A model for effectively evaluating and monitoring primary health care services delivery in the Cape Metropolis in the Western Cape

Abstract

Emanating from the apartheid years, residential areas, facilities, and financing of services were designated according to the race. The best facilities were provided to the ruling white minority which by percentage comprises just over 5% of the total population. The second best was given to the second-class citizens, Asians, and Coloureds (products of mixed racial marriages) they had a slightly lower service structure than the whites. The indigenous blacks (Africans / natives) had the lowest facilities and funding. By law, they were prohibited (needed special permission) to live in towns / urban settings, and they had areas designated according to their race. The advent of democracy resulted in the influx of many blacks to urban centres, moving to the previously designated areas. Even with the advent of democracy, the poor facilities have not changed much limited by the land available and the resultant overcrowding due to urban migration. The current demography (housing) of the Cape Metro is 20% whites who occupy 58% of the land, 37% who occupy 16% of the land, and coloureds and Asians 43% who occupy 26% of the land. The Greater Cape Town (Cape Metropolitan) is divided into districts, and the most crowded is the formerly native housing scheme officially referred to as the Metro District. Very few changes have taken place in the Metro District regardless of the continued influx of urban migrants. The clinicians are few and overworked as their numbers have not changed significantly in the last 28 years of democracy. Primary Health Care has deteriorated, and medical personnel are moving to work in private medical care or opening private practices. The focus of this research is to develop a model to meet the increasing demand and provide PHC and Health Care suitable for the urbanized Metro District Community. Recommendations emanating from the study are made to transform and meet the constitutional expectations of a quality PHC and HC for all the citizens of the country, but specifically the Metro District.