Patients perceptions of primary health care service facilities in Mitchells Plain, Western Cape

Herman, Veronica Cynthia (2020-03)

Thesis (MNur)--Stellenbosch University, 2020.

Thesis

ENGLISH SUMMARY : Background: A large percentage of the population in the Western Cape, living in disadvantaged communities, rely predominately on a Primary Health Care (PHC) delivery system for their health needs. Despite progress legislation, that affords free health to the poor and vulnerable, and health reforms that ensure these rights, users of the PHC delivery system still face daily challenges of unmet needs. There is a sense of disillusionment with their perception of unfulfilled promises, lack of trust and a feeling of being marginalised, in favour of the private healthcare sector. PHC delivery and how it impacts on their health has a direct bearing on their health outcomes. Listening to patients’ perceptions of Primary Health Care services will not only provide insight into the gap between policy implementation and their experiences, but also provide patients with an opportunity to relay their concerns, expectations and fears. Method: A descriptive qualitative research design, with the purpose to describe the perception of the study participants was used. Participants from two PHC facilities in Mitchell’s Plain, Western Cape were invited to participate using a snowball networking sample. The participants were individually interviewed in a private setting away from the PHC facility. A pilot interview was conducted. The aim of the pilot study was to refine the study sampling process and probe relevant responses from the participant, and to assist the researcher to lay aside any preconceived ideas. Ethical principles, such as respect for the person, confidentiality and anonymity, beneficence and non-maleficence were maintained. Trustworthiness, consisting of credibility, transferability and dependability were applied throughout the study. Results: Ten semi-structured one-on-one interviews were conducted in private areas away from the PHC facility. During the data analysis, themes emerged, pertaining to patient-centred care, participants’ perception of healthcare providers at the PHC service facilities, participant’s perception of PHC services and facilities, expectation and proposed solutions for improving PHC service delivery (see table 4.2.page 33). With the expectations of a few participants, it has been found that the providers of the PHC were unhelpful, uncourteous and unprofessional. Gaps and barriers experienced in the PHC service delivery were highlighted, such as long waiting hours, fragmentation of service delivery, misinformation regarding medication delivery and appointments. Constructive suggestions on the improvement of the PHC service delivery and facilities were given. Conclusion: This study provided a unique opportunity to listen to the PHC users’ experiences and perceptions and the reality thereof. The participants highlighted perceived gaps and barriers in the PHC facilities and services and suggested possible improvements to the PHC facilities and services.

AFRIKAANSE OPSOMMING : Agtergrond: ‘n Groot persentasie van die bevolking in agtergeblewe gemeenskappe wat in die Wes-Kaap bly, is hoofsaaklik afhanklik van ‘n Primêre Gesondheidsorgstelsel se dienste vir hulle gesondheidsbehoeftes. Ten spyte van gevorderde wetgewing wat gratis gesondheidsdienste aan die armes en kwesbares verleen, en gesondheidshervorming wat die regte van die verbruikers van die Primêre Gesondheidsorgdienste (PGS) beskerm, staar verbruikers nog steeds daagliks die uitdagings van onbevredigende gesondheidsdienste in die gesig. Daar is ‘n gevoel van ontnugtering weens onvervulde beloftes, ‘n gebrek aan vertroue en ‘n gevoel van marginalisering, met inagneming van die privaatgesondheidsektor. Die PGS diensverskaffing en die impak daarvan op die gesondheid van die verbruiker, het ‘n direkte effek op hulle gesondheidsuitkomste. Deur na die persepsies van pasiënte oor die Primêre Gesondheidsorgdienste te luister, sal nie alleenlik insig gee oor die gaping tussen beleidsïmplementering en hulle werklike ervaringe nie, maar ook geleentheid bied aan pasiënte om hulle besorgdhede, verwagtinge en vrese te deel. Metode: ‘n Beskrywende kwalitatiewe navorsingsontwerp met die doel om die ervaringe van die deelnemers van die studie te beskryf, is gebruik. Deelnemers van PGS fasiliteite in Mitchell’s Plein, in die Wes-Kaap is genooi om deel te neem aan ‘n sneeubalnetwerk steekproef. Onderhoude is individueel met deelnemers in ‘n private omgewing, weg van die PGS fasiliteit gevoer. ‘n Loodsondersoek is uitgeoefen. Die doel van die loodsondersoek is om die steekproefproses van die navorsingstudie te verfyn, relevante response van die deelnemers te peil, en om die navorser te help om enige vooropgestelde idees ter syde te stel. Etiese beginsels soos respek vir ‘n persoon, vertroulikheid, anonimiteit, verootmoediging en skadeloosheid is eerbiedig. Geloofwaardigheid, geloofbaarheid, oordraagbaarheid en betroubaarheid is deurgaans toegepas. Resultate: Tien ongestruktureerde onderhoude is een vir een met deelnemers in private areas, weg van die PGS fasiliteit gevoer. Gedurende die data-analise is temas geïdentifiseer wat met pasiëntgesentreerde sorg te make het; deelnemers se persepies van die dienste wat die PGS verskaf en die fasiliteite van die stelsel; hulle verwagtinge en voorgestelde oplossings vir die verbetering van PGS se diensverskaffing is bekend gemaak. As gevolg van die verwagtinge van ‘n paar deelnemers is bevind dat die PGS se diensverskaffers onbehulpsaam, onbeleefd en onprofessioneel is. Gapings en struikelblokke in die PGS dienslewering is uitgelig, soos lang wagtye, gefragmenteerde diensverskaffing, waninligting ten opsigte van medikasie-verskaffing en afsprake. Konstruktiewe voorstelle vir die verbetering van die PGS se diensverskaffing en fasiliteite is gegee. Gevolgtrekking: Hierdie ondersoek het ‘n unieke geleentheid verskaf om te luister na die ervaringe van PGS verbruikers se persepsies en die werklikhede daarvan. Dit het ook geleentheid aan die deelnemers as PGS verbruikers gebied om hulle besorgdhede, frustrasies en opinies te lig om sodoende aktiewe deelnemers van die bestuur van hulle gesondheidsorg te word.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/108009
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