The success of achieving health security is depended on healthcare facilities, thus
making comprehensive healthcare service provision fundamental. This study aimed to
formulate strategies to ease the serve delivery of quality healthcare in public
healthcare facilities in Fetakgomo Tubatse Local Municipality.
Quality healthcare is a crucial need for every individual. Good health nurtures
happiness and fosters a positive self-esteem. However, numerous public healthcare
facilities are facing a number of hurdles that hinder good service delivery for
communities nationwide, especially those in rural settings. For instance, overcrowding
is one of the main issues highlighting poor service delivery, resulting in people not
receiving good quality of care. This affects the patients’ healthcare experience and
outcomes. The prevailing challenges emphasise the fundamental issues of healthcare
in society. The difficulties faced by both healthcare workers and patients due to poor
service delivery spiral out of control. Some of the common issues include inadequate
facilities, insufficient resources, poor infrastructure, shortage of medical equipment
and supplies, shortage of staff and no consistent water supply among others.
The study adopted the Batho Pele Principles and Donabedian Model to understand
and analyse the role public healthcare facilities play in improving health services. By
examining how these facilities contribute to overall health security. The study aimed
to acquire to acquire knowledge into the efficacy of public healthcare facilities in
achieving health security.
Qualitative methods were adopted for this study. The study population was constituted
by auxiliary nurses, assistant nurses, professional nurses, operational managers,
home-based care workers, counsellors, patients, and/or community members.
Fieldwork was conducted using observations, semi-structured interviews, and focus
group discussions with healthcare workers and patients who were the community
members. The study area was Fetakgomo Tubatse Local Municipality; however, the
research was undertaken only in the Fetakgomo Municipal area, excluding the
Tubatse Municipal area, as the two municipalities are now amalgamated. Findings shows that limited facilities, a shortage of resources, a lack of 24-hour
services, and poor infrastructure hinder healthcare access. Despite these challenges,
patients are generally satisfied with the health services, although issues such as slow
services and medication shortages persist.
The findings of the study contributes to the advancement, awareness and
comprehension of the role management of the facilities play in ensuring effective
healthcare provision and that vulnerable populations have access to public healthcare
services. Furthermore, the study greatly contributes to the achievement of public
health and provides nuances and understanding on the strides, challenges and way
forward for attaining health for all and ultimately contributing to broader discussions
on public healthcare, sustainable development and poverty alleviation in South Africa.
The study concludes that the healthcare facilities in Fetakgomo contributes to health
security; however, they face structural and operational challenges. There is a need for
policy interventions in healthcare to enable facilities to narrow down the quality care
provision gap that already exist. This also study contributes to the current policy
dialogue and serve as a foundation for proven methods aimed at enhancing healthcare
security for the impoverished people and assisting the country to achieve universal
health coverage.
Katlego ya go fihlelela tšhireletšo ya maphelo e ithekgile godimo ga mafelo a
tlhokomelo ya maphelo, ka go realo e dira gore kabo ya tirelo ya tlhokomelo ya
maphelo ye e feletšego e be ya motheo. Maikemišetšo a nyakišišo ye ke go hlama
maano a go nolofatša kabo ya ditirelo tša tlhokomelo ya maphelo ya maemo a godimo
ka mafelong a tlhokomelo ya maphelo a setšhaba ka gare ga Mmasepala wa Selegae
wa Fetakgomo Tubatse.
Tlhokomelo ya maphelo ya boleng ke tlhokego ye bohlokwa go motho yo mongwe le
yo mongwe. Bophelo bjo bobotse bo godiša lethabo le go hlohleletša boitlhompho bjo
bobotse. Efela, mafelo a mantši a tlhokomelo ya maphelo a setšhaba a lebane le
mapheko a mmalwa ao a šitišago ditšhaba nageng ka bophara go hwetša kabo ye
botse ya ditirelo, kudu tšeo di lego ditikologong tša dinagamagaeng. Go fa mohlala,
go tlala kudu ke e nngwe ya ditaba tše dikgolo tšeo di laetšago kabo ye e fokolago ya
ditirelo, yeo e feleletšago ka go dira gore batho ba se hwetše tlhokomelo ya maemo a
mabotse. Se se ama maitemogelo a tlhokomelo ya maphelo a balwetši le dipoelo.
Ditlhohlo tše di lego gona di gatelela ditaba tša motheo tša tlhokomelo ya maphelo
setšhabeng. Mathata ao bobedi bašomi ba tlhokomelo ya maphelo le balwetši ba
lebanego le ona ka lebaka la kabo ye mpe ya ditirelo a tšwela pele ka ntle ga taolo.
Tše dingwe tša ditaba tše di tlwaelegilego di akaretša mafelo a a sa lekanego,
methopo ye e sa lekanego, mananeokgoparara a mabe, tlhaelelo ya didirišwa tša
kalafo le disapholaye, tlhaelelo ya bašomi le kabo ya meetse ye e sego ya ka mehla.
