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Added to these formal evaluations were the observations and reflections of the author from participation in national policy processes in South Africa, first as part of civil society consultations, and then in a Ministerial Task Team, which developed the WBOTs strategy in 2010/2011.
However, there was a larger and significantly greater increase in these rates in facilities with a WBOT than in those without a WBOT.
Another limitation is the crude categorisation of intervention and control sites as having a WBOT or not.
[4,5] The strategy prioritises four 'streams': ward-based PHC outreach teams (WBOTs), enhanced school health services, district clinical specialist teams (DCSTs) supporting maternal, neonatal and child health, and the contracting of private general practitioners to provide public services.
In terms of the PHC re-engineering strategy, each municipal electoral ward should deploy WBOTs, with an average of one team per 1 500 households.
This article describes the application of a plausibility evaluation design that aimed to assess the contribution of WBOTs to PHC performance in NWP, comparing coverage, utilisation and outcome indicators in facilities with and without WBOTs.
All PHC facilities in the province that collected routine data on the indicators potentially influenced by WBOTs (see indicator list below) were included in the study population, and the entire eligible study population was included in the analysis, obviating the need for sampling.
Using routine data from the DHIS, the study compared changes in the performance of PHC facilities with and without WBOTs. Routine data from both the WBOTs and PHC clinics for the period 2011/12 (prior to implementation) to 2014/15 (3 years after the start of implementation) were obtained.
PHC routine indicators--data elements and associated drainage population data--plausibly affected by the activities of the CHWs in the WBOTs at household level were selected and extracted from the DHIS.
In a separate study (not reported here), tuberculosis case detection rates and treatment outcomes were analysed as indicators of the chronic disease care activity of WBOTs.
The median of the differences of all the facilities, stratified into those with functional WBOTs and those without WBOTs, was then determined.
Initial assessment of this model in the City of Tshwane shows that COPC can be implemented through WBOTs within the present health system.
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