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ISDS to HSS Reflections on HST’s contribution to the District Health System

ISDS to HSS Reflections on HST’s contribution to the District Health System. Rakshika Bhana Health Systems Trust 20 th Anniversary Celebration 3 May 2012. National HSS context: current DHS priorities. Planning and monitoring of district health performance

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ISDS to HSS Reflections on HST’s contribution to the District Health System

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  1. ISDS to HSS Reflections on HST’s contribution to the District Health System Rakshika Bhana Health Systems Trust 20th Anniversary Celebration 3 May 2012

  2. National HSS context: current DHS priorities • Planning and monitoring of district health performance • Assessment of facilities to deliver quality health care • PHC re-engineering strategy

  3. The DHS: a changing landscape • 1996 – 2004 • Initiation and implementation • 2004 – 2009 • Review and refinement • 2009 and beyond • Consolidation and innovation

  4. 1996 – 2004Initiation and implementation “What are the prospects of some of the poorest areas in South Africa leading the move towards a district-based health system? Pretty slim. Enter the Initiative for Sub-District Support, aimed at turning the tables upside down” (HST, Annual Report, 1997).

  5. 1996 – 2004Initiation and implementation • Aim of ISDS and its philosophy • Legislative backdrop • Districts (sites) supported: 4 in 1996 rapidly expanding to 20 in 1999 • Key feature of ISDS model: “in-built” knock-on effect • Support strategies adopted

  6. 1996 – 2004Initiation and implementation Basic elements of the package of support for each district included: • Research • Evaluation • Communication • Technical Support • Information • Facilitation • Your own input……...

  7. 1996 – 2004Initiation and implementation External review in 1999 “ISDS has made a significant contribution to district health systems development within South Africa in a relatively short period of time. The experience within and across sites also offers important lessons for further DHS development, and of international relevance. Yet, it is simply too soon to expect ISDS to have made its full contribution to DHS development and to make definitive judgements on whether the activities undertaken within ISDS sites would be sustained if it withdrew its support”

  8. 1996 – 2004Initiation and implementation • 2000 – 2004 • Major developments in both the health and local govt. sectors • HST launched the Community Development Programme • 13 ISRDP districts • Publications development

  9. 2004 - 2009Review and refinement • 2004 Rural Health Conference hosted by HST • HST’s focus areas reviewed and aligned to • National DHS priorities • Emerging global priorities

  10. 2004 - 2009Review and refinement • Focus areas included: • HIV prevention and ART literacy • Integrated Nutrition Programme (INP) • Integrated PHC project (IPHC, Tasc I and II) • Strengthening M&E capacity of district and sub-district management teams • Capacity building for governance structures

  11. 2004 - 2009Review and refinement INP awarded recognition by the Impumelelo Innovations Trust Guidebook for District Hospital Managers

  12. 2009 and beyondConsolidation and innovation

  13. 2009 and beyondConsolidation and innovation HEALTH SYSTEMS STRENGHTENING • Providing support in 16 districts in 6 provinces • Pilot sites for PHC outreach teams in NW • Strengthening HCT in poorly performing districts • TB and HIV case finding in correctional services • Interventions in reducing maternal and child mortality • National Health Facilities Baseline Audit

  14. Areas of impact • Capacitated health professionals • Expanded body of knowledge • Informed civil society organisations • Development of good practices in management and support systems • Understanding trends and milestones for ensuring sustainable support

  15. Looking ahead • Supporting government leadership • Developing models of M&E • Expanding efforts to partners with multilateral organisations on priority health system issues • Quality improvement • Building on lessons of the past to inform good practices going forward • Supporting policy change to attain national and international HSS goals

  16. Acknowledgements • Health care professionals at all levels • HST Facilitators • HST leadership for their vision • Funders • Partners • National and Provincial Departments of Health

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