Primary Health Care Case Study

Is the Primary Health Care approach and the proposed National Health Insurance the way to achieve Health for All in Cape Town?
The 1978 Alma Ata Declaration of the World Health Organisation was aimed at securing optimal health, which is the complete psychosocial and physical well-being of every person globally, and was based on adequate, accessible and affordable Primary Health Care (WHO, 1978). “Health for All” is a vision which has subsequently evolved as the goal of the Primary Health Care (PHC) strategy. This piece examines the role of PHC within the proposed National Health Insurance (NHI) plan, and with the use of readings, personal experiences in the field and reflection, will support the idea that the PHC approach is an effective vehicle
Even though the government has implemented campaigns such as Batho Pele (People First) and the Patients’ Rights Charter, there remains widespread public belief that the quality of care in public facilities is sub-standard to that in private (McIntyre et al, 2009:727). This is supported by the fact that 21% of patients pay out-of-pocket for private facilities rather than utilise public services (McIntyre & van den Heever, 2007:75). I reflected on a comment made by a public-service doctor that patients mention that they are forced to attend public facilities because they cannot afford to see a “special private doctors” (Dr Cartwright, personal communication 2015). The government faces the task of changing public opinion if it is to succeed in persuading the majority to embrace an NHI. Again, direct engagement of people within their communities is the key, by involving them in decisions concerning their health care and empowering them to “own” their health facilities. While good administration and management from National to District levels are essential, the voices of communities whose health and well-being is at stake, must be heard, either through planned meetings, or at least through a suggestion/complaint system at each clinic. I perceived a spirit of unity between the staff and patients at the CHC and felt uplifted by a generally happy and interactive atmosphere. I thought about how vital an overall positive attitude is in making the best of available resources. My feeling of the approach of such a PHC facility being part of an NHI, is that it can