Week 6 - Service Delivery​​

Session 3 - The District Health Systems in South Africa

  1. Spark Questions
  2. Learning Outcome
  3. Session summary and reflection
  4. References

Spark Questions

There are many different types of health services. How do you think health services are comprehensively delivered across the country in South Africa

In South Africa, health services are delivered through a tiered system designed to provide comprehensive, equitable care to the population.

  • Primary care
  • Secondary  care
  • Tertiary  care
  • Quaternary care
 South Africa has private and public sector and private sectors provide more personalised and better quaility care
Even though these forms of healthcare structures exists, there are challenges that persist

Challenges such as:
  • Resource constraints, staff shortages, and infrastructural disparities between urban and rural areas, which affect equitable access. Efforts to strengthen PHC and improve referral pathways are critical for more comprehensive delivery across the country.

Learning Outcome - The District Health Systems in South Africa

  • Describe the district health system.
    •  A Health District is a geographically defined area aligned with municipal district boundaries, within which healthcare services are organized and managed for a specific population. Health districts serve as administrative regions for delivering a standardized package of healthcare services, particularly focusing on primary healthcare. They form the foundation of the District Health System, which aims to bring accessible and coordinated health services to communities, making primary healthcare the core of the national health service.

 

  • Explain the advantages of the district health system. 
    • The management of health services is decentralised so that service delivery is simpler and more responsive. 
    • Health services can be tailored to the needs of a defined population, which better meets the immediate health needs of that population. 
    • Decisions can be localised around the needs of the population. 
    • Health districts facilitate the involvement of communities in their specific needs. 
    • Collecting health information and reporting health statistics is easier and simpler. 

Session summary and reflection

Good service delivery includes quality, access, safety, coverage

Human resources, imfrustructure and ligistics are an intrigal part of service delivery

Service Delivery is done by both public and private sector. Public sectory looks more for helping people of all background and private sectors look more for profits

A Health District is a geographically defined area aligned with municipal district boundaries, within which healthcare services are organized and managed for a specific population. Health districts serve as administrative regions for delivering a standardized package of healthcare services, particularly focusing on primary healthcare. They form the foundation of the District Health System, which aims to bring accessible and coordinated health services to communities, making primary healthcare the core of the national health service.

Advantages of Health District includes:

  • The management of health services is decentralised so that service delivery is simpler and more responsive. 
  • Health services can be tailored to the needs of a defined population, which better meets the immediate health needs of that population. 
  • Decisions can be localised around the needs of the population. 
  • Health districts facilitate the involvement of communities in their specific needs. 
  • Collecting health information and reporting health statistics is easier and simpler. 

What are found in each levels of care (Stephen Pentz,2024)

Primary Hospital Care: 

  • Trauma and emergency care, in-patient care, out-patient visits and paediatric and obstetric care.
  • Provided by family physicians, general practitioners, and clinical nurse practitioners (PHC).
  • May employ specialists – paediatricians, obstetrician/gynaecologists, and general surgery.

Secondary Hospital Care

  • General surgery, orthopaedics, general medicine, paediatrics, obstetrics & gynaecology, family medicine, radiology and anaesthetics.
  • Receive referrals from district hospitals.
  • Platform for training of health workers and research.
Tertiary Hospial Care
  • specialist and sub-specialist care in a number of regional hospitals.
  • The areas of specialty include cardiology, cardiothoracic surgery, craniofacial surgery, diagnostic radiology, ENT, endocrinology, geriatrics, haematology, human genetics, infectious diseases, general surgery, orthopaedics, general medicine, paediatrics, obstetrics & gynaecology, radiology and anaesthetics.
  • Platform for training of health workers and research.
Central Hospital Care
  • Very highly specialized tertiary and quaternary service on a national basis and a platform for the training of health workers and research.
  • Highly specialized referral units for the other hospitals and provide a high cost and low volume service.
  • These hospitals employ high technology and highly trained staff.
 
 
 
 

References:

Stephan Pentz, The District Health System in South Africa, 2024

Session 2
Session 5