Global Presence
EQUITY, an Integrated Primary Health Care Project in South Africa
Project Date: 1997–2003
Soon after the 1994 elections that brought a democratic government to power following decades of apartheid rule, the Government of South Africa, with the assistance of USAID, established the EQUITY Project. The goal of the project is to enable South Africa to address the health problems of all its 40 million citizens with a strategy of "primary health care for all." Management Sciences for Health (MSH) was selected to provide technical assistance and in early 1997 fielded a team of 18 professionals to work alongside South African counterparts.
The project initially focuses on improving the health care system in the Eastern Cape Province, which encompasses the former homelands of Transkei and Ciskei. In addition to two large urban centers, the province also has extensive rural areas where malnutrition, tuberculosis, parasites, and high maternal mortality prevail.
There is an emphasis on community structures, including volunteer health workers; mobile outreach; and high coverage in essential areas such as immunization, family planning, tuberculosis, and control of sexually transmitted diseases. The MSH team is focusing on the development of district management teams, which would make major management decisions to create and control budgets, initiate personnel actions, improve quality of care through objective supervisory methods, and develop improved information systems to allocate and control health resources as well as measure outcomes.
An integrated package of essential services has been designed and introduced in all 650 clinics. This includes appropriate referral guidelines for the 75 rural hospitals serving the 6 million inhabitants of the Eastern Cape Province. Improved drug management and standardized training of clinical staff has resulted in both cost savings and better quality of care in the treatment of common illnesses. The information system functions at all levels and enables monitoring and evaluation of project outcomes as well as costs.
Lessons from the Eastern Cape are spreading to the rest of the country. The drug supply system, for example, is being picked up by other provinces, and the monthly information reporting system is being evaluated and adapted to the needs of other provinces. The baseline survey has been adopted on a national level, and clinical training materials are being developed jointly with South African educational institutions for nationwide use.
Project subcontractors, Program for International Training in Health (INTRAH), University of North Carolina and the Society for Family Health (an affiliate of PSI), are actively involved in extending clinical training and public communication and mobilization especially aimed at the control of sexually transmitted diseases and AIDS. The management innovations introduced under the EQUITY Project are contributing to the movement towards a more equitable and efficient health care system for all in South Africa.
The project initially focuses on improving the health care system in the Eastern Cape Province, which encompasses the former homelands of Transkei and Ciskei. In addition to two large urban centers, the province also has extensive rural areas where malnutrition, tuberculosis, parasites, and high maternal mortality prevail.
There is an emphasis on community structures, including volunteer health workers; mobile outreach; and high coverage in essential areas such as immunization, family planning, tuberculosis, and control of sexually transmitted diseases. The MSH team is focusing on the development of district management teams, which would make major management decisions to create and control budgets, initiate personnel actions, improve quality of care through objective supervisory methods, and develop improved information systems to allocate and control health resources as well as measure outcomes.
An integrated package of essential services has been designed and introduced in all 650 clinics. This includes appropriate referral guidelines for the 75 rural hospitals serving the 6 million inhabitants of the Eastern Cape Province. Improved drug management and standardized training of clinical staff has resulted in both cost savings and better quality of care in the treatment of common illnesses. The information system functions at all levels and enables monitoring and evaluation of project outcomes as well as costs.
Lessons from the Eastern Cape are spreading to the rest of the country. The drug supply system, for example, is being picked up by other provinces, and the monthly information reporting system is being evaluated and adapted to the needs of other provinces. The baseline survey has been adopted on a national level, and clinical training materials are being developed jointly with South African educational institutions for nationwide use.
Project subcontractors, Program for International Training in Health (INTRAH), University of North Carolina and the Society for Family Health (an affiliate of PSI), are actively involved in extending clinical training and public communication and mobilization especially aimed at the control of sexually transmitted diseases and AIDS. The management innovations introduced under the EQUITY Project are contributing to the movement towards a more equitable and efficient health care system for all in South Africa.