Assignment (MPA)--University of Stellenbosch, 2002. / ENGLISH ABSTRACT: Primary Health Care (PHC) approach is currently receiving tremendous attention
worldwide as a mechanism to ensure effective and efficient public health services. The
concept has evolved from the Alma Ata conference (1978). Since then many countries
began to reorient their health services to achieve the goals of availability, accessibility
and affordability of health care for all citizens and a number of management issues came
to the forefront. Therefore, the provision of comprehensive PHC services is the key
aspect to improving health services. A district health system has been identified as an
ideal model for comprehensive PHC services to all the citizens in South Africa.
Public health services in the Cape Metropolitan Area are characterised by functional
fragmentation. Two public authorities render Primary Health Care services, namely the:
Provincial Administration of the Western Cape through CHSO, and the Municipal Health
Department. The fragmented nature of the public health services, which result in poor
coordination of service delivery between the two health authorities, compromises the
quality of service delivery.
Historically, PHC services in the Cape Metropolitan Area - and indeed in the whole
South Africa - have developed in a skewed manner. This work is an attempt at
conceptualising the implications and consequences of this skewed health development.
South Africa is presently undergoing fundamental reform, which has brought the PHC
into disarray of fundamental change. Since the South African health care system is a
highly complex institution, attempts have been made to critically analyse those aspects
and features of inequality, inaccessibility, and inequity. Among these is the historical and
present development of Cape Metropolitan Area health care and the structural features it
assumed with the passing of time, trends and characteristics.
In order to examine the theory in practice, the evolvement of PHC in the Cape
Metropolitan Area will be analysed. The analysis highlights how different political
formations have affected the development of PHC services and points out obstacles and limitations throughout the process, which had to be dealt with. Transformation of the
existing health services, based on the principles of PHC, requires the redressing the
imbalances of the past. Therefore, the integration of the two health authorities into one
entity would best achieve the principles of district health system and will ensure
comprehensive PRe. / AFRIKAANSE OPSOMMING: Die Primêre Gesondheidsorg benadering geniet tans wereldwyd erkenning as 'n
meganisme om doeltreffende openbare gesondheidsdienslewering te versker. Die
konsep, wat ontwikkel en gegroei het uit die Alma Ata-konferensie van 1978, is reeds
deur verskeie regerings ge-implementeer ten einde die doelwitte van beskikbaarheid,
toeganklikheid en bekostigbaarheid van gesondheidsorg vir alle landsburgers te verseker.
Die voorsiening van omvattende Primêre Gesondheidsorgdienste word erken as 'n
noodsaaklike middelom gesondheidsorg te verbeter. Die Distrikgesondheid-stelsel is geidentifiseer
as 'n ideale model vir die implementering van omvattende Primêre
Gesondheidsorgdienste in Suid Afrika.
Publieke Gesondheidsdienste in die Kaapse Metropolitaanse-gebied word gekenmerk
deur die feit dat dit funksioneel gefragmenteer is. Twee publieke owerhede, te wete die
Provinsiale Administrasie van die Wes Kaap en die Kaapse Stadsraad lewer Primêre
Gesondheidsorgdienste, wat aanleiding gee tot swak koordinering met die gevolg dat
dienslewering daaronder ly. Primêre Gesondheidsdienste in die Kaapse Metropolitaansegebied,
soos in die res van Suid Afrika, het op 'n onlogiese, skewe manier ontwikkel
Hierdie werk is 'n poging om die gevolge en implikasies van die onlogiese, skewe
gesondheids-ontwikkeling te konseptualiseer. Daar is gepoog om die uiters
gekompliseerde gesondheidsdiens-stelsel in Suid Afrika krities te analiseer met spesifieke
verwysing na die kenmenrke van ongelykheid, ontoeganklikheid en onbillikheid. Dit
sluit die historiese en huidige ontwikkeling van gesondheidsorg in die Kaapse
Metropolitaanse gebied en die strukturele kenmerke in wat deur die loop van jare as
gevolg van verskeie invloede en neigings sigbar geraak het.
Die ontwikkeling van Primêre Gesondheidsorg in die Kaapse Metropolitaanse-gebied
word ge-analiseer ten einde bogenoemde teorie in die praktyk te bevestig. Die analise
beklemtoon die invloed van verskillende politieke rolspelers op ,die ontwikkeling van
Primêre Gesondheidsorgdienste en bevestig die struikelblokke en beperkings wat deurentyd opgeduik het. Transformasie van gesondheidsdienste soos dit tans daaruit
sien, gegrond op die beginsels van Primêre Gesondheidsorg, vereis dat die ongelykhede
van die verlede aangespreek word. Die integrasie van die twee gesondheidsdiensowerhede
sal die beginsels van die Gesondheidsdistrik-stelsel verwesenlik, wat daartoe
sal aanleiding gee dat omvattende Primêre Gesondheidsorg 'n werklikheid word.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/52632 |
| Date | 12 1900 |
| Creators | Zimba, Anthony Andile |
| Contributors | Schwella, E., Stellenbosch University. Faculty of Economic and Management Sciences. Dept. of School of Public Leadership |
| Publisher | Stellenbosch : Stellenbosch University |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | English |
| Type | Thesis |
| Format | 70 p. |
| Rights | Stellenbosch University |
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