The perceived role of ward-based primary healthcare outreach teams in rural KwaZulu-Natal, South Africa.

Landiwe S Khuzwayo,Mosa Moshabela

doi:10.4102/phcfm.v9i1.1388

Landiwe S Khuzwayo, Mosa Moshabela

Open Access

https://doi.org/10.4102/phcfm.v9i1.1388

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Abstract

BackgroundThe aim of ward-based outreach teams (WBOTs) is to improve access to primary healthcare (PHC) services including health promotion and disease prevention in South Africa. Limited information is available in South Africa on user perceptions of services provided by WBOTs in rural households.AimThe study aimed to explore community awareness and perception of WBOTs, as well people’s motivation to engage and use WBOT services.SettingThe study was conducted between July and September 2015 in iLembe district, KwaZulu-Natal.MethodsThis was exploratory-descriptive qualitative research. Purposive sampling technique was used in this study. A total of 16 key informant interviews and 4 focus group discussions were conducted. The voice recordings were transcribed in isiZulu and translated into English.ResultsFour themes emerged from the data analysis, namely bringing services closer, organising services, expanding services and forming bridges. Respondents demonstrated insightful knowledge and understanding of services provided by WBOTs. They expressed an appreciation of the way WBOT services brought healthcare closer to people and serve to bridge the gap between the community and local healthcare facilities. Respondents identified unclear WBOT work schedules and the failure to carry medication other than vitamin A as the main challenges. However, WBOTs did deliver medication for controlled chronic patients in their households.ConclusionThe study suggests that WBOTs provide a commendable service, but need to expand their service package to further increase access to PHC services and cater for community health needs.

Highlights

More than 30 years after the 1978 Declaration of Alma Alta,[1,2] and in line with the World Health Organization’s (WHO) advocacy for the revitalisation of primary healthcare (PHC),[1] the South African Government developed the 10-Point Plan to transform the healthcare system of the country.[2]
Participants were purposively selected based on their knowledge and experience of ward-based outreach teams (WBOTs) and the WBOT services offered in the households
Research on HIV or AIDS and tuberculosis (TB) treatment adherence has shown that the leading cause of loss to follow-up and treatment default among antiretroviral and TB patients is because of out-of-pocket expenses, patient inability to pay for the transport costs for clinic visits.[14]

Summary

Introduction

More than 30 years after the 1978 Declaration of Alma Alta,[1,2] and in line with the World Health Organization’s (WHO) advocacy for the revitalisation of primary healthcare (PHC),[1] the South African Government developed the 10-Point Plan to transform the healthcare system of the country.[2]. PHC re-engineering is one of the key pillars of the NHI and consists of a four-stream approach which includes contracting private health practitioners at non-specialist level, district-based clinical specialist teams, strengthening school health services and ward-based PHC outreach teams for each electoral ward with an initial focus on improving maternal and child health.[4] The core principles of PHC re-engineering are to attain a population-orientated view to healthcare, including prevention, promotion and good quality; focus on health outcomes, aimed at reducing mortality and morbidity from the major causes of ill-health; develop integrated, efficient and well-supported PHC teams, guided by and accountable to communities; establish a wellfunctioning District Health System (DHS); and to pay closer attention to those factors outside of the health sector that impact health, namely the social determinants of health.[2]. The aim of ward-based outreach teams (WBOTs) is to improve access to primary healthcare (PHC) services including health promotion and disease prevention in South Africa. Limited information is available in South Africa on user perceptions of services provided by WBOTs in rural households

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