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Evidence based interventions to strengthen health systems using a comprehensive primary health care approach
_DSC8390.jpgIn its early years, HST swiftly established benchmarks for excellence in building capacity and systems in health districts and sub-districts. Whilst the journey of improvement towards optimum health systems encounters perennial challenges, our approach in applying good practice in management and implementation support has resulted in far-reaching transformation of public health in South Africa, as the following projects illustrate.
 
South Africa Sustainable Response to HIV, AIDS and TB (SA SURE) provides sustainable technical support for health systems strengthening, with particular focus on HIV and AIDS, TB and maternal, child and women’s health. HST’s mandate is to provide comprehensive district-level support in several provinces, ensuring that programmes are effectively delivered and integrated with other PHC interventions. This five-year programme is based on a consultative and mentoring approach involving district, sub-district and programme managers, extending to staff at facility level as well as communities. 
 
Demonstrating the evolving process of strengthening health systems, SA SURE has generated several subprojects which enable us to adapt, advance and innovate interventions. To address waiting times created by a growing number of patients on antiretroviral treatment (ART), the Chronic Medication Dispensing and Distribution (CCMDD) project is improving access to chronic medication. This is achieved by contracting service providers to supply stable chronic patients with fixed-dose combination medication at more convenient ‘pick-up-points’, close to their home or workplace.
 
The Implementation of RxSolution project supports and facilitates a pharmacy information management system to assist pharmacists based in hospitals and clinics to effectively manage their drug stocks.
 
The Implementation of the Ideal Clinic Dashboard will provide clinics with the means to proactively identify their own areas of low performance, and implement Quality Improvement Plans to ensure adherence to the National Core Standards established by the Office of Health Standards Compliance.
 
Among our completed projects supporting South Africa’s PHC re-engineering initiatives are Re-engineering Quality Improvement (RQI) – which focused on training and mentoring with the Leadership Development Programme model for improving service delivery at facility level – and Strengthening Sub-district Health Management Teams’ Capacity for Service Delivery, covering management, planning and measurement of primary health care service performance.
 
In the realm of mobile health technologies (mHealth), HST has provided mentorship support and training for health workers and community health workers on MomConnect, an initiative offering information on pregnancy and accessible mother-and-baby clinics via free SMS messaging services to all South African pregnant women.