title: Mapping South African allied health primary care clinical guideline activity: establishing a stakeholder reference sample.
abstract: BACKGROUND
  Little is known about allied health (AH) clinical practice guideline (CPG) activity in South Africa, and particularly in relation to primary health care (PHC). This paper reports on a scoping study undertaken to establish a reference framework, from which a comprehensive maximum variation sample could be selected. This was required to underpin robust sampling for a qualitative study aimed at understanding South African primary care AH therapy CPG activities. This paper builds on findings from the South African Guidelines Evaluation (Project SAGE) Flagship grant.
  
  
  METHODS
  South African government websites were searched for structures of departments and portfolios, and available CPGs. Professional AH association websites were searched for CPGs, purposively-identified key informants were interviewed, and CPGs previously identified for priority South African primary care conditions were critiqued for AH therapy involvement.
  
  
  RESULTS
  Key informants described potentially complex relationships between players who may be engaged in South African AH CPGs, in both public and private sectors. There were disability/rehabilitation portfolios at national and provincial governments, but no uniformity in provincial government organisation of, or support for, PHC AH services. There were no AH primary care therapy CPGs on government websites, although there was 'clinical guidance' in various forms on professional association websites. Only two CPGs of priority South African PHC conditions included mention of any AH therapy (physiotherapy for adult asthma and chronic obstructive pulmonary disease).
  
  
  CONCLUSIONS
  A comprehensive and wide-reaching stakeholder reference framework would be required in order to capture the heterogeneity of AH primary care CPG activity in South Africa. This should involve the voices of national and purposively-selected provincial governments, academic institutions, consultants, public sector managers and clinicians, private practitioners, professional associations, and private sector insurers. Provincial governments should be selected to reflect heterogeneity in local economics, population demographics and availability of university AH training programs. This investigation should aim to determine the areas of PHC in which AH are engaged.
authors.affiliation: Centre for Evidence-Based Health Care (CEBHC), Faculty of Medicine and Health Sciences Stellenbosch University, Francie van Zijl Drive, Tygerberg, 7505, Cape Town, South Africa. dizonj@sun.ac.za.|Center for Health Research and Movement Science, University of Santo Tomas, Espana, Manila, 1018, Philippines. dizonj@sun.ac.za.
authors.forename: Janine Margarita
authors.initials: JM
authors.lastname: Dizon
authors.affiliation: International Centre for Allied Health Evidence (iCAHE), University of South Australia, City East Campus, P4-18 North Terrace, Adelaide, 5000, Australia.|Department of Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, 7505, Cape Town, South Africa.
authors.forename: Karen
authors.initials: K
authors.lastname: Grimmer
authors.affiliation: Cochrane South Africa, South African Medical Research Council, Francie van Zijl Drive, Parow Valley, 7505, Cape Town, South Africa.
authors.forename: Shingai
authors.initials: S
authors.lastname: Machingaidze
authors.affiliation: Disability Action Research Team (DART), Howick, KwaZulu-Natal, South Africa.
authors.forename: Pam
authors.initials: P
authors.lastname: McLaren
authors.affiliation: Department of Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Francie van Zijl Drive, Tygerberg, 7505, Cape Town, South Africa.
authors.forename: Quinette
authors.initials: Q
authors.lastname: Louw
mesh_terms: D000328:Adult; D016390:Allied Health Occupations; D000488:Allied Health Personnel; D002648:Child; D003695:Delivery of Health Care; D006076:Government; D006296:Health Services; D006801:Humans; D009938:Organizations; D017410:Practice Guidelines as Topic; D011320:Primary Health Care; D017149:Private Sector; D017150:Public Sector; D013019:South Africa
keywords: Allied health; Clinical practice guidelines; Primary health care; South Africa