Position paper on the provincialisation of personal primary health care services
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Date
2009
Journal Title
Journal ISSN
Volume Title
Publisher
South African Local Government Association
Abstract
Primary health care (PHC) was internationally accepted in 1978 as the preferred system for health care. It is defined in the Declaration of Alma Ata and includes essential care, which is appropriate, available and affordable to the community and the country. It is health care delivered as close to the community as possible with full participation by the community. It forms part of the national health system.
In 1986 the World Health Organisation declared that the most appropriate vehicle for delivery of PHC is the district health system (DHS). The DHS is based on a defined geographical area with a defined population and includes all health care services within that area.
Description
The research has shown the greatest resistance to provincialisation comes from the metropolitan municipalities. The metros have historically provided some PHC services, initially mainly preventative and promotive health services. The scope of services provided has increased over the years to include most PHC services. These services are co-funded by the province and the municipality. Funding from the province is as a subsidy which is insufficient to pay for all services provided. Most district municipalities are supportive of provincialisation of PHC as they do not have the capacity to manage the services. An asymmetrical approach
is generally supported.
Keywords
Primary health care, Provincialisation, South Africa, Municipal health services
Citation
Versteeg, M. Hall, W. de Visser, J et al. (2009). Position Paper on the Provincialisation of Personal Primary Health Care Services. South African Local Government Association