Experiences of Fast Queue health care users in primary health care facilities in eThekwini district, South Africa

Abstract

Background: Comprehensive Primary Health Care (PHC), based on the principles of accessibility, availability, affordability, equity and acceptability, was introduced in South Africa to address inequalities in health service provision. Whilst the Fast Queue was instrumental in the promotion of access to health care, a major goal of the PHC approach, facilities were not prepared for the sudden influx of clients. Increased access resulted in long waiting times and queues contributing to dissatisfaction with the service which could lead to missed appointments and non-compliance with established treatment plans. Objectives: Firstly to describe the experiences of clients using the Fast Queue strategy to access routine healthcare services and secondly, to determine how the clients’ experiences led to satisfaction or dissatisfaction with the Fast Queue service.Method: A descriptive qualitative survey using content analysis explored the experiences of the Fast Queue users in a PHC setting. Setting was first identified based on greatest number using the Fast Queue and geographic diversity and then a convenience sample of health care users of the Fast Queue were sampled individually along with one focus group of users who accessed the Queue monthly for medication refills. The same interview guide questions were used for both individual interviews and the one focus group discussion. Five clinics with the highest number of attendees during a three month period and a total of 83 health care users of the Fast Queue were interviewed. The average participant was female, 31 years old, single and unemployed.Results: Two themes with sub-themes emerged: health care user flow and communication, which highlights both satisfaction and dissatisfaction with the fast queue and queue marshals, could assist in directing users to the respective queues, reduce waiting time and keep users satisfied with the use of sign posts where there is a lack of human resources.Conclusion: Effective health communication strategies contribute to positive experiences by health care users and these can be effected by: (1) involvement of health care providers in planning the construction of health facilities to give input about patient flow, infection prevention and control and provision of privacy, (2) effective complaints mechanisms for users to ensure that complaints are followed up and (3)encouraging users to arrive at the facility throughout the day, rather than the present practice where all users arrive at the clinic early in the morning.

Clinic flow for STI, HIV, and TB patients in an urban infectious disease clinic offering point-of-care testing services in Durban, South Africa

“…Our findings are consistent with the literature on queuing theory, which suggests that networks with nodes of varying efficiencies create bottlenecks and increase overall waiting times [ 22 ]. Networks with many nodes can also create confusion about where to go in the absence of clear communication or sign posts and cause patients to exit care while waiting between rooms [ 13 , 22 , 23 ]. In our setting, nodes such as the chart counter and nurse waiting area had high patient-to-staff ratios, while other nodes such as the vitals station had low ratios, resulting in long waiting times.…”

A practice framework to enhance the implementation of the Policy on Integration of Mental Health Care into primary health care in KwaZulu-Natal province

“…According to Sokhela, Makhanya, Sibiya and Nokes 18 , the fast queue strategy was introduced in South Africa to resolve challenges in a range of health care services, including PHC services, to reduce long waiting periods at the clinics. This includes treatment and follows up of patients and their families with mental illness, referral of patients for drug abuse, sexual abuse, child abuse and other crisis situations.…”

Factors related to quilombola attendance to child follow-up appointments

“…Another factor compromising the attendance of this public is the low availability of appointments, when related to the high demand of children to be consulted. A national and international study, carried out in the district of Thekwini, in South Africa, reveals that the low offer of appointments combined with the overload of consultations increase the demands for the unit's team, as well as the waiting time, and favors the dissatisfaction with the service (29,33) . This increased waiting time, as pointed out by the mothers in our study, can even contribute to abandoning the treatment.…”