Primary health care

Community Participation (CP) is the cornerstone of the Primary Health Care (PHC) approach and a central tenet of current government health policy. However, the successful imlpementation of community participation is bedevilled by differences in the understanding of what is meant by community participation and what motivates health services to seek CP.

Health Systems Trust publishes its
13th edition of the South African Health Review
PRIMARY HEALTH CARE IN SOUTH AFRICA: A REVIEW OF 30 YEARS SINCE ALMA ATA

South Africas top researchers, policy makers, managers and providers have released the outcome of a roundtable discussion held last year, where they grappled with antiretroviral access and the health systems capacity to cope with the increasing demand.

We, the members of the National Consultative Health Forum, representing government, public and private health sectors, statutory bodies, academic and research institutions, community organisations, civil society, non-governmental organisations and organised labour, in our meeting at Birchwood conference centre, Gauteng Province, held on 10-11 April 2008, on Primary Health Care to commemorate the 30th anniversary of the Alma Ata Declaration, hereby:

The use of health care services has almost doubled over the past eight years with 101 million visits to clinics in the 2006/07 financial year, says Health Minister Manto Tshabalala-Msimang.

South Africa faces the most intricate human resource challenges characteristic of health systems in many other countries. Ensuring an adequate human resource pool for the staffing of especially the public health sector is a major task that is complicated by many global and disease burden challenges. Even though the private health sector is not experiencing the same pressures to the same degree, maldistribution within this sector is a serious challenge. Developing a human resource plan for health is very high on the agenda of the National Department of Health. It is globally recognized that a focused human resource strategy backed up by an appropriate implementation plan is a critical ingredient of positive change in health care. Success in this area helps create a positive image and an environment conducive for health care to flourish. Equity, efficiency and effectiveness of the health system depend on the two elements a visionary strategy and a focused plan being appropriately developed and implemented.

The purpose of the National Primary Health Care (PHC) Facilities Survey is to measure progress with regard to availability, accessibility, effectiveness, efficiency and quality of PHC service provision. Comparisons with previous national PHC facilities surveys (1998, 2000) allow conclusions to be drawn about trends and progress made over the past six years at national and provincial levels. This report is one of a series that was compiled from data collected for the national PHC Facilities Survey 2003. As with preceding surveys, this survey seeks to draw conclusions about equity in PHC service provision by means of quantitative description of the services and required resources in a sample of PHC facilities. It is intended that these periodic surveys of PHC facilities will help to promote the use of information in planning and management of services. The survey provides health managers with information that allows them to decide on priority interventions and assists them to appropriately target areas where intervention is most required.

Government health policy emphasises the importance of both decentralisation and equity in the public health sector (NDoH, 2002). The draft National Health Bill establishes a health system with decentralised management (p7) and, in particular, a district health system based on a PHC approach (p38). Concurrently, it states that provinces and municipalities must implement the system with regard to key principles, the foremost being equity (p38). However, it is unclear whether decentralisation and equity exist in harmony particularly in relation to the financing of PHC. This report explores this issue by evaluating the funding of non-hospital PHC services, within the decentralised South African system, against indicators of need. An output of the Local Government and Health Consortium, funded by Health Systems Trust and comprising Health Systems Trust, Centre for Health Policy and Health Economics Unit

Work as part of a team training Primary Health Care nurses for the Limpopo province, based at Tintswalo hospital in the Health Systems Development Unit which is jointly managed by Wits University and the Limpopo DoH. Duties include: * teaching of PHC nursing students and qualified PHC nurses (updates) * spend up to 20% clinical time at the hospital, clinics or some of the units' other programmes e.g. HIV/AIDS research program. Location: The location is in a beautiful area, within half an hour of the Kruger National Park with many private game reserves, the Drakensburg escarpment, the Blyde River Canyon and more, in Acornhoek city, Bohlabela District, Limpopo Province, South Africa. Requirements: Registration with HPCSA as medical practitioner. Additional qualifications in medicine and teaching will be an advantage. Availability of the job: From 01.01.2004 onward Salary: According to experience e.g. MO, SMO, included rural allowance and optional overtime at the hospital. For more details on the job: Contact Dr Theunis Kotzee Cell:+27 072 428 3510, Tel/Fax:+ 27 013 795 5076, Email:adelek@mighty.co.za