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A district health service in Khayelitsha panacea or pipedream?
Abstract
Khayelitsha is an underserviced, largely infonnal urban settlement on the edge of Cape Town. It is home to some 350 000 people. This paper maintains that a district health service would be beneficial in Khayelitsha. Advantages include (i) the integration and co-ordination of services with coherent management of health care; (ii) the ability to prioritise and act on problems with the full range of preventive and curative measures as well as intersectoral support; and (iil) the accountability of health providers. Some ofthe steps taken towards the initiation of a district health service are illustrated in a discussion of the recent changes in health service structures in Khayelitsha. There are many obstacles to the implementation ofa formal district health service and these are discussed briefly.
