The evolution of the South African health system has been characterised by inequities, imbalances as well as fragmentation. The unification of South Africa in 1910 did not consolidate public health administration, which, at the time, was characterised by increasing institutionalisation, professionalism and organisation. This was the status quo up until after 1990, after which there were marked efforts and endeavours to effect de-fragmentation of these essential services. This article has investigated the extent to which community participation is enhanced and expanded in primary health care in South Africa, with the area of focus the township of Khayelitsha near Cape Town, South Africa. Community participation in health care matters should be seen as the organised effort to increase control over resources and regulative institutions in given social situations. This is in line with the Batho Pele principles enshrined in the Constitution of the Republic of South Africa Act 108 of 1996.

The evolution of the South African health system has been characterised by inequities, imbalances as well as fragmentation. The unification of South Africa in 1910 did not consolidate public health administration, which, at the time, was characterised by increasing institutionalisation, professio...