Status of a health care quality review programme in South Africa

Abstract

This paper provides an overview of an accreditation programme for health care facilities in South Africa. It traces the origin of COHSASA (The Council for Health Service Accreditation of Southern Africa) which began as a pilot programme in 1992, to its current status as the only accreditation body in the country. There are brief descriptions of its structure, how it is governed, and how standards were developed and organized. The authors sketch a background of the unique sociopolitical context and legal developments within which the programme operates in South Africa and how the programme is contributing towards the new government's intention to provide equitable and quality health care to all its citizens. There is an outline of the principles on which the COHSASA programme is based and the structure and process of the programme. The programme incorporates an integrated, multi-disciplinary, continuous quality improvement approach with special emphasis on capacity building of hospital staff when necessary. The paper refers to groundbreaking research in Kwa-Zulu Natal where the impact of accreditation is being measured in a randomized control trial. It points to the benefits of accreditation being perceived in both public and private sectors of health care in South Africa and outlines some of the results of the program's implementation.

Challenges of quality improvement in the healthcare of South Africa post-apartheid: A critical review

“…In these instances, decentralisation strengthened the capacity of local organisations to negotiate with central government structures for increased resource allocation to previously neglected groups (Alves et al 2013:76). However, other authors believe that decentralisation has intensified problems of disparity in vulnerable populations, leading to poor-quality health care delivery (Regmi et al 2010:407; Whittaker et al 2000:207). According to Surender (2014:18), separating policy determinants from policy implementers in South Africa has led to a crisis in health delivery.…”

Factors affecting implementation of accreditation programmes and the impact of the accreditation process on quality improvement in hospitals: a SWOT analysis

“…25 It has been reported that an accreditation process may increase staff motivation and improve communication between different service units. 33 The teamwork culture is associated with the willingness of staff to undertake quality improvement initiatives. 23 Moreover, internal quality improvement strategies are inter-related at the same organisational level.…”

Academic hospital accreditation strengthens postgraduate training programmes: Case study from Universitas Academic Hospital

“…Since the COHSASA programme required an initial baseline assessment against the standards, it was felt that this assessment would assist to identify significant deficiencies in the work environment that militated against safe quality service provision. 6 The evaluation process begins with the qualitative and quantitative assessment of several pre-determined criteria. Hospitals are categorised as non-compliant, partially compliant or compliant with each criterion relative to its related standard.…”