Changes in the patient population attending a primary health care clinic in rural South Africa between 1991 and 2001.

Abstract

Serosurveys in the last decade indicate that the prevalence of HIV infection has risen in Hlabisa district KwaZulu-Natal from 4% in 1992 to 14% in 1995 and 35% in 2002. The impact of the HIV epidemic on the patient population attending local hospitals has been reported previously. In particular there has been a marked increase in admissions for tuberculosis and other HIV-associated conditions. However there are few data on the impact of the epidemic on the burden of illness seen at primary health clinic level. Furthermore in 1996 primary health care became free for all in South Africa whereas previously patients paid a nominal fee to see clinic staff. The impact of this change on the attendance at primary care clinics is unknown. Such information is needed for planning effective responses aimed at reducing unnecessary referrals and admissions to hospital and to enable more effective deployment of health care workers. (excerpt)