Strengthening teamwork and respect (STAR) in maternity units: developing a health system intervention in South Africa.

Tanya Doherty ORCID logo ; Ruwayda Petrus ORCID logo ; Sandra Land ; Christiane Horwood ORCID logo ; Veronique Filippi ORCID logo ; Lyn Haskins ORCID logo ; Cleo Phewa ; Sphindile Mapumulo ORCID logo ; Silondile Luthuli ; Vaughn M John ORCID logo ; (2025) Strengthening teamwork and respect (STAR) in maternity units: developing a health system intervention in South Africa. Global health action, 18 (1). p. 2440982. ISSN 1654-9716 DOI: 10.1080/16549716.2024.2440982
Copy

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.

picture_as_pdf

picture_as_pdf
Doherty-etal-2025-Strengthening-teamwork-and-respect-STAR-in-maternity-units.pdf
subject
Published Version
Available under Creative Commons: Attribution 4.0

View Download

Atom BibTeX OpenURL ContextObject in Span Multiline CSV OpenURL ContextObject Dublin Core Dublin Core MPEG-21 DIDL Data Cite XML EndNote HTML Citation JSON MARC (ASCII) MARC (ISO 2709) METS MODS RDF+N3 RDF+N-Triples RDF+XML RIOXX2 XML Reference Manager Refer Simple Metadata ASCII Citation EP3 XML
Export

Downloads