Nyakišišo e amogetše melawana ya Batho Pele le mmotlolo wa Donabedian go
kwešiša le go sekaseka tema yeo mafelo a tlhokomelo ya maphelo ya setšhaba di e
kgathago go kaonafatša ditirelo tša maphelo, ka go hlahloba ka moo mafelo a a nago
le seabe ka gona go tšhireletšo ya maphelo ka kakaretšo. Maikemišetšo a nyakišišo
ye ke go hwetša tsebo ka ga go šoma gabotse ga mafelo a tlhokomelo ya maphelo a
setšhaba go fihlelela tšhireletšo ya maphelo.
Mekgwa ya khwalithethifi e amogeletšwe nyakišišo ye. Bakgathatema ba nyakišišo ba
bopša ke baoki ba okesilari, bathušabaoki, baoki ba profešenale, balaodi ba
tshepedišo, batlhokomelabalwetši ba ka magaeng, bathobamatswalo, balwetši le/goba maloko a setšhaba. Mošomo wa kgoboketšo ya tshedimošo o dirilwe ka go
šomiša ditemogo, dipoledišano tša peakanyoseripa le dipoledišano tša
sehlophanepišo ka bašomi ba tlhokomelo ya maphelo le balwetši bao e bego e le
maloko a setšhaba. Lekala la nyakišišo e be e le Mmasepala wa Selegae wa
Fetakgomo Tubatse; efela, nyakišišo ye e dirilwe fela Mmasepaleng wa Fetakgomo,
go sa akaretšwe Mmasepala wa Tubatse, ka ge bjale mebasepala ye mebedi ye e
kopantšwe go ba o tee.
Dikutullo di laetša gore mafelo a a sa lekanego, tlhaelelo ya methopo, tlhaelelo ya
ditirelo tša diiri tše 24 le mananeokgoparara a mabe di šitiša phihlelelo ya tlhokomelo
ya maphelo. Ntle le ditlhohlo tše, balwetši ka kakaretšo ba kgotsofetše ka ditirelo tša
maphelo, le ge e le gore ditaba tša go swana le ditirelo tša go nanya le tlhaelelo ya
dihlare di sa dutše di le gona.
Dikutullo tša nyakišišo di na le seabe go tšwetšopele, temošo le kwešišo ya tema yeo
taolo ya mafelo e e kgathago go kgonthiša kabo ya tlhokomelo ya maphelo ye e
šomago gabotse le gore badudi bao ba lego kotsing ba na le phihlelelo ya ditirelo tša
tlhokomelo ya maphelo ya setšhaba. Go feta moo, nyakišišo ye e na le seabe kudu
go phihlelelo ya maphelo a setšhaba gape e fa dintlha le kwešišo ka ga dikgato,
ditlhohlo le dikgato tse di latelago go fihlelela maphelo a bohle, mafelelong e ba le
seabe go dipoledišano tše di nabilego ka ga tlhokomelo ya maphelo a setšhaba,
tlhabollo ya moyagoile le phokotšo ya bodiidi ka Afrika Borwa.
Nyakišišo e tšea sephetho sa gore mafelo a tlhokomelo ya maphelo ka Fetakgomo a
na le seabe go tšhireletšo ya maphelo; efela, a lebane le ditlhohlo tša popego le tša
tshepedišo. Go na le nyakego ya magato a tsenogare a pholisi ka go tlhokomelo ya
maphelo go kgontšha mafelo go fokotša sekgoba sa kabo ya tlhokomelo ya boleng
seo se šetšego se le gona. Nyakišišo ye gape e na le seabe go poledišano ya bjale
ya pholisi gape e šoma bjalo ka motheo wa mekgwa ye e hlatsetšwego yeo e
lebantšhitšwego go kgodišo ya tšhireletšo ya tlhokomelo ya maphelo go batho bao ba
ihlokelago le go thuša naga go fihlelela kakaretšo ya maphelo ya lefase ka bophara.
Ku humelela ko fikelela vusirhelri bya rihanyu swi lawuriwa fi switirhisi swa
nhlayisorihanyu, ku endla nyiketo wo nhlayisorihanyu wo twisiseka na vukorhekeri byo
sungula. Dyondzo leyi ley iyi kongomisa ku vumba switirateji ku olovisa vukorhokeri
bya nkoka bya nhlayiso rihanyu eka switirhirhisi swa nhlayisorihanyu eMasipala wa
Xikaya wa Fetakgomo Tubatse
Nhlayisorihanyu wa nkoka i xilaveko xa nkoka ka munhu un’wana. Rihanyu ra kahle ri
byara ntsako no kondltela vumunhu kahle. Hambiswiritano, switirhisi swa
nhlayisorihanyonyingi swi na swiphiqo swo tala leswi kavanyetaka vukorhokeri bya
kahle migangeni ya tiko hinkwaro, ngopfu eka lava nga etindhawini ta le matikoxikaya.
