Quality of Care Offered to Children Attending Primary Health Care Clinics in Johannesburg (Report‪)‬

Primary health care (PHC) and the health of young children are popular focus areas for international organisations, politicians, heads of state, policy-makers and health professionals alike. They are the subject of innumerable policy statements and plans. In South Africa, the national health department has undoubtedly prioritised PHC, particularly in its fiscal decisions. Indeed, free primary health care for young children was one of the first decrees of Nelson Mandela on assuming the presidency in 1994, and free primary care services were extended to the whole population by 1996. Unfortunately, there is limited evidence that this strategy has borne success. Most gains lie within the infrastructural domain, such as the number of new clinics built or upgraded (approximately 3 000 since 1994), (1) rather than in improvements in the quality of care or, more importantly, reductions in morbidity and mortality. Saving Children: A Survey of Child Health Care in South Africa (2) suggests that in 26% of hospital cases resulting in deaths, deficiencies were identified in the clinical care at PHC level, entailing poor case assessment and management and delayed referral.