Original Research

Why high tech needs high touch: Supporting continuity of community primary health care

Ellenore D. Meyer, Johannes F.M. Hugo, Tessa S. Marcus, Rebaone Molebatsi, Kabelo Komana
African Journal of Primary Health Care & Family Medicine | Vol 10, No 1 | a1616 | DOI: https://doi.org/10.4102/phcfm.v10i1.1616 | © 2018 Ellenore D. Meyer, Johannes F.M. Hugo, Tessa S. Marcus, Rebaone Molebatsi, Kabelo Komana | This work is licensed under CC Attribution 4.0
Submitted: 28 August 2017 | Published: 21 June 2018

About the author(s)

Ellenore D. Meyer, Department of Family Medicine, University of Pretoria, South Africa
Johannes F.M. Hugo, Department of Family Medicine, University of Pretoria, South Africa
Tessa S. Marcus, Department of Family Medicine, University of Pretoria, South Africa
Rebaone Molebatsi, Department of Obstetrics and Gynaecology, School of Medicine, University of Pretoria, South Africa
Kabelo Komana, Department of Obstetrics and Gynaecology, School of Medicine, University of Pretoria, South Africa


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Abstract

Background: Integrated care through community-oriented primary care (COPC) deployed through municipal teams of community health workers (CHWs) has been part of health reform in South Africa since 2011. The role of COPC and integration of information and communication technology (ICT) information to improve patient health and access to care, require a better understanding of patient social behaviour.

 

Aim: The study sought to understand how COPC with CHWs visiting households offering health education can support antenatal follow-up and what the barriers for access to care would be.

 

Method: A mixed methodological approach was followed. Quantitative patient data were recorded on an electronic health record-keeping system. Qualitative data collection was performed through interviews of the COPC teams at seven health posts in Mamelodi and telephonic patient interviews. Interviews were analysed according to themes and summarised as barriers to access care from a social and community perspective.

 

Results: An integrated COPC approach increased the number of traceable pregnant women followed up at home from 2016 – 2017. Wrong addresses or personal identification were given at the clinic because of fear of being denied care. Allocating patients correctly to a ward-based outreach team (WBOT) proved to be a challenge as many patients did not know their street address.

 

Conclusion: Patient health data available to a health worker on a smartphone as part of COPC improve patient traceability and follow-up at home making timely referral possible. Health system developments that support patient care on community level could strengthen patient health access and overall health.


Keywords

community orientated primary care; technology enabled primary care; primary health care

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