Is South Africa closing the health gaps between districts? Monitoring progress towards universal health service coverage with routine facility data
Abstract 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 approac...
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| Format: | Article |
| Language: | English |
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BMC
2021-09-01
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| Series: | BMC Health Services Research |
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| Online Access: | https://doi.org/10.1186/s12913-021-06171-3 |
| _version_ | 1818718456506220544 |
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| author | Candy Day Andy Gray Annibale Cois Noluthando Ndlovu Naomi Massyn Ties Boerma |
| author_facet | Candy Day Andy Gray Annibale Cois Noluthando Ndlovu Naomi Massyn Ties Boerma |
| author_sort | Candy Day |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-17T19:51:20Z |
| format | Article |
| id | doaj.art-6eb76d4803ee4d11a2fee3c5e38d0d93 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-17T19:51:20Z |
| publishDate | 2021-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-6eb76d4803ee4d11a2fee3c5e38d0d932022-12-21T21:34:43ZengBMCBMC Health Services Research1472-69632021-09-0121S111310.1186/s12913-021-06171-3Is South Africa closing the health gaps between districts? Monitoring progress towards universal health service coverage with routine facility dataCandy Day0Andy Gray1Annibale Cois2Noluthando Ndlovu3Naomi Massyn4Ties Boerma5Health Systems TrustDiscipline of Pharmaceutical Sciences, University of KwaZulu-NatalHealth Systems TrustHealth Systems TrustHealth Systems TrustDepartment of Community Health Sciences, University of ManitobaAbstract 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.https://doi.org/10.1186/s12913-021-06171-3Universal health coverageService coverage indexRoutine dataSurvey dataSubnational disaggregation |
| spellingShingle | Candy Day Andy Gray Annibale Cois Noluthando Ndlovu Naomi Massyn Ties Boerma Is South Africa closing the health gaps between districts? Monitoring progress towards universal health service coverage with routine facility data BMC Health Services Research Universal health coverage Service coverage index Routine data Survey data Subnational disaggregation |
| title | Is South Africa closing the health gaps between districts? Monitoring progress towards universal health service coverage with routine facility data |
| title_full | Is South Africa closing the health gaps between districts? Monitoring progress towards universal health service coverage with routine facility data |
| title_fullStr | Is South Africa closing the health gaps between districts? Monitoring progress towards universal health service coverage with routine facility data |
| title_full_unstemmed | Is South Africa closing the health gaps between districts? Monitoring progress towards universal health service coverage with routine facility data |
| title_short | Is South Africa closing the health gaps between districts? Monitoring progress towards universal health service coverage with routine facility data |
| title_sort | is south africa closing the health gaps between districts monitoring progress towards universal health service coverage with routine facility data |
| topic | Universal health coverage Service coverage index Routine data Survey data Subnational disaggregation |
| url | https://doi.org/10.1186/s12913-021-06171-3 |
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