Action for health in Impendle/Pholela/Underberg 1997/98 : ISDS Technical Report 2d

Introduction

The Impendle, Pholela and Underberg (IPU) district unit is one of six provisional districts in the Indlovu Region (Region B) of KwaZulu-Natal (see Map 1).

The district has a history of innovative interventions in health care delivery. In 1940, Sydney and Emily Kark established a pioneer rural health unit at Pholela. The Pholela Health Centre was the first community health centre in Natal Province. By 1943 this unit was demonstrating the effectiveness of an integrated curative-preventive approach to health needs.

The health centre delivered community-oriented primary health care where principles of community involvement, multi-sectoral collaboration and preventive and promotive health were implemented. Unfortunately the Karks initiative did not receive continued support from the government and the initial gains were not sustained.

Another more recent intervention was the District Team Problem Solving exercise introduced by the Centre for Health and Social Studies (CHESS). The programme has contributed towards improving health care delivery in the district by giving district level health management staff the skills to analyse and solve health problems.

More recently, the Initiative for Sub-District Support (ISDS) has sought to promote district development by focusing on those factors which affect the quality of care in selected districts around South Africa. The IPU district is one of these sites.

A situation analysis was done to find out and report on the health services in the district. The intention was to make the analysis as participatory as possible. Different health workers were asked to collect information on the conditions, resources, problems and needs of each sub-district and to share this with colleagues from other sub-districts.

Several meetings were held in different health facilities to inform people as to what information would be useful. These meetings included the nursing staff, environmental health officers, general assistants, security officers, representatives from community forums (Hlanganani Development Forum), preschool committees and local traditional medical practitioners. The following is a report on the findings of that process.