By Gofaone Motsamai

In public clinics across the North West Province, healthcare workers share limited resources and juggle growing patient numbers – all while trying to meet the standards of the Ideal Clinic Realisation and Maintenance (ICRM) programme.

Introduced in 2013, the programme is a national strategy aimed at improving service quality in public primary health care (PHC) facilities and is part of the national Department of Health’s plan to roll out National Health Insurance (NHI).

Healthcare professionals implementing the ICRM in the province have mixed experiences, according to a recent study by Lebogang Reginald Sechoaro, a Master of Nursing graduate from the North-West University (NWU) and an operational manager for PHC nursing based in the Maquassi Hills sub-district.

The study focused on the challenges healthcare staff encounter and sought to formulate strategies to address the challenges. “Some participants perceived the ICRM as a compliance-driven intervention with very little emphasis on achieving quality patient care,” says Lebogang, reflecting on the feedback gathered during the research.

He found that while healthcare workers understood the goals of the ICRM programme, the reality on the ground often made these difficult to realise. Facilities generally managed to attain Ideal Clinic status each quarter, but inconsistencies were noted. Challenges included inadequate infrastructure, shortages of staff and medical resources, and broader systemic problems in the health sector.

To address these, participants in the study proposed practical solutions. “Provincial departments of Health and Treasury need to provide sufficient funding in order to improve and sustain the programme performance,” Lebogang says.

He adds that district management must also “develop a plan that addresses the creation of additional infrastructure, maintenance of buildings, shortages of staff and functional communication, including monitoring and evaluation of the ICRM programme at regular intervals”.

The study highlights the gap between policy and practice in public healthcare reform, and proposes interventions that, if implemented, could reduce strain on staff and improve service delivery for healthcare users across the province.

Lebogang Reginald Sechoaro