Provinces not on same page regarding clinic committees

Information recently presented in parliament sheds light on how many clinic health committees there are in each province and how many members these committees have. Such clinic committees are a requirement in terms of the National Health Act, but provinces have some flexibility in determining how these structures should be constituted and how they should function.

According to SECTION27’s National Health Act guide 2019(NHA Guide), only four provinces have passed provincial legislation or adopted policies regulating clinic committees. These are the Eastern Cape, Free State, KwaZulu-Natal and the Western Cape.

In an ideal world clinic committees will help to ensure that clinics, and the healthcare system, remains responsive to the needs of communities. Unfortunately, as stated in the NHA Guide, committees “remain insufficiently governed and have various weaknesses including political interference, lack of knowledge of roles (among committee members, community members and health facility management), lack of empowerment and lack of funding”.

In response to a recent parliamentary question from Freedom Front Plus MP Phillip van Staden, Health Minister Dr Zweli Mkhize said that Clinic Health Committees have the following functions:

• Serve as a link between Primary Health Care, community based services and households;
• Participate in the achievement of improved health outcomes;
• Promote community participation, local accountability and intersectoral collaboration;
• Engage with the management of Primary Healthcare facilities with regards to planning, monitoring and oversight of Health Services; and
• Engage with other governance structures e.g. ward committees to ensure streamlining of initiatives which provide a broader platform in engaging with stakeholders.

Mkhize also shared figures showing that the size of clinic committees differs substantially between provinces. In the Northern Cape the average clinic committee has only five members, while in the Eastern Cape and KwaZulu Natal committees on average have 15 members. (We mention averages in the above, but it is possible that all committees in a province are the same size.)

The national average is just over 10 members per clinic committee.

Here is a slightly modified version of a table that Mkhize shared in his parliamentary response. We added a column with the average number of committee members in each province.

Province	Number of clinic health committees	Total number of committee members	AVG members per committee
Eastern Cape	696	10440	15
Free State	139	973	7
Gauteng	1488	11904	8
KwaZulu-Natal	592	8880	15
Limpopo	492	4428	9
Mpumalanga	263	3156	12
Northern Cape	169	845	5
North West	301	2107	7
Western Cape	200	2400	12
Total	4340	45133	10,4

According to Mkhize, members of clinic committees only receive renumeration (to cover costs) in four of the nine provinces – typically either R200 or R500 per quarter. Some variation is to be expected given that travel distances might vary. The provinces that provide renumeration are Eastern Cape, KwaZulu-Natal, North West and Western Cape. There might also be some variation between districts.

 

*Note: SECTION27 is mentioned in this article. Spotlight is published by SECTION27 and the Treatment Action Campaign but is editorially independent. This independence is jealously guarded by the editors. Spotlight is a member of the Press Council.