Challenges and solutions to nurse-delivered integrated primary health care in Nelson Mandela Bay

Abstract

Background: Delivery of a comprehensive and integrated primary health care service to increase healthcare access, quality, equity and efficiency requires an effective working environment.

Aim: To explore perceptions of primary health care nurses in the Eastern Cape, South Africa, regarding the adequacy of their working environment for integrated primary health care service delivery.

Setting: Selected public primary health care clinics in a subdistrict of the Nelson Mandela Bay metropole, Eastern Cape, South Africa.

Methods: A qualitative descriptive explorative design was used. Semi-structured interviews were conducted with nine nurses working in the selected facilities. Data were thematically analysed.

Results: Availability of members of the multidisciplinary primary health care team, nurse competency, responsiveness and productivity levels compromise integrated primary health care. Service delivery is further negatively impacted by a lack of resources and non-optimal collaboration among members of the primary health care team.

Conclusion: Challenges to rendering an effective integrated primary health care service exist within the primary health care working environment. To significantly increase comprehensive and integrated primary health care service delivery as a quality component of South African healthcare, these challenges need to be addressed.

Contribution: An evidence-based description of aspects of primary health care workspaces that compromise integrated primary health care delivery is provided. This information can be used to improve integrated primary health care services. Integrated services are a prerequisite for the Ideal Clinic Initiative, which is a foundation of the implementation of the National Health Insurance (NHI) scheme for South Africa.