Original Research

Primary healthcare services in the rural Eastern Cape, South Africa: Evaluating a service-support project

Angela A. Morris-Paxton, Stephen Reid, Rose-Marie G. Ewing
African Journal of Primary Health Care & Family Medicine | Vol 12, No 1 | a2207 | DOI: https://doi.org/10.4102/phcfm.v12i1.2207 | © 2020 Angela A. Morris-Paxton, Stephen Reid, Rose-Marie G. Ewing | This work is licensed under CC Attribution 4.0
Submitted: 15 July 2019 | Published: 02 April 2020

About the author(s)

Angela A. Morris-Paxton, Drug Utilisation Research Unit, Department of Pharmacy, Faculty of Health Sciences, Nelson Mandela University, Port Elizabeth, South Africa
Stephen Reid, Primary Healthcare Directorate, Faculty of Health Sciences, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
Rose-Marie G. Ewing, Donald Woods Foundation, Vincent, East London, Eastern Cape, South Africa


Background: In 2012, 38% of the South African population resided in the rural areas of the country. The professional healthcare services are concentrated in the urban areas, resulting in an imbalance between urban and rural healthcare services.

Aim: The aim of this study was to evaluate the use of a non-governmental organisation (NGO)-supported mobile healthcare service in a remote area.

Setting: Eastern Cape Province in South Africa.

Methods: The walking distance between the community and the nearest fixed government healthcare service was evaluated and compared with the recommendations of World Health Organization (WHO). Services provided to people visiting the mobile community service were recorded, and descriptive data were analysed and compared with the anonymised patient records of the nearest fixed service clinic.

Results: Of the 30 outreach points served by the NGO, 24 points were at a distance more than the WHO-designated walking distance and 11 points were more than twice the WHO-designated distance from the perspective of fixed clinic. The average headcount per annum of the outreach NGO mobile clinics exceeded those of the fixed Department of Health (DoH) clinics by an average of 250 patients per clinic session. The increase in services was also noteworthy, with a mean differential of 1774 services per annum for the same day above that of the DoH clinics.

Conclusion: Mobile services could make a difference to the utilisation of essential healthcare facilities. The provision of augmented NGO-led mobile clinical outreach services and joint government–NGO partnerships holds possibilities for improving healthcare for those living in remote rural areas.


clinical outreach services; Eastern Cape; NGO; primary healthcare; rural areas


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