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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Main Authors: Graham Bresick, Klaus B. von Pressentin, Robert Mash
Format: Article
Language:English
Published: AOSIS 2019-07-01
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.
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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