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Table 1 Key characteristics of case study districts

From: Emergence of three general practitioner contracting-in models in South Africa: a qualitative multi-case study

Contracting model
 Contracting model(s) Decentralized-purchaser Contracted-purchaser Centralized-purchaser Contracted-purchaser Centralized-purchaser
 Total population 595,542 3,165,745 718,549
 Uninsured population 493,389 2,115,620 674,771
 Percentage uninsured (%) 82.85 66.83 93.91
 Population density 26 people/km2 503 people/km2 22 people/km2
 Socio-economic quintile (SEQ)a 4 5 3
 Rural vs. urban Rural Urban Rural
Health status
 Crude death rate (per 1000 population) 3.6 4.7 4.6
 HIV antenatal prevalence (15–49 years) 15.6 23.4 30.1
 Incidence of TB (per 100,000 population) 806 351 511
Health service
 PHC utilization rateb 2.41 1.64 2.78
 PHC nurse clinical workloadc 25.3 36.7 34.6
 PHC doctor clinical workload 26.5 29.1 34.5
 No. of GPs contracted through model as of June 2016 14 87 29
 Number of PHC health facilities 50 70 73
  1. aThe SEQ is derived from the South African Index of Multiple Deprivation (SAIMD). SAIMD is a composite indicator of socio-economic status developed from census data. It encompasses material, employment, educational and living environment deprivation. There are five SEQs based on a numeric SAIMD value with SEQ 1 representing the most deprived and 5 the least deprived
  2. bPHC utilization rate is the rate at which PHC services are utilized by the catchment population. It represents the average number of visits per person per year in the catchment population with the denominator being a census-derived estimate. It is useful in determining the overall PHC utilization patterns and could be specifically relevant in tracking equity in health service utilization
  3. cThe PHC clinical workload is the average number of patients seen per health care worker (professional nurse or doctor) per clinical work day. These represent health care workers employed within the public sector as opposed to those contracted-in to provide services