The Status of Clinic Committees in Primary Level - Health Systems ...

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The Status of Clinic Committees in Primary Level Clinics in South Africa 4.7 Clinic committee: constitution and convener ...............................................................................34 4.8 Number of members on clinic committees ................................................................................... 35 4.9 Term of office for clinic committees .............................................................................................. 36 4.10 Frequency of meetings ................................................................................................................ 36 4.11 Process of appointment onto clinic committees ............................................................................. 37 4.12 Composition of the clinic committees ........................................................................................... 38 4.12.1 Local Government Councillors ......................................................................................... 38 4.12.2 Clinic staff membership ..................................................................................................... 39 4.12.3 Members of the community .............................................................................................. 39 4.12.4 Gender representation ....................................................................................................... 39 4.12.5 Head of the health facility ................................................................................................ 39 4.13 Portfolios ..................................................................................................................................... 39 4.14 Activities of clinic committees ...................................................................................................... 40 4.15 Involvement with finances ........................................................................................................... 41 4.16 Mechanisms of communication between clinic committees and communities ............................... 43 4.18 Training needs .............................................................................................................................. 45 4.19 Summary of results ...................................................................................................................... 45 CHAPTER 5: DISCUSSION ................................................................................................................... 46 5.1 Introduction ................................................................................................................................. 46 5.2 A supportive political context ....................................................................................................... 46 5.3 Compliance and implementation ................................................................................................. 47 5.3.1 Composition of the clinic committees .................................................................................. 47 5.4 Individualised activities versus a primary health care approach .................................................... 48 5.5 Impact of clinic committees .......................................................................................................... 49 5.6 Factors influencing functioning of clinic committees ..................................................................... 49 5.6.1 Support from health facility staff ........................................................................................ 49 5.6.2 Resources .......................................................................................................................... 50 5.6.3 Training ............................................................................................................................ 50 5.6.4 Socio-economic contexts ................................................................................................. 50 5.6.5 Guidelines ......................................................................................................................... 50 CHAPTER 6: CONCLUSION .................................................................................................................. 51 RECOMMENDATIONS .......................................................................................................................... 52 REFERENCES ......................................................................................................................................... 54 3
List of Tables and Figures Table 1: Clinic committees and community health centre committees in South Africa ........................ 11 Table 2: Levels and forms of community participation ........................................................................ 13 Table 3: Contrasting approaches to community participation ............................................................. 14 Table 4: Response rate and overview of facilities included in the survey ........................................... 28 Table 5: Access to electricity by Province: 2003 and 2008 ................................................................. 31 Table 6: Comparison of existence of clinic committees 2003 and 2008 .............................................. 32 Figure 1: Days of operation ................................................................................................................. 29 Figure 2: Water supply in clinics ......................................................................................................... 29 Figure 3: Problems with water supply.................................................................................................. 30 Figure 4: Electricity supply in clinics ................................................................................................... 30 Figure 5: Working toilets for patients and staff .................................................................................... 31 Figure 6: Clinic committee status ........................................................................................................ 32 Figure 7: Number of years in existence ............................................................................................... 33 Figure 8: Clinic committees with a constitution ................................................................................... 34 Figure 9: Clinic Committee Convenor ................................................................................................. 35 Figure 10: Number of members per clinic committee ............................................................................ 35 Figure 11: Term of office ...................................................................................................................... 36 Figure 12: Frequency of meetings ......................................................................................................... 37 Figure 13: Appointment onto clinic committees .................................................................................... 37 Figure 14: Local councillor membership .............................................................................................. 38 Figure 15: Portfolios .............................................................................................................................. 40 Figure 16: Activities of clinic committees ............................................................................................. 41 Figure 17: Involvement with finances .................................................................................................... 42 Figure 18: Mechanisms of communication ........................................................................................... 44 4
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