Measuring the move towards equity from the site of service delivery - The Western Cape Results

Why a provincial report?

To work towards a target of equity in our society it is necessary that inequities be continuously addressed at all levels. Much of the past discussion on achieving equity in health care has focused on the inter-provincial allocation of budgetary resources and national policy development. Present discussions, however, should include assessments of the impact of government policy, particularly at the level of service delivery.

Since the national health care system hinges on being a functional primary health care system it is necessary to measure the impact of policies at the site of delivery. The choice of a clinic survey as a tool to measure moves towards equity in health service delivery in South Africa, is premised on the need for information at the site of service delivery. Two kinds of reports can emerge from the clinic survey: a national report focused on inter-provincial inequities and, provincial reports focused on intra-provincial inequities. The national report can inform national strategy whilst the disaggregated provincial reports can inform policy and programme planning at a provincial, regional, and even district, level.

The objectives of the provincial reports are:

• To describe the quality of health care in selected clinics in each of the regions of the nine provinces.
• This description would be in terms of indicators related to inputs, processes and outputs.
• To describe the differences in terms of the quality of service between regions within the provinces.