A Communication Strategy for Health in the Kalahari

While all provinces in South Africa have already established health districts (albeit some with interim boundaries), the Northern Cape has decided that its lowest level of decentralised health management will be the regional level. This set-up was decided upon by taking into account that the Province occupies almost one-third of South Africas surface area and yet is home to less than 2% of its total population (giving a total density of only 1.98 persons per square kilometre) (Northern Cape ReHMIS report 1996:7). Another consideration which was accounted for in deciding on health regions instead of the conventional health districts is that budgetary constraints precluded this Province from having too many management structures (Pillay:1997:1). The Province has instituted six health regions viz. Lower Orange, North West, Upper-Karoo, Diamond Fields, Namaqualand and the Kalahari.

It is generally envisaged that the benefits of PHC in most parts of South Africa is likely to be slow as there are many areas (especially rural areas) that are burdened with gross infrastructural deficiencies. The absence of a good road infrastructure, the lack of basic services such as electricity and water, and a deficiency of a good and reliable communication infrastructure, has made (and will continue to make) the implementation of PHC through local health facilities difficult. The Kalahari., however, is quite fortunate in that its primary health care facilities have a relatively good infrastructure compared to other health districts in South Africa. A good indicator of this is that all eight of the fixed clinics in this Region have grid electricity, adequate water supply and a telephone. Road infrastructure in the Region is also comparatively good.

Despite this favourable infrastructural base, the enormous distances between the Regions seven towns (in which the health facilities are located) makes communication for a practical and efficient management of Primary Health Care at this region-wide level, difficult. Also, like in most other areas of South Africa, the information needs of health managers and workers are inadequate and an impediment to a well functioning health locale. Therefore, the successful implementation of a decentralised health care system for the Region will also depend on improving the communication and information needs of health workers, managers and consumers alike.

By being involved in the Kalahari site HealthLink and the Initiative for Sub-District Support (ISDS) have recognised the need to improve communication within the health sector in this Region. In so doing, both have committed themselves to developing certain strategic interventions which will help address the communication issues facing health care in the Kalahari.

Before exploring these interventions it is important to firstly contextualise this communication strategy report against a) the Kalahari Region as a health region b) ISDSs involvement in the Region, and c) the role of HealthLink within the Kalahari.