Clinic

Community participation is widely accepted as a desirable feature of any health system and is considered to be an important aspect of developing and fostering effective governance at various levels of the health system. Good governance is a fundamental tenet of South African health care and the National Health Act No. 61 of 2003, makes provision for formally constituted, broad based governance structures which include community representation at various levels of healthcare delivery. Effective governance of the health system is critical to ensure both access to quality health services and the accountability of the health services to communities.

An in-depth case study was done looking at two primary care clinics serving the same community. One clinic is a typical government-funded public sector clinic offering a comprehensive 24-hour service the other is an NGO-funded day clinic offering a range of primary care services. The aim of the research was to understand and explore key issues in the functioning of the two clinics, in order to draw out lessons for district management teams. A variety of information was collected, using different methods. This included patient statistics, staff numbers, stock levels of drugs, perceptions of patients in the clinic and of people in the surrounding community, perceptions of staff using both questionnaires and individual interviews, perceptions of students, participant observations, etc. Comparison of each set of data collected in the two clinics was done, to highlight common issues and to understand similarities and differences.

This booklet is a step-by-step guide for monitoring and evaluating some key aspects of quality of STI management at Primary Health Care facilities in the public sector.

This book is written to explain the purpose of the District STI Quality of Care Assessment tool (DISCA)and to provide a clear guide for the correct use of this tool.It is written for district managers,clinic supervisors andother members of staff who would be involved in conducting an evaluation of the quality of care provided to people with sexually transmitted infections (STIs). In the appendix are a number of teaching guides related to aspects of STI management that could be photocopied and left at clinics to assist the clinicians.

This study aimed to assess the integration of HIV/AIDS care and support in Gautengs primary health care (PHC) services. With this aim in mind, the research sought to provide answers to three main sets of questions. Firstly, are care and support services for people with HIV/AIDS being provided at PHC clinics, what is the quality of these services, and to what extent are these services being utilised? Secondly, are the inputs (e.g. staff knowledge and attitudes) and support systems (e.g. drug supplies), necessary for good quality, accessible HIV/AIDS care, present in the PHC infrastructure? Thirdly, what if any, systems changes are required to improve the access and quality of PHC services for people living with HIV/AIDS? This research was conducted in collaboration with, and partly funded by, the Gauteng Provincial Department of Health which is in the process of disseminating primary health care clinical guidelines in the Province.

The concept of doctors visiting clinics to support primary health care is well established but the role that these doctors should play is not clear, and varies from area to area.

This report covers the deliberations during the visit on 30 April 1999 as well as other information gathered during and after the visit. The report aims to assist the district management team to prioritise future activities in financial management and in enhancing their capacity.

The care and management of patients with STDs is inadequate in South Africa. The endemicity of STDs, and the synergy between STDs and HIV, makes rectification of this situation urgent. To improve and sustain the quality of STD care delivery at primary care level, it is essential that district managers are given a method of obtaining quality of care information at regular intervals.