basic services

This report seeks to add impetus to the process of improving the efficiency of services and access to information at the PHC level by attempting to develop a communication strategy at a sub-district level. It is based on an evaluation of the Impendle/Pholela/Underberg ISDS site and highlights the role of both HealthLink and ISDS within it.

Since Primary Health Care (PHC) has now been accepted as the foundation of health care delivery in South Africa, Health Districts have become the microstructure through which this health care system will be implemented. While it is hoped that the traditionally under-resourced areas of South Africa will benefit most from the new emphasis on PHC, the move to a fully functional district health system is bound to be a slow and retarded process. This is primarily due to the enormity of the task of restructuring a health sector ravaged by the legacy of apartheid development. Current changes taking place in implementing primary health care are still only transitionary. Existing district boundaries are still only of an interim nature, healthcare personnel in key positions within the Health Districts have only been appointed on an interim basis, and educating and driving home the importance of the district health system to health workers and communities in remote areas of the country will take time to yield its desired level of acceptance.

Since Primary Health Care (PHC) is now accepted as the foundation of health care delivery in South Africa, health districts have become the vehicle through which this health care system will be implemented. One of the main reasons for the establishment of the district health system is to engender a move towards decentralised health management. The basic modus operandi for the management and delivery of health care is through a hierarchical four-tiered structure: i.e. national, provincial, regional and district level. The national Department of Health is responsible for overall co-ordination and determination of national health policy the provincial Departments are responsible for the co-ordination of the health system within each province, for the provision of specialist health services, and for the monitoring and support of districts and the district/regional authorities are responsible for the actual delivery of health care and for the provision of non-specialist health services within each district.

If your interest in youth health has been aroused by the escalating figures of the prevalence of HIV infection amongst South African youth, you would be convinced that the epidemic has managed to send a wake up call to all organisations and institutions targeting youth health.