Health sector reforms initiated in South Africa in 1994 adopted a primary health care approach
to strengthen the health system and achieve public health outcomes through disease prevention
and health promotion.1 This led to the building of many new clinics to make health services
more accessible, affordable and equitable. However, the pressures of a predominantly hospitalcentric
health care system and emerging epidemics prevented the successful provision of quality
comprehensive, integrated primary care to millions of South Africans. Also, little attention was
given to community partnerships and multi-sectoral collaboration.