Article |
| id | doaj-art-517f5e1bcfb84e6e8a994aaf28ef32db |
| institution | Kabale University |
| issn | 1654-9880 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Global Health Action |
| spelling | doaj-art-517f5e1bcfb84e6e8a994aaf28ef32db2025-02-11T15:10:10ZengTaylor & Francis GroupGlobal Health Action1654-98802025-12-0118110.1080/16549716.2024.24409822440982Strengthening teamwork and respect (STAR) in maternity units: developing a health system intervention in South AfricaTanya Doherty0Ruwayda Petrus1Sandra Land2Christiane Horwood3Veronique Filippi4Lyn Haskins5Cleo Phewa6Sphindile Mapumulo7Silondile Luthuli8Vaughn M. John9South African Medical Research CouncilUniversity of KwaZulu-NatalDurban University of TechnologyUniversity of KwaZulu-NatalLondon School of Hygiene and Tropical MedicineUniversity of KwaZulu-NatalUniversity of KwaZulu-NatalUniversity of KwaZulu-NatalUniversity of KwaZulu-NatalUniversity of KwaZulu-NatalDisrespect and abuse in maternity services in South Africa has been described over several decades and are rooted in the country’s complex socio-political landscape and unequal health system which places strain on public sector health professionals. Strategies to improve the quality of health care typically involve once-off didactic teaching or outside technical consultants focused on improving specific health programmes. These approaches fail to encourage self-reflection or to establish learning cultures. Participatory learning processes, embedded in routine service delivery, are a potentially powerful way to improve ownership and accountability for health system performance. We describe the process followed to develop the Strengthening Teamwork and Respect (STAR) intervention which is being implemented in nine district hospitals in two rural districts of KwaZulu-Natal. The intervention approach draws on a conceptual framework for learning health systems, with intervention strategies informed by participatory learning and action theory. The intervention design was an iterative process informed by literature reviews, formative data collection, consultation with provincial, district and hospital management stakeholders, expert reviewer inputs and piloting of proposed activities. This process produced the STAR intervention approach and toolkit, consisting of: identification and training of champions, creation of STAR teams, convening of learning sessions to work through STAR toolkit activities, identification, implementation and monitoring of change projects, and onsite and virtual mentorship from the STAR development team. Endline cross-sectional surveys and a parallel process evaluation will advance the evidence base for interventions to improve respectful care and cultures of teamwork and learning within maternity units in rural low- and middle-income settings.http://dx.doi.org/10.1080/16549716.2024.2440982maternity carerespectful careteamworkhealth system interventionparticipatory learning and actionlearning health systems |
| spellingShingle | Tanya Doherty Ruwayda Petrus Sandra Land Christiane Horwood Veronique Filippi Lyn Haskins Cleo Phewa Sphindile Mapumulo Silondile Luthuli Vaughn M. John Strengthening teamwork and respect (STAR) in maternity units: developing a health system intervention in South Africa Global Health Action maternity care respectful care teamwork health system intervention participatory learning and action learning health systems |
| title | Strengthening teamwork and respect (STAR) in maternity units: developing a health system intervention in South Africa |
| title_full | Strengthening teamwork and respect (STAR) in maternity units: developing a health system intervention in South Africa |
| title_fullStr | Strengthening teamwork and respect (STAR) in maternity units: developing a health system intervention in South Africa |
| title_full_unstemmed | Strengthening teamwork and respect (STAR) in maternity units: developing a health system intervention in South Africa |
| title_short | Strengthening teamwork and respect (STAR) in maternity units: developing a health system intervention in South Africa |
| title_sort | strengthening teamwork and respect star in maternity units developing a health system intervention in south africa |
| topic | maternity care respectful care teamwork health system intervention participatory learning and action learning health systems |
| url | http://dx.doi.org/10.1080/16549716.2024.2440982 |
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