Perceived quality of primary healthcare post-National Health Insurance pilot implementation

Newborn and infant hearing screening at primary healthcare clinics in South Africa designated as National Health Insurance pilot sites: An exploratory study

Background

Primary healthcare (PHC) is the first point of entry, providing basic services to individuals. South Africa is in the process of re-engineering its PHC as part of National Health Insurance (NHI) plans to ensure universal healthcare coverage.

Aim

This study aimed to establish whether newborn and infant hearing screening (NIHS) could be integrated into the re-engineering process of the PHC as part of the NHI framework.

Setting

The NHI pilot clinics in five provinces in South Africa.

Methods

A non-experimental, descriptive, cross-sectional survey research design was adopted. Questionnaires were sent to nursing managers, unit managers or acting managers at PHC facilities. Nineteen of these self-administered questionnaires were completed. Data were analysed using descriptive statistics.

Results

Immunisation services were the most common type of service offered at the clinics. Over a quarter of the respondents indicated that NIHS services were offered at their facility in the form of universal NIHS. Equipment was limited with a lack of valid and reliable screening measures. Only 2 (11%) respondents indicated budgetary resources. Follow-up and referral pathways were reported by 10 (53%) respondents, which did not include an audiologist.

Conclusions

There is a need for careful and systematic planning in terms of early hearing detection programmes at PHC level. Planning needs to commence with considerations of who will perform NIHS, training of these personnel by audiologists and the role of the audiologist within the teams outlined in the NHI Bill.