Original Research

The ability of primary healthcare clinics to provide quality diabetes care: An audit

Elizabeth M. Webb, Paul Rheeder, Jacqueline E. Wolvaardt
African Journal of Primary Health Care & Family Medicine | Vol 11, No 1 | a2094 | DOI: https://doi.org/10.4102/phcfm.v11i1.2094 | © 2019 Elizabeth M. Webb, Paul Rheeder, Jacqueline E. Wolvaardt | This work is licensed under CC Attribution 4.0
Submitted: 22 March 2019 | Published: 17 October 2019

About the author(s)

Elizabeth M. Webb, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
Paul Rheeder, Department of Internal Medicine, School of Medicine, University of Pretoria, Pretoria, South Africa
Jacqueline E. Wolvaardt, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa


Background: In South Africa, much of diabetes care takes place at primary healthcare (PHC) facilities where screening for diabetic complications is often low. Clinics require access to equipment, resources and a functional health system to do effective screening, but what is unknown is whether these components are in place.

Aim: The aim of this study was to assess the capacity of primary care clinics in one district to provide quality diabetes care.

Setting: This study was conducted at the Tshwane district in South Africa.

Methods: An audit was done in 12 PHC clinics. A self-developed audit tool based on national and clinical guidelines was developed and completed using observation and interviewing the clinic manager and pharmacist or pharmacy assistant.

Results: Scales, height rods, glucometers and blood pressure machines were available. Monofilaments were unknown and calibration of equipment was rare. The Essential Drug List was the only guideline consistently available. All sites reported consistent access to medication, glucose strips and urine dipsticks. All sites made use of the chronic disease register, and only 25% used an appointment system. No diabetes-specific structured care form was in use. All facilities had registered and enrolled nurses and access to doctors. Availability of educational material was generally poor.

Conclusion: The capacity to deliver quality care is compromised by the poor availability of guidelines, educational material and the absence of monofilaments. These are modifiable risk factors that could be resolved by the clinic managers and staff development educators. However, patient records and health information systems need attention at policy level.


diabetes; primary care; quality; audit; clinic


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Crossref Citations

1. Designing an integrated, nurse-driven and home-based digital intervention to improve insulin management in under-resourced settings
Patrick Ngassa Piotie, Paola Wood, Elizabeth M. Webb, Johannes F.M. Hugo, Paul Rheeder
Therapeutic Advances in Endocrinology and Metabolism  vol: 12  first page: 204201882110546  year: 2021  
doi: 10.1177/20420188211054688