**8. Re-engineering of primary health care**

Although the health budget of South Africa is on the upper end if compared to some of its neighbors, its health outcomes do not reflect that. This discordant has been attributed to a weak primary health care system [31]. The purpose of the reengineering of Primary Health Care (PHC) is to improve both access and quality of health services to the general public. The need for the re-engineering was identified when the South African government acknowledged that although PHC services have been in existence for many years, they did not meet acceptable levels of both access and quality of services. The re-engineering of PHC was based on the three pillars as described below:


Evaluation of PHC services in South Africa have reported psycho-social support to be low [32], which can be improved by the integration of community health workers, who were specifically tasked with providing follow-up clinic and hospital

care, as well as psychosocial support for patients and their family members [33]. Moreover, the re-engineering of primary health care purposed to, among others, to offer health promotion and prevention services at community level, which is needed for all disease categories offered at PHC level [34].

Primary healthcare is the first contact a person has with the health system for any health problem, and if well functional, the PHC re-engineering was expected to be a mechanism of relieving overburdened tertiary hospitals in South Africa [35] as most patients' problems will be resolved at that level. A well-functioning district health system is the intended outcome of the re-engineering of primary health care process, which will result in a greater emphasis on health promotion, disease prevention, and community participation and empowerment [36]. Mental health services should therefore benefit for these intended good.
