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
Health systems strengthening has become a top priority of many global and national health agendas as a way to improve health outcomes. With the global health context becoming increasingly complex, national health systems are beginning to move away from a focus on disease-specific health responses to comprehensive strengthening of health systems. The global community agrees that without a systems approach, population health outcomes will not further improve and health related development goals such as the United Nation’s Millennium Development Goals (MDGs) for 2015 will not be met.
There is widespread consensus that providing universal, sustainable, affordable and quality health services underpins efforts to achieve equitable health outcomes. UNICEF in 2010-2011 conducted a two-phase landscape analysis, funded by the Rockefeller Foundation, to investigate how health insurance and other social health protection mechanisms contribute to achieving universal health coverage (UHC). The work built on previous research examining the protection from impoverishment that health insurance provides to vulnerable groups, the potential for increasing and expanding insurance coverage, and the options for and constraints limiting the use of insurance to attain UHC.
The field of global health is witnessing a shift in focus from disease-driven initiatives to projects aimed at increasing the sustainability and strengthening of health systems. A crucial component to this is universal health coverage (UHC), which seeks to address financing schemes for health, separate from efforts to provide both adequate numbers of health workers and structures for health-care delivery. UHC may be provided by government or through a combination of private insurance schemes, public-sector planning, and employer-based programs. Countries across the world, from China and India to Rwanda and Mexico, are beginning to implement different universal health coverage schemes, marking a rise in interest and political will for universal health coverage.
This issue of the HST Update examines the information plays a pivotal role in the health care industry and questions if the needs of the health care workers are being met.
The theme of this month's "Update" is greater integration of the public and private health sectors in South Africa. It explores ways in which convergence of public and private health care in South Africa can be used to increase people's access to health care, and to ensure both greater efficiency and equity in the provision of health care. Some of the suggested mechanisms are complex, controversial and may take time to implement. Other steps may be simpler and should be introduced now - if only to prevent the situation described above happening again.
Global Health Watch 3 comprises five broad sections. The first section, entitled ‘The global political and economic architecture’, provides an analysis to locate the decisions and choices that impact on health. The second section, ‘Health systems – current issues and debates’, provides a view of current issues and debates on health systems across the world, from which it is possible to draw appropriate lessons and propose concrete actions for promoting health. The third section, ‘Beyond health care’, is a recognition that health encompasses areas beyond the provision of health care.
Health system strengthening is a key objective in both the Negotiated Service Delivery Agreement and the Re-engineered Primary Health Care approach. Effective utilisation of routine data is crucial for improving the effectiveness of service delivery as well as for improvement of health information systems. There remains considerable scope for improved utilisation of routine data for quality improvement.
THE NATIONAL DEPARTMENT OF HEALTH HOSTS A CONFERENCE THEMED “NATIONAL HEALTH INSURANCE: LESSONS FOR SOUTH AFRICA”
Health Systems Trust (HST) will celebrate twenty years of supporting health service delivery in South and southern Africa in 2012. This is a long time in the life of any non-governmental organisation and we attribute this to HST’s enduring commitment to quality and never being content to deliver simply technically correct products and services that merely meet the minimum requirements of health systems strengthening policies and frameworks. Through our work we strive to inspire – not only our clients, but also ourselves. We strive to be associated with products and services that are inspirational and we realise how important it is to have our own internal systems operating like clockwork to enable us to execute our vision and mission.