An evaluative study of primary health care implementation strategy in the cholera infested District 28 of KwaZulu-Natal

Submitted in fulfillment of the requirements for the degree of Master of Arts: Curationis in the Department of Nursing Science at the University of Zululand, 2003.

Cholera has been controlled before under Primary Health Care strategies but all of a sudden it has become a pandemic disease killing people thus affecting the socio-economic status of the country. This state of affairs is not in line with the statement issued out by the World Health Organization which states "Health for all by year 2000". The main aim of this study was to investigate the extent at which the Primary Health Care strategy has been implemented in the cholera infested areas of District 28. Objectives of the study were: • To determine to what extent was the Primary Health Care strategy implemented. * • To determine availability of resources namely provision of good water supply and good sanitation. • To recommend implerhentation of an effective health promotion and disease prevention programme. The information gathered in this study would help the health planners in District 28 in strategic planning. A quantitative research method was used to determine how the respondents viewed the present state of primary health care services with regard to availability of resources and how much successful these services meet the community needs. The target population consisted of community members, environmental officers, community health care workers, directors and nurses. The questionnaire was used a* for collecting data and interviews were also conducted. The study revealed that some rural communities had poor water supply and poor sanitation which might have been the cause of the outbreak of cholera in District 28. In spite of the existence of health education programmes in some areas of District 28, and efforts made by some of various categories of health workers in providing health education, the community members revealed knowledge deficit with regard to personal hygiene, food hygiene, waste disposal and water purification. Health services are inaccessible to the majority of rural communities due to poor roads, transport, cost and distance. The main recommendations of the study were as follows.- • Strengthening of health education programmes and campaigns. • Provision of resources namely safe adequate water supply and good sanitation to rural communities. • Improvement of infrastructure namely transport and construction of roads.