Primary Health Care

Overcrowding, long queues and bad service remain a common occurrence at public clinics. In a move to make primary health care facilities function optimally, government initiated a plan – transforming Public Clinics into Ideal Clinics – to address these deficiencies and improve the quality of service.

In the plan, attention is paid to service delivery, waiting times, human resources, infrastructure, financial management as well as supply chain management.

In a briefing to Parliament, the nine provincial health departments gave a progress report on their implementation of the Ideal Clinic Initiative. This included an account of their successes, challenges and gaps and the measures put in place to address these.

Ideal Clinics are running in all provinces with varying degrees of success. A few reported good progress; others had satisfactory results and the rest are lagging behind in the number of clinics that have achieved Ideal Clinic status.

Common challenges include insufficient budget, poor infrastructure, lack of vital equipment, inadequate human resources, poor external signage and security services, slow supply chain processes and bad data management. Big lessons learnt include the need to prioritise budgets for the Ideal Clinic programme, to carry out weekly monitoring and to strengthen the leadership and governance of facilities. MPs urged departments to fast track their services to the people.

Provincial departments also reported on community health workers (CHW), saying they are a key factor in the effective provision of health services to communities. Critically, they create connections between the vulnerable and healthcare systems and provide preventive, early identification of diseases, referral to and promotion of health services. In most cases, they reside within the community, are familiar with the community, elected by the community, and participate in community forums. There are discrepancies among provinces when it comes to paying these workers. Some provinces pay them directly; and others have contracted nonprofit organisations to do so. There is also uncertainty about their level of training, how many are required and how much they should be paid. The Department has a draft policy on the improvement of CHW remuneration and conditions of service. It is engaging with National Treasury to see how the policy can be implemented in the next financial year.