- Title
- A theoretical study on primary health care services within a South African context
- Creator
- Mkalipi, Thembinkosi Delport
- Subject
- Primary health care -- South Africa
- Subject
- Health facilities -- South Africa Clinics -- South Africa
- Date Issued
- 2018
- Date
- 2018
- Type
- Thesis
- Type
- Masters
- Type
- MPA
- Identifier
- http://hdl.handle.net/10948/32193
- Identifier
- vital:31979
- Description
- Primary health care (PHC) is a system introduced to bring health services closer to communities. It was introduced with its challenges such as the management and treatment of various illnesses including HIV, TB and STI’s which have affected certain communities. The non-communicable diseases which require the attention of PHC institutions still face numerous challenges including the referral system and clinics with limited medicine. The study revealed that there are limited measures in place to deal with communities in rural areas who require medical assistance from government. Further challenges identified from the study included human resource management, supply chain management, finance and other administrative support systems. The inadequate funding of the Department of Health appears to be directly related to adequate service delivery problems. The study adopted a qualitative research methodology which incorporated an extensive desktop analysis and literature review approach. No human participants were involved. Health legislation is an important enabler and a necessary component of health policy. Research has shown that since 1995 when the first edition of the review appeared, South Africa has been engaged in a constant process of public health law reform and despite significant gains, some legislative processes have stalled. Examples include the certificate of need provided for in the National Health Act, the introduction of compulsory continuing professional development for pharmacists, the recognition of specialist nurses as prescribers, and the introduction of international benchmarking for medicinal processes. The process of introducing NHI remains contested with the legislative component, still under developed. Although NHI will in due course be a game changer and there has been some strengthening of the health service in the NHI pilot district to date, in general, implementation has been slower than anticipated in the NHI green paper released in August 2011. The NHI white paper indicated that public health care spending was likely to increase substantially over the next 15years from 4% to 6% of the GDP. Several mechanisms for raising revenue have been proposed, including some combination of an increase of VAT or payroll tax, or an increase of personal income tax. NHI also has the potential to improve efficiencies in the overall health system through improved pooling, strategic purchasing, medicine price reduction through central procurement, redistribution, improved quality in the public sector and providing greater access to general practitioners. Development of, and amendment to the relevant health technology assessment policy and legislative frameworks are needed in order to inform appropriate universal health coverage and to align with the 2015 NHI white paper Addressing social determinants is the cornerstone of the National Department of Health’s primary health care system. A engineering strategy, and an approach that is embedded in the country’s national development plan is needed. However the translation of this policy commitment to programmatic action at different levels in the health system and in partnership with other sectors remains elusive Evidence indicate that South African patients face challenges in accessing heath care particularly those from rural areas. The main challenge is the lack of a coordinated strategy to ensure continuous access to treatment, cure and support for chronic conditions. This study has shown that the private for profit hospital sector is well resourced and caters to a population that is wealthier, urban and more likely to be formerly employed. The public hospital sector catering to the majority of South Africans, faces lower human resourcing ratios, financial constraints and ageing infrastructure. The ideal clinic realisation and maintenance programme was assigned in response to the current deficiencies in the quality of primary health care services and to lay a strong foundation for the implementation of national health insurance. There is an urgent need to develop cohesive, sustainable systems to support evidence based decisions on appropriate regime choices, while minimizing risks associated with medication. This study has shown the importance of a robust national PV system in order to reduce the significant burden of drug induced diseases, to inform treatment policies with real world evidence, to improve outcomes of common diseases, such as HIV, TB, hypertension, and diabetes through optimal therapeutic management, and to ensure the safety of large scale therapeutic interventions such as vaccines, especially when newly introduced. Results from the study suggest that there is a failure by policy-makers to adequately address the challenges faced by PHC institutions. There also appears to be a backlog in terms of the promulgation of enabling legislation to address certain of the challenges. The Department of Health has a number of draft policies which are negatively affecting the level of service delivery. The study revealed that the challenges include, inter alia, inadequate budgeting, staff shortages, aging infrastructure, the non-availability of certain medicines in hospitals, a poor referral system with limited measures in place to address HIV, TB and STI’s as well as non-communicable treatments.
- Format
- xiv, 87 leaves
- Format
- Publisher
- Nelson Mandela University
- Publisher
- Faculty of Arts
- Language
- English
- Rights
- Nelson Mandela University
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | SOURCE1 | THEMBINKOSI DELPORT MKALIPI.pdf | 1 MB | Adobe Acrobat PDF | View Details Download |