5.6 CONTRIBUTIONS AND LIMITATIONS OF THE REVIEW
5.6.3 Limitations of the study
Owing to the timeframe of this review (as outlined in Table 1.2), this study was far from an exhaustive review of rural health development research in South Africa. The search strategy for this study was limited to five databases and academic research published between 2013 and 2018, of which only 50 were selected. This search strategy limited the articles included in the dataset. The timeframe further limited the amount of information gathered and analysed in the scoping searches (pilot study and literature review), thereby restricting the amount of grey literature gathered for this review.
5.7 SUMMARY
This study set out to apply a mixed method approach to a systematic review of South African rural health development research. The findings of the study provided valuable insight into the focus of academic research published between 2013 and 2018, and the degree to which its focus aligned with the research, policies, programmes and strategies of development practitioners, CSOs, NGOs and the South African DOH.
The review found that although research and practice had aligned to an extent, there were important areas of research which had been largely overlooked. It further found that academic research in the field of rural health development relied heavily on participant dependent research methods thereby limiting the exposure of researchers to the phenomena being studied. The importance of evidence-based, rural-proofed policies, strategies and programmes relied on the output of objective research presenting policymakers and practitioners with credible data to utilise in the planning, development and implementation of development strategies and policies.
The prioritisation of rural health needs and the inclusion of rurality as a variable in South African healthcare policy and strategy was crucial. Rural areas had been historically underserved in South Africa, and the health outcomes and infrastructure were a testament to the neglect of rural communities. Rural health development research guided by reviews such as this one is crucial to the improvement of rural health outcomes. It is the responsibility of researchers to engage with the issues of rural health and provide policymakers with the tools to fix a broken system failing the rural communities of South Africa.
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ANNEXURE B: LITERATURE REVIEW CATEGORIES
ROLE OF NGOS AND CIVIL SOCIETY
Broad Theme Categories
Trans-disciplinary collaboration in meeting healthcare goals
L.2.1 Evaluation L.2.2 Advocacy L.2.3 Collaboration
The role of CSOs in rural health development L.2.4 Participation development L.2.5 Community involvement L.2.6 Knowledge sharing
RURAL-PROOFING POLICY
Broad Theme Categories
Process of rural-proofing L.3.1 Geographical considerations L.3.2 Defining rural
L.3.3 Resource distribution Interdisciplinary & interdepartmental cooperation &
collaboration
L.3.4 M&E L.3.5 Governance L.3.6 Evaluation
STATE-LED INTRVENTION AND THEIR RURAL CONSEQUENCES
Broad Theme Categories
National Health Insurance (NHI) L.4.1 Rural-proofing L.4.2 Equity of access
L.4.3 District Health System (DHS) Nelson Mandela/Fidel Castro Medical
Collaboration (Cuban Solution)
L.4.4 Burden of disease/ disease profile
L.4.5 Resource distribution L.4.6 Education
THE SOUTH AFRICAN RURAL HEALTHCARE CONTEXT
Broad Theme Categories
Rural-urban disparities L.5.1 Access
L.5.2 Geographical considerations L.5.3 Resource distribution
District Health System (DHS) L.5.4 Governance
L.5.5 Resource distribution L.5.6 M&E
FINAL CATEGORIES
Structure of Health System LF.1
Rural Context LF.2 Participatory Development LF.3 Resource Distribution LF.4 Governance LF.5 Access LF.6 M&E LF.7 Rural-Proofing LF.8 Evaluation LF.9 SEARCH TERMS
1. Structure of the health system, rural health development, South Africa 2. Rural context, rural health development, South Africa
3. Participatory development, rural health development, South Africa 4. Resource distribution, rural health development, South Africa 5. Governance, rural health development, South Africa
6. Access to health care services, rural health development, South Africa 7. Monitoring and Evaluation, rural health development, South Africa 8. Rural-proofing, rural health development, South Africa