Thembelihle Sylvia Patience Ngxongo

  • Designation: Associate Professor and the Head of the Nursing Department, in the Faculty of Health Sciences at Durban University of Technology (DUT) in South Africa
  • Country: South Africa
  • Title: Experiences of Nurses Regarding The Implementation Of An Ideal Clinic Project In Kwazulu-Natal, South Africa


The key outcome of the vision of the South African government is the attainment of a long and healthy life for all its citizens. In view of this, the government of South Africa embarked on a phased implementation of National Health Insurance in order to achieve universal health coverage so as to provide access to appropriate, affordable efficient quality health services for all its people. In 2013, Ideal Clinic Realisation and Maintenance (ICRM) program was formed to lay a strong foundation for the implementation of the National Health Insurance. The ICRM program is an initiative that was established as a way of systematically improving and correcting shortages in the PHC facilities in the public sector and transforming the existing government-owned public PHC clinics into ‘ideal clinics’. An ideal clinic is defined as a clinic with good infrastructure, adequate staff, adequate medicine and supplies, good administrative processes, and sufficient adequate bulk supplies. The target was to achieve the 50% of clinics mark in selected vital areas such as staffing, resource allocation, and utilization by 2019. However, reports indicated that this target was not achieved by 2019. Thus, a study was conducted in one of the eleven Districts of Kwa-Zulu-Natal Province of South Africa to explore and describe the experiences of nurses regarding the implementation of an ideal clinic project.   A qualitative research design was employed guided by Donabedian’s structure, process, and outcomes model. Data was collected using semi-structured interviews with 58 nurses from 18 PHC clinics between 15 September and 25 October 2020 and analyzed using Tesch’s open coding approach. The findings from the study revealed that structural limitations, processes involved in the running of the clinic, the support offered to the PHC clinics, communications and staff involvements, staff training, and administration of an ideal clinic project were the major obstacles that interfered with the successful implementation of the ideal clinic project. Little support was offered to nurses who are the drivers of the ideal clinic project and their negative experiences and perceptions made it difficult to fulfill the ideal clinic project standards. The recommendations were made with special reference to the employment of more trained staff, improvement of the infrastructure of the facilities, staff involvement in the implementation of any programs, and adequate support of staff members regarding the implementation of the ideal clinic project.

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