ArticleAfrican health sciences2020
Barriers and facilitators to implementing coronary care networks in South Africa: a qualitative study.
Article in African health sciences, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
What it found
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.
- Barriers to the Implementation of Acute Coronary Syndrome Guidelines in Healthcare: A Systematic Review.Reviews in cardiovascular medicine · 2026Pooled it
- Using evidence briefs to support future implementation planning: the case of early fibrinolysis for myocardial infarction and rehabilitation for the amputee patient in Colombia.Health research policy and systems · 2026Article
- Article
- A Qualitative Analysis of Barriers to Evidence-Based Care in the Prehospital Management of Patients with Suspected Acute Coronary Syndrome.Prehospital emergency care · 2025Article
- Delays in Cardiovascular Emergency Responses in Africa: Health System Failures or Cultural Challenges?Global health, science and practice · 2024Article
- A resuscitation systems analysis for South Africa: A narrative review.Resuscitation plus · 2024Review
- Patient and provider perspectives on barriers to myocardial infarction care among persons with human immunodeficiency virus in Tanzania: A qualitative study.International journal of STD & AIDS · 2024Article
- Reproductive health issues, infections and non-communicable diseases.African health sciences · 2020Article
Corrections and comments
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Authors and funding
5 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundST-elevation myocardial infarction (STEMI) is on the rise in sub-Saharan Africa. South Africa consistently fails to deliver timely reperfusion to these patients, possibly due to under-developed coronary care networks (CCN).
objectivesTo determine the current perceived state of CCNs, to determine the barriers to optimising CCNs and to suggest facilitators to optimising CCNs within the South African context.
methodsA qualitative descriptive approach was employed, by performing two structured in-depth and two focus group interviews (n=4 and 5, respectively), inviting a purposely heterogeneous sample of 11 paramedics (n=4), doctors (n=5), and nurses (n=2) working within different settings in South African CCNs. Recorded interviews were transcribed verbatim and subjected to content analysis.
resultsParticipants described an under-resourced, unprioritised and fragmented CCN with significant variation in performance. Barriers to CCN optimisation resided in recognition and diagnosis of STEMI, transport and treatment decisions, and delays. Participants suggested that thrombolysing all STEMI patients could facilitate earlier reperfusion and that pre-hospital thrombolysis should be considered. Participants highlighted the need for regionalised STEMI guidelines, and the need for further research.
conclusionNumerous barriers were highlighted. Healthcare policy-makers should prioritise the development of CCNs that is underpinned by evidence and that is contextualised to each specific region within the South African health care system.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.