Primary health care remains at the top of the government’s agenda. To address the issues of inequity, the Department of Health adopted mobile health clinics to ensure that the places that are hard to reach have access to primary health care. Without good health people do not have means to enjoy other aspect such as education and employment. Apartheid policies implemented by the old regime resulted in many rural areas in South Africa remaining underdeveloped and underserviced. Hence, the introduction of mobile health clinic ensured that the population in rural areas have access to health care. Unlike fixed clinics, there are no specific sets of guidelines set up for the operations of mobile health clinic. This include, displaying health posters at mobile health clinics, providing patients with safe drinking water at the mobile site. With more and more mobile health clinics being added to the rural population there should be established scope of services to for rural population. This will ensure equality of service delivery between the mobile health clinics and fixed clinics. Thus, guaranteeing its acceptability to the users. Using qualitative methods the study explored the experiences of patients at the mobile health clinic. Following the health equity model the study explored what the community of KwaMachi use the mobile health clinic for and the experiences of individual when accessing health care at the mobile health clinic. The findings suggest that patients have both positive and negative experiences at the mobile health clinic. The majority of respondents commented that mobile health clinic offered them an entry point to the South African national health system. They also pointed out the services offered are limited. Hence, providing a range of primary health care services will ensure the maximisation of positive experiences at the mobile health clinic and this is likely to contribute positively to the morbidity and mortality rates in rural areas in South Africa. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2013.

There is strong evidence from developing countries to support the hypothesis that physical accessibility of health services, particularly absolute distance from clinics, is a major determinant of health service utilization and health status. In South Africa, such evidence is very limited and as a result the relationship between absolute distance and health service utilization and health status is not fully understood. As an attempt to understand this relationship, a household survey of mothers with children aged 12-23 months was conducted in a rural district of KwaZulu-Natal province, South Africa. Maternal and child health (MCH) service utilisation and MCH status patterns were then compared at different absolute distances from PHC clinics. The find ings reveal that the study population is characterised by impoverished living conditions (86%), high functional illiteracy (67%), high fertility and unemployment rates . In comparison with other studies conducted previously in the same population, MCH service utilization rates are high. Based on mean distances of homesteads from PHC clinics in the entire study area before the Clinic Upgrading and Building Programme it has been concluded that the physical accessibility of fixed PHC clinics, when compared with the WHO recommendations, was suboptimal. When this assessment is based on clinic usage patterns, it is found that clinic usage decreased from 86.4% at 0-5 km to 79% at 6-10 km with a dramatic decrease to 37.8% at distances beyond 10 km. This decrease in usage at distances above 5 km translates into a considerable reduction in effective coverage of the target population by PHC clin ic services if it is considered that above 50% of the population live greater than 5 km from these clinics. An assessment of the effect of distance of homesteads from PHC clinics on specific MCH service utilization and MCH status has found very few or no significant differences between mothers and children living at 0-5 km, 6-10 km or > 10 km from these clinics. This observation is consistent even after adjustment for the effects of potential confounding. The fact that distance from clin ics has little or no effect on the indicators of MCH service utilization and MCH status is counter-intuitive. A few explanations can be provided. These include the fact that only 50% of the population, even in one of the most rural parts of South Africa access clinics on foot. Since the traditional assumption has been that this distance effect is a function of straight-line walking distances between homesteads and clinics, Euclidian distances alone may be a poor explanatory variable for health service utilization. Furthermore, if the hypothesis is valid that health status is a function of service utilization, it may also be a poor explanatory variable for health status of community members who are reliant on these services. Secondly, based on data from other sources, there is evidence that there have been steady declines in both mortality and fertility rates in the study population over the past 10-20 years suggesting that client communities are already benefiting quite substantially from health services in general and from MCH services in particular in spite of residual distance barriers. In other words, this distance effect on service utilization and health status may be more evident in populations with much higher background infant, child and maternal mortality rates. Thirdly, it is also possible that distance effect still exists, but that methodological limitations prevented this study from showing this effect. For instance, the fact that people use mobile clinics for some MCH services may have confounded the effect of distance from fixed clinics. It is also possible that people use different facilities for different services even though they are further away, and the assumption that all facilities have equal attraction for clients and that the only determinant of use is distance may be flawed. For example, it is evident from this and from other studies in South Africa that whereas most clients use fixed clinics for vaccinations, deliveries are now increasingly conducted at hospitals. Other methodological issues include the fact that certain health outcomes such as stunting are not an exclusive reflection of health service inputs, but are a function of social and economic determinants. Based on these findings, a number of recommendations are made. / Thesis (Ph.D.)-University of Natal, Durban, 2004.

This dissertation is an examination of salient factors that influence the health seeking behaviour of mothers/caregivers of pre-school children in Kwangwanase, KwaZuluNatal province, South Africa. Health seeking behaviour for pre-school children is poorly understood, and is influenced by an array of complex factors that inhibit full utilisation of available health services. Amongst other things, health-seeking behaviour is influenced by cultural beliefs about children's illnesses as well as the local availability of treatment options, and the perceived quality of care provided. This dissertation represents the findings of a combined qualitative and quantitative research approach using free listing, pile sorts, interview schedules, logbooks and observation to explore health-seeking behaviour. Research focussed on the local knowledge held in relation to childhood illnesses that affect children under age six, along with the explanatory models used to discern causation and shape decisions regarding treatment and care. Mothers and caregivers of Kwangwanase draw upon their existing knowledge of children's illnesses, including notions of disease causation, when making diagnoses and deciding between home treatments and professional consultation. Mothers and caregivers pay close attention to the well being of small children. They are constantly involved in the routine management of health and illness. Various treatment options are utilised in a pragmatic way, as mothers and caregivers pick and choose from all available health resources as and when they see fit. Cultural beliefs, accessibility, religious views and other factors influence their choice of health service. Depending on the quality of the care provided and the outcome of the therapeutic intervention, mothers and caregivers are likely to consult several different health care providers in a sequential manner. / Thesis (M.A.)-University of Natal, Durban, 2002.

KwaZulu-Natal is the province worst affected by the disease burden of HIV and AIDS with 38.7% of pregnant women attending antenatal clinics (ANC) testing positive for HIV in 2008 (South Africa National Department of Health, 2008; Horwood et al, 2010). The lack of male partner involvement has been recognized as a contributing factor to poor programme adherence by women initiated into the prevention of mother-to-child-transmission (PMTCT) programme in South Africa (Peltzer et al, 2011a). Increasing male partner involvement in the services, therefore, has been acknowledged as one of the strategies that may have an impact in the success of the programme (DOH, 2008; Peltzer et al., 2011a; Reece et al, 2010; Vika et al, 2010) This study aimed to explore and describe male partner involvement in PMTCT services in a selected primary health care facility in KwaZulu-Natal. Five areas were investigated: demographic factors; knowledge; socio-cultural factors; programmatic factors; and the interrelationship between demographic factors, knowledge, socio-cultural factors and programmatic factors on male involvement in PMTCT. A quantitative exploratory descriptive design was conducted in November 2012 at a selected primary health care facility in KwaZulu-Natal. Questionnaires were issued to 90 men. The study revealed some association between certain variables of interest and male involvement. The study recommended that PMTCT programmes need to boost their awareness strategies as a means of increasing male involvement in the services. / Theses (M.N.)-University of KwaZulu-Natal, Durban, 2013.