Knowledge Management and Monitoring

Current HealthLink Projects:

South African Health Review
The 13th edition of the widely-acclaimed South African Health Review was launched in December 2008, with the keynote address being delivered by the Minister of Health, Barbara Hogan. This edition of the Review focused on primary health care in South Africa, 30 years after the historic Alma Ata Declaration which famously linked health and health status to the broader social determinants of health. The Review included a national and international perspective of primary health care, focussing on areas such as policy and legislation, determinants of health, lifestyle, infectious diseases, mental health, maternal and child health, nutrition and environmental health. The Review also featured issues around human resources, finance, and information and concluded with an Indicators chapter, that presents a selection of the best available data on the functioning and performance of the South African health system.

The District Health Barometer

The District Health Barometer (DHB) project has been in existence since 2005 and provides an overall view of district health performance at primary health care level. The DHB uses health data in an effective manner by making use of selected indicators to provide clear and easily understandable information for appropriate decision making. The DHB provides an original source of data on a deprivation index, per capita expenditure and cost per patient day equivalent at district level.

An external evaluation on the project, conducted by Kedibone Health Systems Consultants, show that the DHB is widely disseminated and has been found to be instrumental in developing capacity. The publication has been widely cited by academics in SA and by those from international institutions. The approach, however, remains on making the report practically useful and bringing it closer to the people who need it the most.

The 4th edition (DHB 2007/08) was launched at the Health Informatics of South Africa conference on 6 July 2009. Information in the  2007/08 report includes 32 indicators, up to 8 years of data with trend illustrations, profiles (for each of the 9 provinces and 52 districts), and an accompanying CD with various files, resources and definitions.  A web-enabled Geographic Information System provides indicator data by district.

Health Management Information Systems

The Health Information Systems and Monitoring and Evaluation support initiative established within the Health Systems Trust aims to support and facilitate improvements in various areas of Health Information Systems and Monitoring and Evaluation at national and provincial levels. Our current projects include:

• Health Information Systems for Data Capturers (HISDC) Project
• Strengthening of Health Information Systems in the Western Cape Province
• Health Data Quality Improvement in the Gauteng Province
• Client Satisfaction Surveys in Hospitals in the Gauteng Province

Review of Structures, Competencies and Training Interventions to Strengthen District Management in the National Health System
Funder: Atlantic Philanthropies

The last formal national evaluation of health management training was undertaken almost a decade ago and was reported, by Schaay et al, in the 1998 South African Health Review.

There has been limited use of the competencies as a framework for developing training course content and, with the proliferation of courses being offered to health managers, there is concern about both the content and the quality of many of these courses.

Development of a Health Plan and Vision for 2020 for the Eastern Cape Department of Health
Funder: Department of Health, Eastern Cape Province

The Eastern Cape Department of Health has embarked on a long-term strategic vision and planning process called the “Service Development Plan”. HST was contracted by the Department to provide it with technical assistance.

Women and HIV & AIDS Gauge
Funders: Open Society Foundation for South Africa, Open Society Initiative for Southern Africa, and Open Society Initiative New York, Women’s Global Network for Reproductive Rights, ATHENA network and Ipas

“The Women and HIV & AIDS Gauge” (WHG) was launched in March 2009, a re-branding of the “Treatment Monitor”. The change of focus and subsequent change of name sought to acknowledge the feminised nature of the HIV epidemic with most infections infecting and affecting women. The WHG focuses on the impact of HIV and AIDS on women and their ability to access services within a sexual and reproductive health and rights framework.

The WHG also notes the impact the epidemic has had on women from a gendered burden-of-care perspective. In keeping with this, and as part of our advocacy strategy, project staff contribute a monthly column to Nurses Update, the Nurses Journal. The theme for the column has been HIV and AIDS and Women’s Health. Articles have included subject areas such as mental health, adolescent
sexuality, tuberculosis, cervical cancer, abortion, political engagement of women and medical male circumcision.

The project also provides technical support to the National Department of Health regarding the finalisation of the medical Termination of Pregnancy guidelines, with a particular emphasis on HIV and AIDS and sexual and reproductive health and rights care integration. Similarly, the project has also worked in collaboration with the Global Women’s Network for Reproductive Rights, the Medical Abortion Consortium, the Open Society Initiative for Southern Africa and the South African Law Commission, with a view to documenting gaps and questions in the area of abortion and HIV.

The project continues to host the “60percent” discussion list which has grown substantially. The list continues to grow and has over 370 members and a high traffic load. The project has also been responsible for developing policy briefs, and hosting satellite sessions at key conferences. Other initiatives that the project has been involved with include: working with the International Community of HIV Positive Women in their forced sterilisation project, and also co-hosting their Southern African regional strategic planning workshop in October 2008. Plans for forming a HIV Positive Women’s South African organisation have been developed. The project is also represented on the regional UNAIDS/WHO team to consider the implementation of medical male circumcision for Southern Africa and has contributed to the development of the manuals used by technical experts in this area.

The HST Bulletin

The bi-weekly HST Bulletin is an e-mail based news bulletin which focuses on public health issues in Southern Africa. It features news articles, academic and peer reviewed articles, latest research publications and reports, events and job opportunities.  The topics covered in the bulletin are wide ranging and aim to inform the reader on the latest developments (mainly focussing on Southern Africa) in health legislation, the HIV/AIDS pandemic, inequities in the public, primary health care and rural health care environments as well as to focus on the major diseases such as malaria, TB, and STIs.

Membership reflects a wide range of audiences from academic institutions (both local and international) to government employees, journalists, donor organisations, medical insurance and pharmaceutical companies, other non-governmental organisations and private individuals.

Electronic Discussion Lists

HST hosts electronic health discussion forums and mailing lists to facilitate information sharing, communication, and networking, around broad and strategic public health issues. Electronic discussions are used as a tool for generating ideas, debating issues as well as informing and influencing health sector policy development.