Abstract
M.Cur.
The overall aim of the study is to explore and describe the factors that influence the accessibility of PHC services in Alexandra Township. Most of the time the public clinics in Alexandra rely on part-time nursing personnel to render health services. Sometimes there are so few nurses on duty that they cannot manage to perform all the services required in the clinic and the community. There are long queues of patients and they are often turned away because they cannot be attended to. Statistics (Clinic Statistics, Jan 2000-Dec 2000) show that about 100 000 people out of the total population of 350 000 people (Community Statistics, 1999) attend these clinics in a year. This number includes people who come to the clinics three or more times per year for services such as family planning, Tuberculosis and well baby.
To achieve the objectives of the study a quantitative, non-experimental, exploratory, descriptive and contextual design as described by Polit and Hungler (1997:166,456 & 466) and Burns and Grove (1997:52) was chosen. A pilot study (Burns and Grove 1997:52) was done in three phases with 12 patients, 10 community members and two professional nurses from the clinics. After that 300 interview schedules were administered to 160 randomly selected patients attending the four public clinics in the area and 140 members of the community. Ten questionnaires were distributed among the remaining 10 professional nurses. The researcher as a participant observer, made observations with the aid of an observation list, which was developed after the three phases of data collection to verify the data, collected.
A quantitative descriptive data analysis (Burns & Groove 1997:779) was done with the use of SPSS computer program. Content analysis was done on the open-ended questions and the results of the observations. The demographics of the residents reveal that the community is a vulnerable area (White paper, 1997:14) which should be the focus of the health service providers. Although the
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services are geographically accessible, they are provided in an unacceptable, inefficient, ineffective and inequitable manner. Moreover services are functionally, socially, physica.lly and financially inaccessible. Health education factors add to the inaccessibility of the services to the people. Guidelines to improve these factors were formulated to make public PHC services in the area more accessible. These findings have implications on nursing practice, education and research. A replica of the study in similar and different contexts in SA is recommended.