Abstract
This article reports on the views of public health workers regarding recent changes in the delivery of primary health care to people living and working in the Bothaville rural area. These changes in mobile health care form part of the Initiative for Sub-District Support's programme to provide sustained, concerted support to sub-districts to bring about improvements in health care management and health care delivery. Main shortcomings of the recent changes were identified as inadequate transportation facilities in rural areas, insufficient information dissemination to rural dwellers and lack of farmers' participation in rural health matters. Furthermore, poor communication and co-operation between different public health services prevailed and the need for an integration of these services was emphasised.
Highlights
Background to the studyWith the dawn of the new political dispensation in South Af rica during 1994, the health sector set out for major reform by commencing on the implementation of a single comprehen sive, equitable and integrated public health system in South Africa in the form of a National Health System (NHS)
An important component of the primary health care (PHC) approach entails delivering health care to historically neglected rural areas all over South Africa, which is done by a mobile clinic system, taking PHC to people living on farms
The main advantage of the previous system of mobile health pertained to^the fact that all rural dwellers received PHC at home and Im munisations were provided at all farm schools
Summary
With the dawn of the new political dispensation in South Af rica during 1994, the health sector set out for major reform by commencing on the implementation of a single comprehen sive, equitable and integrated public health system in South Africa in the form of a National Health System (NHS). In order to address the challenges of implementing the DHS at grassroots level, the Health Systems Trust (HST), in col laboration with provincial health departments, initiated a pilot programme of “bottom-up” support to, at first, only a selected number of districts (as pilot sites). This programme is known as the Initiative for Sub-district Support (ISDS) (Health Sys tems Trust, 1997:2). The components include research, evaluation, communication, technical support, in formation, facilitation and participation (Engelbrecht, 1997:2)
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