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A framework for implementation of community-orientated primary care in the Metro Health Services, Cape Town, South Africa

Robert Mash, Charlyn Goliath, Hassan Mahomed, Steve Reid, Derek Hellenberg, Gio Perez
African Journal of Primary Health Care & Family Medicine | Vol 12, No 1 | a2632 | DOI: https://doi.org/10.4102/phcfm.v12i1.2632 | © 2020 Robert Mash, Charlyn Goliath, Hassan Mahomed, Steve Reid, Derek Hellenberg, Gio Perez | This work is licensed under CC Attribution 4.0
Submitted: 26 June 2020 | Published: 18 December 2020

About the author(s)

Robert Mash, Division of Family Medicine and Primary Care, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Charlyn Goliath, Metro Health Services, Western Cape Government, Cape Town, South Africa
Hassan Mahomed, Metro Health Services, Western Cape Government, Cape Town, South Africa; and, Department of Global Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
Steve Reid, Primary Health Care Directorate, University of Cape Town, Cape Town, South Africa
Derek Hellenberg, Department of Family Medicine, University of Cape Town, Cape Town, South Africa
Gio Perez, Metro Health Services, Western Cape Government, Cape Town, South Africa


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Abstract

In South Africa, the national policy on re-engineering primary health care (PHC) supports the implementation of ward-based outreach teams with community health workers. In the Western Cape, a community-orientated primary care (COPC) approach has been adopted in provincial goals for 2030 and the key strategies for the improvement of district health services. This approach is expected to improve health and also save costs. A task team was established in the Metropolitan Health Services to develop an implementation framework for COPC. The framework was developed in an iterative process with four learning sites in the metropole over a period of 18 months. The framework consists of 10 inter-related elements: geographic delineation of PHC teams, composition of PHC teams, facility-based and community-based teamwork, partnership of government and non-government organisations, scope of practice, information system, community engagement, stakeholder engagement, training and development of PHC teams, system preparation and change management. This framework was implemented at the four learning sites and is now being taken to scale and further assessed in the metropole

Keywords

primary health care; community-orientated primary care; primary care; service delivery; health system design; community health workers

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