Evaluating the performance of South African primary care: a cross-sectional descriptive survey
Introduction: In 2018 governments reaffirmed their commitment to implementing primary health care (PHC) in the Astana Declaration. South Africa has introduced a number of health reforms to strengthen PHC and enable universal health coverage (UHC). UHC requires access to quality primary care and prog...
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| Format: | Article |
| Language: | English |
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AOSIS
2019-07-01
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| Series: | South African Family Practice |
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| Online Access: | https://safpj.co.za/index.php/safpj/article/view/4981 |
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| author | Graham Bresick Klaus B. von Pressentin Robert Mash |
| author_facet | Graham Bresick Klaus B. von Pressentin Robert Mash |
| author_sort | Graham Bresick |
| collection | DOAJ |
| description | Introduction: In 2018 governments reaffirmed their commitment to implementing primary health care (PHC) in the Astana Declaration. South Africa has introduced a number of health reforms to strengthen PHC and enable universal health coverage (UHC). UHC requires access to quality primary care and progress needs to be measured. This study aimed to evaluate the quality of South African primary care using the Primary Care Assessment Tool (PCAT).
Methods: A descriptive cross-sectional survey used data derived from a previous analytical observational study. Data from 413 patients, 136 health workers and 55 managers were analysed from 30 community health centres across four provinces of South Africa. Scores were obtained for 10 key domains and an overall primary care score. Scores were compared in terms of respondents, provinces and monthly headcount.
Results: Patients rated first contact accessibility, ongoing care and community orientation as the poorest performing elements ( 50% scoring as ‘acceptable to good’); first contact utilisation, informational coordination and family-centredness as weaker elements ( 66% scoring as ‘acceptable to good’); and comprehensiveness, coordination, cultural competency and availability of the PHC team as stronger aspects of primary care (≥ 66% or more scoring as ‘acceptable or good’). Managers and providers were generally much more positive about the performance of PHC.
Conclusion: Gaps exist between PHC users’ experience of care and what PHC staff believe they provide. Priorities to strengthen South African primary care include improving access, informational and relational continuity of care, and ensuring the implementation of community-orientated primary care. The PCAT is a useful tool to measure quality of primary care and progress with UHC. |
| format | Article |
| id | doaj-art-e74effdb0b9f440fb6711563a2826e49 |
| institution | DOAJ |
| issn | 2078-6190 2078-6204 |
| language | English |
| publishDate | 2019-07-01 |
| publisher | AOSIS |
| record_format | Article |
| series | South African Family Practice |
| spelling | doaj-art-e74effdb0b9f440fb6711563a2826e492025-08-20T03:06:53ZengAOSISSouth African Family Practice2078-61902078-62042019-07-0161310.4102/safp.v61i3.49813957Evaluating the performance of South African primary care: a cross-sectional descriptive surveyGraham Bresick0Klaus B. von Pressentin1Robert Mash2University of Cape TownStellenbosch UniversityStellenbosch UniversityIntroduction: In 2018 governments reaffirmed their commitment to implementing primary health care (PHC) in the Astana Declaration. South Africa has introduced a number of health reforms to strengthen PHC and enable universal health coverage (UHC). UHC requires access to quality primary care and progress needs to be measured. This study aimed to evaluate the quality of South African primary care using the Primary Care Assessment Tool (PCAT). Methods: A descriptive cross-sectional survey used data derived from a previous analytical observational study. Data from 413 patients, 136 health workers and 55 managers were analysed from 30 community health centres across four provinces of South Africa. Scores were obtained for 10 key domains and an overall primary care score. Scores were compared in terms of respondents, provinces and monthly headcount. Results: Patients rated first contact accessibility, ongoing care and community orientation as the poorest performing elements ( 50% scoring as ‘acceptable to good’); first contact utilisation, informational coordination and family-centredness as weaker elements ( 66% scoring as ‘acceptable to good’); and comprehensiveness, coordination, cultural competency and availability of the PHC team as stronger aspects of primary care (≥ 66% or more scoring as ‘acceptable or good’). Managers and providers were generally much more positive about the performance of PHC. Conclusion: Gaps exist between PHC users’ experience of care and what PHC staff believe they provide. Priorities to strengthen South African primary care include improving access, informational and relational continuity of care, and ensuring the implementation of community-orientated primary care. The PCAT is a useful tool to measure quality of primary care and progress with UHC.https://safpj.co.za/index.php/safpj/article/view/4981primary health careprimary carehealth services evaluationcontinuityaccessibilitycomprehensivenesscoordinationsouth africa |
| spellingShingle | Graham Bresick Klaus B. von Pressentin Robert Mash Evaluating the performance of South African primary care: a cross-sectional descriptive survey South African Family Practice primary health care primary care health services evaluation continuity accessibility comprehensiveness coordination south africa |
| title | Evaluating the performance of South African primary care: a cross-sectional descriptive survey |
| title_full | Evaluating the performance of South African primary care: a cross-sectional descriptive survey |
| title_fullStr | Evaluating the performance of South African primary care: a cross-sectional descriptive survey |
| title_full_unstemmed | Evaluating the performance of South African primary care: a cross-sectional descriptive survey |
| title_short | Evaluating the performance of South African primary care: a cross-sectional descriptive survey |
| title_sort | evaluating the performance of south african primary care a cross sectional descriptive survey |
| topic | primary health care primary care health services evaluation continuity accessibility comprehensiveness coordination south africa |
| url | https://safpj.co.za/index.php/safpj/article/view/4981 |
| work_keys_str_mv | AT grahambresick evaluatingtheperformanceofsouthafricanprimarycareacrosssectionaldescriptivesurvey AT klausbvonpressentin evaluatingtheperformanceofsouthafricanprimarycareacrosssectionaldescriptivesurvey AT robertmash evaluatingtheperformanceofsouthafricanprimarycareacrosssectionaldescriptivesurvey |