Primary health care in Mpumalanga - Guide to district based action

Beck, Maureen
Other Authors: 
Harrison, David [ed]
Publication Year: 
South Africa
Published by: 
Health Systems Trust


Mpumalanga is one of the nine provinces of the Republic of South Africa. The population of the province is about 3 150 000 (1993 estimate).1 There are 10 provincial government departments. One of these is the Department of Health, Welfare and Gender Affairs which is responsible for the Health portfolio. Within this department, there are two chief directorates: one for health and the other for welfare and a sub-directorate of Gender Affairs which gives policy support to all the provincial departments.

Tremendous change is taking place in the character and organisation of health services in Mpumalanga. These changes are in accordance with policy guidelines from the National Department of Health2, and they involve:

  • decentralisation of services to the regions and districts to bring the services close to the people
  • adoption of the district health system as the vehicle for health care delivery in the province
  • the choice of primary health care as the strategy for delivery of universal health care to individuals, families and communities in the province
  • the need to involve stakeholders in planning and delivery of health services to the communities through meaningful community participation and
  • the need and desire to create a health service that cares for, and is responsive to client needs.

This guide is intended for you (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. As the key actions highlighted in the guide are put into practice, the province will be able to achieve its health goals and objectives - in line with the goals of the Reconstruction and Development Programme and the National Programme of Action for Children in South Africa. The guide provides a detailed description of the health services and should not be seen as prescriptive, but as providing guidelines. In applying the guidelines, you are encouraged to use your initiative and judgement.

The guide is divided into four parts. The first part, on service organisation and management, contains four chapters. The first chapter describes the philosophy behind the new changes. Chapter 2 sketches the services presently available in the province. The third chapter introduces the district health system, while chapter 4 describes the role of the communities in health development.

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