Indigenous knowledge and caregivers' use of data elements in home-based healthcare

Abstract

Home-Based Healthcare (HBHC) is an important aspect of South Africa's healthcare system. HBHC is the provision of care services to patients by trained or semi-trained caregivers at home. In South Africa HBHC was introduced in 2001 to address many problems with traditional healthcare such as overcrowding in public health facilities. South Africa has one of the highest HIV/AIDS infection rates in the world, which is often accompanied by opportunistic infections such as tuberculosis. HBHC is envisaged to address these challenges, thus relieving the burden on primary healthcare. HBHC is itself faced with many problems which include poor information or data management, unclear information flows, and insufficient information storage. It is also not clear how caregivers use data elements and there is no coherent indigenous knowledge base for the capturing, implementation and utilisation of data elements in local HBHC providers. This is particularly important to caregivers who rely on frameworks of indigenous knowledge in interpreting and making decisions on how to provide a care service to patients. In reality, caregivers operate in indigenous environments requiring the utilisation of local knowledge. This study explores the relationships between, and approaches to, data elements in different HBHC providers and communities. Three interpretive case studies in the Eastern and Western Cape Provinces of South Africa were conducted. Semistructured interviews, focus groups, participant observation and document analysis were used for data collection. The primary research question was: What happens when caregivers from various communities interact with data elements when providing a care service? Caregivers' indigenous knowledge and use of data elements was then harnessed in a knowledge base. The results from this study can be used by HBHC managers to develop their forms and training materials as the initial set of data elements used in HBHC has been identified. Caregivers from different communities can also learn how these data elements are used in other communities.