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Health in South Africa: changes and challenges since 2009

Published by: 
The Lancet

Since the 2009 Lancet Health in South Africa Series, important changes have occurred in the country, resulting in an
increase in life expectancy to 60 years. Historical injustices together with the disastrous health policies of the previous
administration are being transformed. The change in leadership of the Ministry of Health has been key, but new
momentum is inhibited by stasis within the health management bureaucracy. Specific policy and programme changes
are evident for all four of the so-called colliding epidemics: HIV and tuberculosis; chronic illness and mental health;
injury and violence; and maternal, neonatal, and child health. South Africa now has the world’s largest programme of

A national audit of home and community-based care (HCBC) organisations in South Africa

Published by: 
AIDS Care Journal

Home and community-based care (HCBC) has emerged as a way to provide cost-effective and compassionate care to people living with HIV (PLHIV) and those affected by the epidemic. HCBC organisations provide integrated services which address the basic needs of those infected and affected such as food, shelter, healthcare, protection from abuse and malnutrition. The main objective of the study was to conduct an audit of HCBC organisations in South Africa in order to provide the Government with empirical information on their existence, distribution, services and challenges. The primary approach to this task was to conduct a telephonic audit of organisations rendering HCBC services.

Financial Management in Taung Health District: North West Province

Published by: 
Health Systems Trust
This report covers the deliberations during the visit on 30 April 1999 as well as other information gathered during and after the visit. The report aims to assist the district management team to prioritise future activities in financial management and in enhancing their capacity.

A Communication Strategy for Health in the Kalahari

Published by: 
Health Systems Trust
Since Primary Health Care (PHC) is now accepted as the foundation of health care delivery in South Africa, health districts have become the vehicle through which this health care system will be implemented. One of the main reasons for the establishment of the district health system is to engender a move towards decentralised health management. The basic modus operandi for the management and delivery of health care is through a hierarchical four-tiered structure: i.e. national, provincial, regional and district level. The national Department of Health is responsible for overall co-ordination and determination of national health policy the provincial Departments are responsible for the co-ordination of the health system within each province, for the provision of specialist health services, and for the monitoring and support of districts and the district/regional authorities are responsible for the actual delivery of health care and for the provision of non-specialist health services within each district.

A Communication Strategy for the Tonga/Shongwe Health District in Mpumalanga

Published by: 
Health Systems Trust
Since Primary Health Care (PHC) has now been accepted as the foundation of health care delivery in South Africa, Health Districts have become the microstructure through which this health care system will be implemented. While it is hoped that the traditionally under-resourced areas of South Africa will benefit most from the new emphasis on PHC, the move to a fully functional district health system is bound to be a slow and retarded process. This is primarily due to the enormity of the task of restructuring a health sector ravaged by the legacy of apartheid development. Current changes taking place in implementing primary health care are still only transitionary. Existing district boundaries are still only of an interim nature, healthcare personnel in key positions within the Health Districts have only been appointed on an interim basis, and educating and driving home the importance of the district health system to health workers and communities in remote areas of the country will take time to yield its desired level of acceptance.

Measuring the move towards equity - from the site of service delivery

Series Name: 
Facilities Survey
Published by: 
Health Systems Trust
It is important that policies and strategies towards equity in service provision are measured in terms of their impact on health service delivery. This would begin to demonstrate the practical impact of health reform.

In an attempt to measure in part the progress (or lack of progress) towards equity one step would be to measure the quality of service provision at the community (primary care) level. This would give an overview of the disparities between as well as in provinces, and between rural, urban and peri-urban parts of the country.

Making a difference to school childrens health

Published by: 
Health Systems Trust
This study investigated the School Health Services in KwaZulu-Natal, in order to make recommendations that could make a positive impact on the health of school-aged children. Different aspects of the School Health Services were considered including health inspection and health education undertaken by the School Health Teams, perceptions both of providers and of recipients of the service, as well as the costs of the provision of the service in KwaZulu-Natal.

Guidelines for the Development of Better Communication in Health Districts

Published by: 
Health Systems Trust
Very little has been written about the role of communication within the context of the DHS. It is hoped that this document will help and inspire health workers and those who have an interest in DHS development to act to improve communication. Most of this report has been based on the experiences in the ISDS sites.