Is South Africa closing the health gaps between districts? Monitoring progress towards universal health service coverage with routine facility data

dc.contributor.authorDay, Candy
dc.contributor.authorGray, Andy
dc.contributor.authorCois, Annibale
dc.contributor.authorNdlovu, Noluthando
dc.contributor.authorMassyn, Naomi
dc.contributor.authorBoerma, Ties
dc.date.accessioned2021-10-01T03:30:14Z
dc.date.issued2021-09-13
dc.date.updated2021-10-01T03:30:14Z
dc.description.abstractAbstract Background South Africa is committed to advancing universal health coverage (UHC). The usefulness and potential of using routine health facility data for monitoring progress towards UHC, in the form of the 16-tracer WHO service coverage index (SCI), was assessed. Methods Alternative approaches to calculating the WHO SCI from routine data, allowing for disaggregation to district level, were explored. Data extraction, coding, transformation and modelling processes were applied to generate time series for these alternatives. Equity was assessed using socio-economic quintiles by district. Results The UHC SCI at a national level was 46.1 in 2007–2008 and 56.9 in 2016–2017. Only for the latter period, could the index be calculated for all indicators at a district level. Alternative indicators were formulated for 9 of 16 tracers in the index. Routine or repeated survey data could be used for 14 tracers. Apart from the NCD indicators, a gradient of poorer performance in the most deprived districts was evident in 2016–2017. Conclusions It is possible to construct the UHC SCI for South Africa from predominantly routine data sources. Overall, there is evidence from district level data of a trend towards reduced inequity in relation to specific categories (notably RMNCH). Progress towards UHC has the potential to overcome fragmentation and enable harmonisation and interoperability of information systems. Private sector reporting of data into routine information systems should be encouraged.
dc.identifier.citationBMC Health Services Research. 2021 Sep 13;21(Suppl 1):194
dc.identifier.urihttps://doi.org/10.1186/s12913-021-06171-3
dc.identifier.urihttp://hdl.handle.net/1993/36025
dc.language.rfc3066en
dc.rightsopen accessen_US
dc.rights.holderThe Author(s)
dc.titleIs South Africa closing the health gaps between districts? Monitoring progress towards universal health service coverage with routine facility data
dc.typeJournal Article
local.author.affiliationRady Faculty of Health Sciencesen_US
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