Primary health care
and District health
Primary healthcare
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Definition
Levels of referral
Free health care – who qualifies?
Physiotherapists are first line practitioners!
The district health system in
South Africa
Decentralisation and health sector reform:
Decentralisation/deconcentration is defined by
Bossert as “shifting power from the central
offices to peripheral offices of the same
administrative structure”.
South African case the establishment of provincial
regional and district offices for health is an example of
decentralisation
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District health system
continued
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'A DHS based on PHC is a more or less selfcontained segment of the national health
system. It comprises first and foremost a
well-defined population living within a clearly
delineated administrative and geographic
area. It includes all the relevant health care
activities in the area, whether governmental
or otherwise'
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'This level of the health care system should be
responsible for the overall management and control
of its health budget, and the provision and/or
purchase of a full range of comprehensive primary
health care services within its area of jurisdiction.
Effective referral networks and systems will be
ensured through co-operation with the other health
districts. All services will be rendered in
collaboration with other governmental, nongovernmental and private structures'
District health information
system
DHIS are defined as the effective and efficient
collection, analysis and evaluation of
information relating to characteristics of people
and communities, their external milieu (i.e.
environmental, soci-cultural economic and
available health system) and health affecting
intervention at individual and collective levels,
so as to enable informed decision making. (Ndimande
2001)
Community service to improve access to
quality health care to all South Africans
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Introduced in 1998 with 26 doctors followed
by dentists in 2000 and pharmacists in 2001.
In 2003 seven more professions started
doing community service, namely, clinical
psychology, dietetics, environmental health,
occupational health, physiotherapy,
radiography and speech, language and
hearing therapy.
If health professionals decide to go abroad without
finishing the community service, they are required to
complete the programme within a period of 2 years
before being registered by the Medical and Dental
Board of South Africa or SA Nursing Council. If they do
6 months before leaving the country, they are only
required to do the remaining 6 months. If they leave
before 6 months, they are expected to start afresh (do
12 months) when they return.
Aim of community service
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To improve access to quality health care to
all South Africans, more especially in
previously under-served areas.
To provide young professionals with an
opportunity to develop skills, acquire
knowledge, behavior patterns and critical
thinking that will help them in their
professional development.
KEY RESPONSIBILITIES:
(Included in the Job description)
1. Treatment of patients using specialized skills and knowledge to improve their
over-all well being and recovery thus ensuring successful rehabilitation of the
patients.
2. Co-operating with the multi-disciplinary team of doctors, nursing personnel
and other staff members to ensure quality patient care.
3. Supervision and management of physiotherapy assistants and to promote
physiotherapy and rehabilitation services in the hospital and community.
4. Educational sessions with the patients, medical staff, the community,
caregivers, family , personal development and in-service training.
5. Availability for after hours services where applicable.
6. Responsible for maintenance of equipment, to report low stock levels,
shortages of consumables, malfunction of equipment and to give inputs on
budget matters.
7. Effective documentation of all treatments, administrative tasks and statistical
data to adhere to the ethical and administrative requirements of the Hospital,
Physiotherapy Department and other relevant organizations.
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Key responsibilities
1. Treatment of patients using specialized skills and knowledge to
improve their over-all well being and recovery thus ensuring
successful rehabilitation of the patients.
2. Co-operating with the multi-disciplinary team of doctors,
nursing personnel and other staff members to ensure quality
patient care.
3. Supervision and management of physiotherapy assistants and
to promote physiotherapy and rehabilitation services in the
hospital and community.
4. Educational sessions with the patients, medical staff, the
community, caregivers, family , personal development and in
service training
5. Availability for after hours services where
applicable.
6. Responsible for maintenance of equipment, to
report low stock levels, shortages of consumables,
malfunction of equipment and to give inputs on
budget matters.
7. Effective documentation of all treatments, administrative
tasks and statistical data to adhere to the ethical and
administrative requirements of the Hospital, Physiotherapy
Department and other relevant organizations.