Transformation management of primary health care

M.Cur.The purpose of this study is to compile a strategy for transformation management in a local authority. Traditionally local authorities rendered preventative and promotive services. The provinces were responsible for rendering of curative services. This service delivery was fragmented due to political policies and diversification. With the new political dispensation in South Africa, the White Paper for the transformation of health services in South Africa (1997), gives direction for the integration of health service delivery to achieve the following mission focussing on equity, acceptability, accessibility, affordability, availability and appropriateness. These policy/legislative changes therefore require a strategy for transformation management of primary health care services. This impacts on the current service delivery system. The type of service delivery has to be reconstructed, to accommodate free primary health care services for all South Africans, additional services like curative services, dental services and termination of pregnancy services. Human resource management will also undergo significant changes as the local authority is expected to take over the existing provincial staff allocated to clinics. This could result in labour unrest if not well managed. There are also financial constraints that will impact on this process of transformation. The scarcity or shortage of medicines, equipment and other supplies necessary for quality service delivery also impact on the transformation process. The changing environment is difficult to handle, especially as it involves human beings who react differently towards change. Some individuals adapt easily in a changing environment, others resist change. Many meetings have been held to discuss the transformation of health services. The outcomes of these meetings have clearly demonstrated that health personnel are experiencing problems which are a direct result of the transformation process. Therefore it is important for management in a local authority in the East Rand, to devise a transformation strategy in order to implement primary health care services effectively and efficiently. The transformation strategy requires careful planning and decision making, that will be beneficiary to all the role players involved. Management in a local authority will have to take a leading role in the transformation management of primary health care services. This situation can be either a "challenge" or a "dilemma"