A community-involvement model for improving primary health care services in a Western Cape Metropolitan Municipality

Sayers, Stanley Andrew

A community-involvement model for improving primary health care services in a Western Cape Metropolitan Municipality

Author(s)

Sayers, Stanley Andrew

Date Issued

2026

Type

bachelor thesis

Publisher

Cape Peninsula University of Technology

Abstract

Community involvement in the public domain is a subject of great complexity, despite the large body of legislation internationally, nationally and within the City of Cape Town. This study analyses attempts by central, provincial and local spheres of government to honour the constitutional provision of the right to have access to health services. The study consists of an extensive review of the literature that comprises books, legislation and journal articles accessed from the internet. In the process, a study is made of community involvement theory, primary health care (PHC) theory and legislation pertaining to health. On the basis of this study, an input/output transformational systems model is presented of how the Health Department of the City of Cape Town can guide its management staff in achieving their primary health care objectives. The model is a normative one intent on assisting managers to attain understanding of set objectives effectively and efficiently. The assumptions underlying the model emphasise that the model strives to improve performance. Data were collected by means of a mixed approach of a questionnaire and semi-structured interviews among clinic management staff in the Health Department and ward committee members from the subcouncil. The analysis of the data collected by the questionnaire was done using SPSS, with the assistance of a registered statistician. Four major focus areas transpired from the quantitative instrument. These areas of significant concern are clinics do not have community profiles; the risk management of prevailing diseases in certain communities; clinic staff are not familiar with ward councillors or community leaders; and inactive health committees. However Ward committees as described in the Municipal Structures Act No. 117 of 1998 part 4 section 72 (3), a ward councillor represents a ward in council, with 10 additional members representing women and disabled, arts and culture, business, community based organisations, designated vulnerable groups, education, environment, faith based organisations, safety and security organisations, sports and youth. This advantages opportunity to incorporate ward committees (legislative governance representative structure) in planning health programmes must be given earnest consideration within the current resource scarce environment. Hence the proposed model for health and wellbeing, indicate “community governed” as component A in the model. The community governed oblidge the clinic to conduct a community needs assessment or focus group (community profile) sessions, that will eventuate into capacity building, partnerships and community self-reliance. Hence ward committees and health committees interrelations across provincial and municipal health governance structures within the Western Cape. One critical aspect in the provision of primary health care that enjoyed attention during the semi-structured interviews is the inaccessibility of health clinics owing to safety and public transport. The study concludes by advising on the feasibility of conducting further research on the importance of community profiles in the provision of primary health care.

Additional information

Thesis (Doctor of Public Administration)--Cape Peninsula University of Technology, 2026

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