Affordable primary health care in low-income countries: can it be achieved?

Logie, Dorothy; Rowson, Mike; Mugisha, Noleb M.; McPake, Barbara

doi:10.4102/phcfm.v2i1.246

Cited by 7 publications

(13 citation statements)

References 5 publications

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“…Unfortunately negative attitudes and unprofessional behaviour of providers noted in this study have all too often been documented within the SA health care literature. 4 , 21 , 22 , 31 , 36 , 37 , 38 Although limited to certain individuals, these attitudinal barriers may well end the user's relationship with the facility, 4 , 37 , 39 as was evident in this study. The impatient, rude and abusive behaviour of users may demonstrate their lack of trust in and respect for the provider-patient relationship.…”

Section: Discussionmentioning

confidence: 67%

“…Ongoing trust relationships form the foundation of client centred healthcare 39 and are especially important in the management of chronic diseases. 28 PWDs often suffer from chronic conditions or require ongoing healthcare due to the nature of their impairments, 40 , 41 but are twice as likely than their non-disabled peers to experience inadequate care at health facilities.…”

Section: Discussionmentioning

confidence: 99%

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The impact of health service variables on healthcare access in a low resourced urban setting in the Western Cape, South Africa

Scheffler

Visagie

Schneider

2015

Afr. j. prim. health care fam. med.

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BackgroundHealth care access is complex and multi-faceted and, as a basic right, equitable access and services should be available to all user groups.ObjectivesThe aim of this article is to explore how service delivery impacts on access to healthcare for vulnerable groups in an urban primary health care setting in South Africa.MethodsA descriptive qualitative study design was used. Data were collected through semi-structured interviews with purposively sampled participants and analysed through thematic content analysis.ResultsService delivery factors are presented against five dimensions of access according to the ACCESS Framework. From a supplier perspective, the organisation of care in the study setting resulted in available, accessible, affordable and adequate services as measured against the District Health System policies and guidelines. However, service providers experienced significant barriers in provision of services, which impacted on the quality of care, resulting in poor client and provider satisfaction and ultimately compromising acceptability of service delivery. Although users found services to be accessible, the organisation of services presented them with challenges in the domains of availability, affordability and adequacy, resulting in unmet needs, low levels of satisfaction and loss of trust. These challenges fuelled perceptions of unacceptable services.ConclusionWell developed systems and organisation of services can create accessible, affordable and available primary healthcare services, but do not automatically translate into adequate and acceptable services. Focussing attention on how services are delivered might restore the balance between supply (services) and demand (user needs) and promote universal and equitable access.

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Section: Discussionmentioning

confidence: 67%

Section: Discussionmentioning

confidence: 99%

The impact of health service variables on healthcare access in a low resourced urban setting in the Western Cape, South Africa

Scheffler

Visagie

Schneider

2015

Afr. j. prim. health care fam. med.

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“…The initiation of a community-health forum through which community members can voice their pleasure, frustration and hopes for healthcare and which can assess services against predetermined minimum standards and criteria for quality is recommended. 45 It is also recommended that a doctor be appointed in the community to assist with curative work and to drive a process focused on determining and addressing the determinants of ill health in the community.…”

Section: Recommendationsmentioning

confidence: 99%

Implementation of the principles of primary health care in a rural area of South Africa

Visagie

Schneider

2014

Afr. j. prim. health care fam. med.

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BackgroundThe philosophy of primary healthcare forms the basis of South Africa's health policy and provides guidance for healthcare service delivery in South Africa. Healthcare service provision in South Africa has shown improvement in the past five years. However, it is uncertain as to whether the changes have reached rural areas and if primary healthcare is implemented successfully in these areas.ObjectivesThe aim of this article is to explore the extent to which the principles of primary healthcare are implemented in a remote, rural setting in South Africa.MethodA descriptive, qualitative design was implemented. Data were collected through interviews and case studies with 36 purposively-sampled participants, then analysed through Interpretative Phenomenological Analysis.ResultsFindings indicated challenges with regard to client-centred care, provision of health promotion and rehabilitation, the way care was organised, the role of the doctor, health-worker attitudes, referral services and the management of complex conditions.ConclusionThe principles of primary healthcare were not implemented successfully. The community was not involved in healthcare management, nor were users involved in their personal health management. The initiation of a community-health forum is recommended. Service providers, users and the community should identify and address the determinants of ill health in the community. Other recommendations include the training of service managers in the logistical management of ensuring a constant supply of drugs, using a Kombi-type vehicle to provide user transport for routine visits to secondary- and tertiary healthcare services and increasing the doctors’ hours.

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“…Although PHC is implemented as a national programme in Ghana, findings show marked inequalities in the geographical distribution and utilisation of PHC services consistent with Getu and Devereux. 55 In line with Logie et al, 56 findings show that PHC appears to be more evident in rural settlements and poor communities across the country although it had significant relevance to peri-urban and cosmopolitan areas plagued with the double burden of disease. Practically, it supports Quashigah's views 57 that PHC initiatives like those on basic sanitation and safe water present the surest means of tackling epidemics, effects of sedentary living and other health conditions associated with overpopulated urban areas in Ghana.…”

Section: Discussionmentioning

confidence: 61%

Primary healthcare implementation in practice: Evidence from primary healthcare managers in Ghana

Appiah-Agyekum

2020

African Journal of Primary Health Care & Family Medicine

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Affordable primary health care in low-income countries: can it be achieved?

Abstract: <strong>How to cite this article:</strong>Logie DE, Rowson M,Mugisha NM, McPake B. Affordable primary health care in low-income countries: Can it be achieved? Afr J Prm Health Care Fam Med. 2010;2(1),Art. #246, 3 pages. DOI:10.4102/phcfm.v2i1.24

Cited by 7 publications

References 5 publications

The impact of health service variables on healthcare access in a low resourced urban setting in the Western Cape, South Africa

The impact of health service variables on healthcare access in a low resourced urban setting in the Western Cape, South Africa

Implementation of the principles of primary health care in a rural area of South Africa

Primary healthcare implementation in practice: Evidence from primary healthcare managers in Ghana

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