Xikombiso, ku tala ka vona ii xin’wana xa swiphiqonkulu swo kombiso vukorhokeri bya
le hansi swo va vanhu va nga kumi nhlayiso wa nkoka wa kahle. Leswi swi khumba
nhlayiso wa xipiriyoni xa vavabyi na mimbuyelo. Mitlhotlho yi nga kona yi tiyisisa
masungulo ya swiphiqo swa nhlayiso wa rihanyu evanhwini. Ku nonohwa loku
langutaneke hi vatirhi va hinkwavo va nhlayisorihanyu na vavabyi hikwalaho ka
vukorhokeri bya le hansi a bya ha lawuleki. Swin’wana swa swiphiqo swo fanana swi
katsa switirhisiwa swi nga ringaniki, swithirisi swi nga ringanelangiki, swimakiwa swa
le hansi, vuhlayiseki bya swa vutshunguri na miphakelo, ku kayivela ka vatirhi na
nkayivelo wo phakela mati nkarhi un’wana na un’wana.
Dyondzo yi tirhisile milawu ya Batho Pele na modele wa Donabedian ku twisisa no
hlela ntirho wa switirhisiwa swa vanhu swa nhlayisorihanyu swi wu tlangaka ku
antswisa vukorhokeri bya rihanyu, hi ku kambisisa leswi switirhisiwa swi nga na xiae
ka vusirheleri hinkwabyo bya rihanyu. Dyondzo yi kongomisa ku kuma vutivi mayelana
na vuswikoti byo humesa mbuyelo wa switirhisi swa vanhu swa nhlayiso wa rihanyu.
Maendlelo ya nkoka ya tirhisiwile ka yondzo leyi. Eka vanhu hinkavo va dyondzo leyi
ku na vaongori va le kaya, vapfuneta vaongori, vaongori va xiphurofexinali, vafambisi
va swa matirhelo, vatirhi vo hlayisa va le kaya, vatsundzuxi va swa miehleketo,
vavabyi na/ kumbe swirho swa muganga. Ntirho wa le handle ka hofisi wu endliwile ku
tirhisiwa vuxoperi, swihlolahlola swa swivutiso fanana na mikanerisano ya ntlawa nkongomo hi vavabyi na vatirhi va nhlayiso rihanyo lava a va va ri swirho swa miganga.
Nkongomo wa dyondzo a ku ri wa Masipala wa Xikaya wa Fetakgomo Tubatse,
hambiswiritano, ndzavisiso wu endliwile ntsena endhawini ya Masipala wa
Fetakgomo, ku nga katsiwi Masipala wa nhawu ya Tubatse, tanihihileswi timasipala
letimbirhi tikatsiweke.
Swikumiwa swi komba leswaku ku na switirhisiwa swo pimiwa, ku kayivela ka
switirhisiwa, pfumaleko wa vukorhokeri bya 24-awara na swimakiwa swa le hansi swi
kavanyetaka mfikelelo wa nhlayisorihanyu. Handle ka mitlhontlho leyi, vavabyi va
enetekile hi vukorhokeri bya rihanyu, hambileswi swiphiqo swo fana na vukorhokri
byo nonoka na nkayivelo wa mirhi ya vutshunguri yi yaka emahlweni.
Swikumiwa swa dyondzo swi na xiave ka yiso emahlweni, mipfhumba na matwisiselo
ya ntirho wa mafambiselo ya switirhisiwa wu nga na nkoka ku endlela ku va na nyiketo
wa nhlayisorihanyu na vanhu hinkwavo va nga riki na ntshembo wo fikello ka
vukorhokeri bya vanhu va nhlayisorihanyu. Ku yisa emahlweni, dyondzo yin a
xiavenkoka ka ku kuma rihanyu ra vanhu no nyika mavonelo yo hambana na
matwisiselo ya magoza, mitlhontlho no yisa emahlweni ku kuma rihanyu ra hinkwavo,
emakumu ku va na xiave ka mikanerisano yo anamanyana eka nhlayisorihanyu wa
vanhu, nhluvkiso wo yisa emahlweni no susa vusiwani eAfirika Dzonga.
Dyondzo yi gimeta leswaku switirhisi swa le Fetakgomo swi na xiave ka vusirheleri
bya rihanyu; hambileswi, swi nga na mitlhontlho ya swa xivumbeko na swa matirhelo.
Ku na xilaveko xa manghenelelo ya pholisi eka nhlayisorihanyu ku endla leswaku
switirhisi swi tsongahata nyiketo wa vangwa ra nkoka wa nhlayiso lowu nga kona.
Dyondzo leyi yi na xiave ka n’wangulano wa pholisi ya sweswi no tirha tanihi
masungulo ya maendlelo ya vumbhoni yo kongomisiwa ku fikelela mphutselo wu nga
pimiwiki wa rihanyu.
