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SOUTH AFRICAN HEALTH POLICY ENVIRONMENT
The health sector is a key player in the South African Government’s strategy to fight poverty, discrimination and to build the nation (Democracy and Governance Human Science Research Council (Hsrc) 2005; The Presidency RSA 2008; Policy and Co-Ordination and Advisory Service: Social Sector 2010; The Presidency RSA 2010; World Health Organization 2010). The vision for the health sector is “A Long and Healthy Life for All South Africans” (National Department of Health 2009a). The South African administration’s Programme of Action includes a ten-point plan for the improvement of the health sector, which was formalised in a Negotiated Service Delivery Agreement (NSDA) (The Presidency: National Planning Commission 2010). The National Department of Health specifically agreed to improve life expectancy of South Africans, to curb child and maternal mortality, to decrease the burden of HIV and tuberculosis and to increase the effectiveness of the healthcare system, as part of the Presidency’s Medium Term Strategic Framework (National Department of Health 2012b).
These policies build on the three streams of the re-engineering of the primary healthcare system: (1) district clinical specialist teams; (2) strengthening of school health services; and(3) ward-based primary healthcare teams (National Department of Health 2008a; c. 2011; Community Media Trust 2011; National Department of Health 2012c; National Department of Health Ministerial Task Team 2012; National Department of Health). Although physiotherapists are not part of these teams, they are indispensable for building capacity in these teams, which include community health workers, and being a part of the referral system (World Health Organization 2006b).
The gap in the provision of community health workers, core members of the primary healthcare teams, is substantial (National Department of Health 2011b). The implication of this under-provision is that other team members may have to step in in areas of general competence needed by the team, such as epidemiological surveys, health promotion and prevention, palliative care, social mobilisation, linking resources with community needs, improvement of health outcomes and the celebration of team health days (Lehmann and Sanders 2007). In South Africa practitioners of traditional African medicine are also role players in providing health care (National Department of Health 2008a). Therefore, “a key professional competency is the ability to work with teams consisting largely of basic and ancillary health workers and supportive staff” (Frenk et al. 2010: 1984). Another responsibility of health practitioners is therefore the transfer of skills to these cadres of workers (World Health Organization 2006a; National Department of Health 2011a; 2011b).
1. ORIENTATION TO THE RESEARCH
2. METHODOLOGY
3. SITUATION ANALYSIS
4. COMMUNITY PHYSIOTHERAPY MODE
5. CORE COMPETENCY FRAMEWORK
6. EDUCATIONAL AND ASSESSMENT STRATEGIES
7. CONCLUSIONS AND RECOMMENDATIONS
