Exploring the clients’ experience of Primary Health Care services prior to and post the implementation of appointment systems in City Health Clinics, Western Cape, South Africa

Abstract

Long waiting times have, for many years, been synonymous with primary health care in South Africa, and this is evident by the long queues and consistent client dissatisfaction. There are multiple contributing factors that exacerbate waiting time in Primary Health Care (PHC) facilities such as shortage of health care providers, increase in the uninsured population and South Africa’s quadruple burden of diseases. Health establishments have initiated numerous strategies to reduce long waiting times with varying degrees of success. These strategies have mostly been quantified and linked to indicators to measure their level of success in relation to quality healthcare. This research explores the clients’ perception of one such intervention, which is the implementation of an appointment system in primary care facilities in the City of Cape Town. Qualitative, exploratory descriptive methods were used to gain understanding of the impact the appointment system has had on the clients’ experience of attending health care services. The researcher also explored how clients perceive their role with regard to the shaping of their clinic’s appointment system. Semi-structured in-depth interviews were conducted with fifteen purposively sampled clients from five City Health clinics, who have implemented an appointment system through the guidance of the Appointment System Learning Initiative (ASLI). Maximum variation in sampling ensured the inclusion of small, medium and larger facilities within different geographical settings. Data analysis was done using a thematic coding approach, the themes were derived from the emerging data and were used to guide the researcher in gaining a rich picture of the clients’ experiences within the clinics. Ethical approval was requested and received from both the University of the Western Cape (UWC) and City Health prior to engaging any participants.