Material constraints at rural clinics in Transkei

A 1-day survey of a random sample of rural government clinics in Transkei was conducted in order to assess the existence, magnitude and distribution of material constraints which impair the proper functioning of comprehensive community-based health services. Information on the availability of 50 material requirements was obtained from questionnaires completed by professional nurses in charge of clinics; these requirements included physical structures, equipment, logistics, medicines and other disposable supplies. Each measurement was given a score depending on its relevance towards three groups of primary health care services, namely care for mother and child, promotion of community health in general, and treatment of minor ailments, emergencies and long-term medication. The results show that material constraints exist at all clinics and that they are substantial at the majority of clinics. The three groups of services are affected, promotion of community health in general being more impaired than the other two. In addition each requirement was assessed separately and the effects of its non-availability were evaluated. Recommendations as to how these constraints can be remedied through short-term intervention or long-term planning are made.