Annual Report 2007/08

Message from the CEO

The year under review has been an exciting time for the Health Systems Trust (HST). Changes in global financial markets have necessitated the scrutiny of our policies and our traditional ways of working, and have required that we become more focused and more competitive in a resource-scarce environment. At our conference to mark the fifteenth anniversary of the organisation, we celebrated our various contributions to building the public health sector in South Africa and re-committed ourselves to providing cutting-edge research and materials to further our aim of health systems-strengthening both within and beyond the borders of South Africa. The conference also provided us and our partners with a platform to review our work and to identify key public health research and implementation issues that the organisation should be focusing on.

Together with a team of three Directors, I have had the privilege of leading this organisation since November 2007 and have been humbled by the achievements and commitment of the staff of HST. Under the tutelage of Irwin Friedman, the Research Programme Cluster has contributed to health policy dialogue and to the health system reform debate by conducting essential national research studies on prioritised public health population needs. The Research Programme Cluster has conducted important research on maternal and child health, particularly on the impact of maternal education on infant feeding and the achievement of maternal and child health related Millennium Development Goals.

Recognising the dual nature of the HIV and TB epidemic, the cluster has produced a significant body of knowledge on various aspects of both TB and reproductive health, with a special emphasis on adherence and support systems. The cluster has continued to conduct health systems research on diverse issues such as occupational illnesses, work processes, human resources and capacity building. Under the leadership of Ronel Visser, the HealthLink Cluster continued to provide independent and objective policy reviews on health systems performance through the publication of the fourteenth South African Health Review. This years Review focused on primary health care, thirty years after the Declaration of Alma Ata, and provides an analysis of just how far South Africa has come in this area. The cluster also actively supported district health systems development by monitoring performance on an annual basis through the District Health Barometer. Now in its fourth year of publication, the Barometer continues to garner much national and international interest.

Monitoring the implementation of the National Strategic Plan is another key activity of this cluster and the Treatment Monitor has also developed international links and has contributed to UN reports and other multi-country initiatives. The Secretariat of the Global Equity Gauge Alliance continues to be hosted by HST, with plans for the production of a second edition of the Global Health Watch currently underway.

With Nomonde Bam at the helm, the District Support and Community Development Cluster has worked tirelessly to provide a wide-range of capacity building, training and mentoring services, in order to improve services at a sub-district level. The cluster has provided training and support to both health personnel and community-based organisations, strengthening the delivery and integration of primary health care. Working to underpin the process and outcomes of district health planning was a key focus of this cluster and this has contributed to the introduction of monthly primary health care reviews, where District Health Plan indicators and targets are monitored and tracked. Working with some of the basic determinants of health, such as food security, remains the mainstay of this clusters work and interventions in this regard include steps to improve household food availability and to improve the health status of vulnerable groups, particularly children, pregnant and lactating mothers, and malnourished patients.

Collective action, taken to achieve the transformation of our health systems through health systems research, and the use of proven evidence-based interventions, remain our best tools to strengthen health system performance and to attain health care for all. I look forward to continuing to work with our partners, the HST Board of Trustees and the Trusts staff in the year ahead. I would like to thank our Board of Trustees, our funders, and our partners at the Department of Health, for their confidence and support during my tenure as Chief Executive Officer. I also extend my sincere gratitude to all HST staff for their unstinting commitment to achieve the goals and mission of the Trust. All of us at HST share the collective conviction that the inequity amongst, and lack of access to, universal and high-quality primary health care services by all South Africans, remains the greatest challenge to achieve the noble goal of good health for all. We at the Trust will continue to commit to the overcoming of such challenges that lie before us during the years ahead.