Universal health care

At present, some (but not all) municipalities provide health services. There is considerable diversity between municipalities in relation to the range and extent of health service provision. Historically, local government health services have been restricted largely to the provision of preventive, promotive and rehabilitative primary care services, with particular emphasis on communicable disease control and environmental health. In addition, some municipalities provide ambulance services on an agency basis for the respective provinces (i.e. ambulance services have historically been a provincial responsibility, but in most cases provinces pay municipalities to provide these services on their behalf). In an effort to reduce fragmentation of health services, some municipalities are increasingly providing integrated preventive and curative primary care services.

This guide is intended for health service managers, providers and consumers in the province. The purpose of the guide is to help all people involved in health care to understand the philosophy underlying the new developments in health care provision in the province help those involved in health care to define their own roles and responsibilities stimulate and guide all involved in health care to translate plans into action and concepts into practice and enable health providers to explain to communities the changes and what the District Health System is all about. The guide will help to accelerate the implementation of integrated health care services within the district health system, based on primary health care principles.

The rapid escalation of drug costs is a world wide problem. But by all accounts, drug prices in South Africa's private sector are among the highest in the world. The South African government has responded to this problem by way of developing a national drug policy . An important element of this is an essential drugs programme which has, in the first instance, been developed for the public sector primary health care facilities.

The delivery of good quality primary level services to all people in South Africa is one of the key policy principles of the post-apartheid national health system.

If the principal aim of the public health sector is to improve the health of South Africans, then our focus must be the health of rural people. In other words, the reform efforts and upheavals which have left the South African health system creaking and groaning in protest must continue until it is turned on its head - and is explicitly biased towards rural health. Rural people bear the greatest burden of disease, mainly because rural people bear the greatest burden of poverty. But paradoxically, urban dwellers are better served by both public and private health care resources. Simply put, rural people are generally poorer and less healthy -and have less access to health care.

An easy-to-read overview of the district health system aimed at everyone in the district health team. This Pocket Guide to District Health Care in South Africa is aimed especially at you as a member of the district health team - whether you work in a government facility, or a non-government organisation, or the private sector. But everyone is welcome to read it!