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South African Health Review 2004

It is with great pleasure that we present the 9th edition of the South African Health Review, in the year that South Africa celebrates 10 years of freedom and democratic rule. The importance of this Review is not only in its critical reflection on progress made in making health services available to all South Africans over the  past 10 years, but also in laying a data-driven framework against which future achievements can be assessed to enhance improvements in health care, especially in view of the government having declared this term of its office as one of heightened delivery of resources and services to communities.

Within a relatively short period of 10 years, we have amalgamated our fragmented public health systems into one, established a district health system for health care delivery, built more clinics, particularly in rural communities, afforded pregnant women and children under six years of age free care as well as free primary health care services to all citizens. South Africa is also in her initial stages of implementing the largest ever HIV and AIDS Care, Management and Treatment programme in the world, which will make universal access to ART a reality.

Answering the question on how well our health system is performing in providing equitable health services to all South Africans, remains a challenge in the absence of adequate comparative data and indicators. Nevertheless, significant strides have been made in establishing a Health Information System (HIS), although much work still needs to be done. Also the amount and quality of data on the health system have improved, although gaps still exist, leading in some instances to discrepancies both in the data reported and the conclusions drawn.

We are confident that the South African Health Review will prove to be a valuable resource to policy makers, planners, health managers, researchers, academics, health workers and students; as well as to both South African and international health and development organisations. We also expect that this Review will act as a catalyst in motivating researchers and health workers around the country, to not only become active participants and committed contributors to the development of an effective national HIS, but also be users of available information to improve the health services.

The production of the South African Health Review would not have been possible without collective commitment and hard work of a number of individuals and teams. The Board of Trustees of the Health Systems Trust (HST) extends its appreciation to all those who made the time and effort to contribute to the Review. We are thankful to all the authors of the chapters, editorials and commentaries. We appreciate the invaluable input to the Review made by the HST Editorial Committee and Peer Reviewers; the national and provincial Departments of Health. Finally, we would like to acknowledge the contributions and indispensable support of all HST staff.

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