| Summary |
There are gaps between policy and practice in primary health care and improving primary level health services is notoriously slow. The Initiative for Sub-district Support (ISDS) has grappled with the dilemma of improving the technical aspects of primary health care delivery, whilst at the same time balancing this with a developmental approach that capacitates local staff. This document is evidence of the success achieved by ISDS in this balancing act. District staff can produce the required outcomes if given time, support, technical guidance and follow-up. This is made possible by the ongoing presence of ISDS facilitators, good working relationships, technical expertise and understanding of districts. The ISDS has been working on two major goals for the past six years. The first is developing and strengthening the district health system and the second is in improving
the quality of primary care services.
The ISDS has worked in all provinces and in all types of districts ranging
from the most well resourced metropolitan districts to the poorest of
rural districts. Currently the ISDS is working mainly in the 13 most
disadvantaged rural districts in South Africa. This work is part of the
Integrated Sustainable Rural Development Programme (ISRDP), a
presidential lead project, aimed at improving the lives of the most needy.
This document highlights some of the lessons that have been gathered
by working with mainly the management structures of the districts and
sub-districts, but also from our interactions with senior management at
provincial and national level. |
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