As can be seen from 7, there is variation in the reported implementation of the selected PHC package indicators. Reasonably good progress has been made with implementation in the eight provinces that responded, but there is better reported progress in the urban provinces of Gauteng and the Western Cape. All provinces reported that human resource constraints were the most common reason that hampers PHC package implementation, followed by infrastructure challenges. Functioning clinic committees, a measure of accountability to users of services and communities, needs to be addressed, and in the North West it was reported that there is not a single functioning clinic committee. SECTION 5: A NATIONAL PHC PACKAGE FOR SOUTH AFRICA 5.1 Introduction This section proposes an essential package of interventions for South Africa, based on the literature review and information presented in previous sections. The proposed services have not been costed. Prior to formal adoption of the PHC service package, accurate costing should be done to ensure affordability and feasibility of implementation. This next sub-section presents a set of generic norms and core standards for clinics and community health centres. This is then followed by the key assumptions about staff categories, a generic list of community-based services, and the criteria and components of the proposed PHC package of services and interventions. 5.2 Norms for clinics and community health centres Clinics should provide comprehensive integrated PHC services using a one-stop approach for at least 8 hours a day, five days a week. The clinic should receive a supportive monitoring visit at least once a month to support personnel, monitor the quality of service and identify needs and priorities. The clinic will have at one member of staff who has completed an accredited PHC course. Clinic managers should receive training in facilitation skills and PHC management. An annual plan should be developed for each facility, based on a situation analysis of the community’s health needs, the routine health information data collected at the clinic and an on an evaluation of the provision of PHC services. There should be a mechanism for monitoring services and quality assurance and at least one annual service audit.
As can be seen from 7, there is variation in the reported implementation of the selected PHC package indicators. Reasonably good progress has been made with implementation in the eight provinces that responded, but there is better reported progress in the urban provinces of Gauteng and the Western Cape. All provinces reported that human resource constraints were the most common reason that hampers PHC package implementation, followed by infrastructure challenges. Functioning clinic committees, a measure of accountability to users of services and communities, needs to be addressed, and in the North West it was reported that there is not a single functioning clinic committee. SECTION 5: A NATIONAL PHC PACKAGE FOR SOUTH AFRICA 5.1 Introduction This section proposes an essential package of interventions for South Africa, based on the literature review and information presented in previous sections. The proposed services have not been costed. Prior to formal adoption of the PHC service package, accurate costing should be done to ensure affordability and feasibility of implementation. This next sub-section presents a set of generic norms and core standards for clinics and community health centres. This is then followed by the key assumptions about staff categories, a generic list of community-based services, and the criteria and components of the proposed PHC package of services and interventions. 5.2 Norms for clinics and community health centres Clinics should provide comprehensive integrated PHC services using a one-stop approach for at least 8 hours a day, five days a week. The clinic should receive a supportive monitoring visit at least once a month to support personnel, monitor the quality of service and identify needs and priorities. The clinic will have at one member of staff who has completed an accredited PHC course. Clinic managers should receive training in facilitation skills and PHC management. An annual plan should be developed for each facility, based on a situation analysis of the community’s health needs, the routine health information data collected at the clinic and an on an evaluation of the provision of PHC services. There should be a mechanism for monitoring services and quality assurance and at least one annual service audit.
review_of_primary_health_care_package_for_south_africa-draftnov.docx