Rural district hospitals – essential cogs in the district health system – and primary healthcare re-engineering

Karl Willem du Pré le Roux, Ian Couper


The re-engineering of primary healthcare (PHC) is regarded as an essential precursor to the implementation of National Health Insurance in South Africa, but improvements in the provision of PHC services have been patchy. The authors contend that the role of well-functioning rural district hospitals as a hub from which PHC services can be most efficiently managed has been underestimated, and that the management of district hospitals and PHC clinics need to be co-located at the level of the rural district hospital, to allow for proper integration of care and effective healthcare provision.

Authors' affiliations

Karl Willem du Pré le Roux, Zithulele Hospital, Eastern Cape, South Africa; Honorary Lecturer, Primary Health Care Directorate, Faculty of Health Sciences, University of Cape Town, South Africa; Rural Doctors Association of South Africa Executive Committee

Ian Couper, Professor and Director, Centre for Rural Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

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District hospitals; Primary health care (PHC); District health system; Re-engineering of PHC; South Africa; Rural health; National Health Insurance (NHI); Integration of care

Cite this article

South African Medical Journal 2015;105(6):440-441. DOI:10.7196/SAMJ.9284

Article History

Date submitted: 2014-12-11
Date published: 2015-05-06

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