| Summary |
The National Primary Health Care Survey 2000 constitutes a follow-up of the 1997 and 1998 surveys as part of an ongoing monitoring exercise of the status of PHC provided in fixed clinics. The 2000 survey also establishes a baseline of data on the status of PHC provided by satellite and mobile clinics. It also mirrors the status of PHC provision in the country, and highlights major differences between provinces and in urban and rural settings. |
| More Details |
The survey focuses on the following aspects of PHC: range of services, human resources, equipment, infrastructure, drugs and supplies, supervision, record keeping and support. A random sample of 445 clinics (10% per province) was drawn, stratified proportionally according to the actual number of fixed, satellite and mobile clinics.
Despite vast variations amongst the provinces, the 2000 survey generally indicates notable progress towards equity in service provision in as much as:
- Availability of antenatal care has improved substantially since 1997
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- Turn-around times of various tests has improved
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- DOTS has been implemented widely
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- Home visits are conducted in a high percentage of cases
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- Health workers perceive the referral system to be efficient
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- Patient load at fixed clinics were found to be lower than in 1997
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- Availability of electricity increased markedly
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- No expired drugs were found at any of the facilities visited
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- Supply of condoms, oxygen, methyldopa, ORS, penicillin, ciprofloxacin and oral contraception had improved somewhat since 1998.
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On the negative side inequity in PHC provision continues, with notable variation from province to province:
- Various types of tests performed as part of PHC notably tests for HIV and syphilis - are often unavailable
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- Many clinics do not have access to emergency transport
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- Skills updating in STD syndromic management and TB received less attention than in 1998
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- Essential PHC equipment like adult and baby scales and diagnostic kits was found to be unavailable in some cases
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- Telephone and electricity interruptions often occur
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- Many clinics do not have piped water available
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- Mobile clinic vehicles are often regarded as unsuitable for the road conditions they are used in
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- Medical waste is often disposed of by other means rather than incineration
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- Iron tablets, doxycycline and erythromycin were found to be less available compared to previous surveys
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- Clinics in some provinces are poorly stocked with EDL drugs selected for purposes of this survey
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- The drugs prescribed by the National Tuberculosis Programme are not well implemented in all provinces
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- The regularity of nurse supervisor visits has abated since 1997
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- Feedback on reports submitted by clinics is highly unsatisfactory
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- TB record keeping is generally very poor
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- Little progress has been made in facilitating community participation since 1998.
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Thus it would seem that despite the sustained emphasis on the strengthening of PHC in South Africa and worthy progress evidenced by this survey, a more concerted effort is required to accelerate the move towards equity. In comparing the availability of resources and services across the provinces this report should prove useful to the provinces in assessing their progress towards equity relative to that of other provinces. |
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