Abstract
Globally challenges regarding healthcare provision are sometimes related to a failure to estimate client numbers in peri-urban areas due to rapid population growth. About one-sixth of the world's population live in informal settlements which are mostly characterised by poor healthcare service provision. Poor access to primary healthcare may expose residents of informal settlement more to the human immunodeficiency virus (HIV) and to acquired immunodeficiency syndrome (AIDS) than their rural and urban counterparts due to a lack of access to information on prevention, early diagnosis and treatment. The objective of this study was to explore and describe the experiences of both the reproductive health services' clients and the healthcare providers with regard to the provision of reproductive health services including the prevention of HIV and AIDS in a primary healthcare setting in Tshwane. A qualitative, exploratory and contextual design using a phenomenological approach to enquire about the participants' experiences was implemented. Purposive sampling resulted in the selection of 23 clients who used the reproductive healthcare services and ten healthcare providers who were interviewed during individual and focus group interviews respectively. Tesch's method for qualitative data analysis was used. Ethical principles guided the study, and certain strategies were followed to ensure trustworthiness. The findings revealed that females who lived in informal settlements were aware of the inability of the PHC setting to provide adequate reproductive healthcare to meet their needs. The HCPs acknowledged that healthcare provision was negatively affected by policies. It was found that the community members could be taught how to coach teenagers and support each other in order to bridge staff shortages and increase health outcomes including HIV/AIDS prevention.
Highlights
The provision of healthcare services is a fundamental human right entrenched in the Constitution of the Republic of South Africa and strengthened by the Batho Pele principles (Department of Public Service and Administration [DoPSA], 1997, p. 18)
The following six themes emerged from the data: the impact of policies for health sector transformation on staff provision, the impact of staff shortage for reproductive health services on clients, the dual needs of clients accessing reproductive health services, mandatory overtime for healthcare providers, the need for community-based care to provide reproductive health services, and support needed for the provision of community-based care
The following abbreviations will be used to differentiate between the participants, individual interviews and the focus groups interviews: healthcare provider (HCP); female who made use of primary healthcare services (PHC) services; individual interviews (InI) and focus group interviews (FGI)
Summary
The provision of healthcare services is a fundamental human right entrenched in the Constitution of the Republic of South Africa and strengthened by the Batho Pele principles (Department of Public Service and Administration [DoPSA], 1997, p. 18). The population growth experienced after the first democratic elections in South Africa in 1994 resulted in some populations having limited access to health services in some parts of the country as there was influx of migrants to urban areas who settled in informal settlements increasing the population in these cities exponentially. These areas are populated mostly by people who are often unemployed, live in poor living conditions and who have insufficient access to health services The least populated of all nine provinces were the Free State with 2 753 200 and the Northern Cape with 1 162 900 (Statistics South Africa, 2013, p. 3)
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