Public views on community involvement in local health services in South Africa

Abstract

An analysis of the information collected in a nation-wide health survey shows that the South African public favours the involvement of communities in local public health services. There are variations in the support for community involvement in four aspects of health services examined, namely decision on opening times of clinics, determination of patient-provider relationship, recruitment of staff and determination of service charges. Multivariate analysis indicates that the level of support for community involvement is significantly low for Whites relative to other races, lower for rural residents than for city dwellers and high for people with a very good health status. Further focused research is required for improved understanding of the problems and policy options in community involvement in public health programmes. Since 1994 the new government has consistently expressed a strong commitment to involve communities in the design and implementation of health policies and programmes. However, considerable amount of uncertainty remains on how to translate such commitment into practical action at the local level.