Health insurance

Conducting expenditure and resource allocation reviews for effective district health system management - A review of expenditure and resource allocation in the Mmametlhake health district of Mpumalang

Published by: 
Health Systems Trust
Delivering a sustainable health service is a fine balance between the needs of the community and the health resources available. Managers require a clear picture of how resources are allocated, what is driving costs and how efficiently services are being provided. The District Heath Expenditure Review(DHER) provides such a picture. The DHER also empowers health managers to improve service and financial planning and strengthen management support systems. This report contains a DHER conducted in the Mmametlhake Health District in Mpumalanga for the financial year ending 31 March 1999. The process to obtain, verify and report on the data took place during the first six months of 2000 and culminated in a report presented to the MEC for Health in Mpumalanga on 10 October 2000.

An Economic Analysis of Community Health Worker Programmes in the Western Cape Province

Published by: 
Health Systems Trust
The role and functioning of Community Health Worker (CHW) programmes in South Africas health system requires clearer definition and evaluation. This report seeks to inform this process by providing information for CHW programmes, the national and provincial policy-makers and district level health managers involved in the debate. It provides information about CHW programmes in the Western Cape province and presents an innovative evaluation methodology.

Social Health Insurance

Published by: 
Health Systems Trust
Social health insurance was first proposed in the 1980s. It was seen as a key mechanism for extending health care coverage and promoting equity in South Africa. Lack of policy action has meant that the SHI has not been implemented and wide disparities between health care in the public and private sectors remain untouched. This summary brief explains why consensus was never reached on the exact form social health insurance should take, and suggests strategies for building support amongst important stakeholders. The chapter critiques features of the governments most recent proposal, published in 1997.

Health Financing

Series Name: 
HST Update
Published by: 
Health Systems Trust
It is well known that South Africa spends a considerable amount of money on health services compared to other middle-income countries. Yet, the average health status of South Africans is relatively poor.

The development of the District Health System in South Africa: Lessons Learned from the Experience of ISDS: Technical Report 5

Published by: 
Health Systems Trust

Will districts become effective vehicles for improving the quality of care, or expensive paper-shuffling machines? Will district management teams walk an interminable treadmill, or slowly, but surely improve the quality of care? These are the niggling and uncomfortable questions that motivate participants in the Initiative for Sub-District Support (ISDS).

Over the past year, the ISDS has tried to develop systematic processes of support to management teams in selected districts in South Africa, aimed at strengthening their ability to improve the quality of health care. Through this experience, we hope to be able to share lessons with other districts to create a positive spin-off effect, demonstrate the process of district development, and pinpoint persistent obstacles.