South Africa studies systems strengthening

October 2010 | Volume 9, Issue 5

Seven people seated in front of many laptop computers on opposite sides of a long desk, one many looks over a woman’s shoulder

Fogarty recently sponsored a health economics
workshop in South Africa.

While South Africa is now firmly committed to improving its health indicators, its significant financial investments are linked to disturbingly poor health outcomes. The Priority Cost Effective Lessons for Systems - South Africa, known as PRICELESS-SA, supports the development of country-specific evidence to show how scarce resources can be used to inform high impact interventions and enable health systems to work more effectively and efficiently. The initiative is based at the University of the Witwatersrand School of Public Health in Johannesburg.

PRICELESS-SA will measure cost effectiveness but additionally will in the process, gain an understanding of how a culture of information and evidence is fostered and applied. Tools are beginning to be developed and field-tested. Work will provide much needed information at a critical moment for SA policymakers who have shown a high level of buy-in. Economic evaluation will focus on integrated approaches to the care of mothers and children, and services for patients with chronic conditions at the district/primary health care level.

The project is now gaining momentum, driven by Dr. Karen Hofman from Fogarty, working with Professor Stephen Tollman, Director of the MRC/Wits Rural Public Health and Health Transitions Research Unit. In addition to creating a governance structure of senior decision makers, they have formed a Secretariat and developed a targeted R and D agenda. To develop expertise in health economics, a successful short course was recently offered at the Wits Faculty of Health Sciences, sponsored by Fogarty. Faculty from the SA Medical Research Council and the University of Queensland trained 30 promising students from varied backgrounds including government departments of health and finance.

This work builds on the Disease Control Priorities project DCP-2 that was based at Fogarty until 2006. PRICELESS-SA and related work in India are part of the Disease Control Priorities Network. Fogarty is partnering in this endeavor with the Gates Foundation, the SA MRC, the WHO and the Universities of Washington, Seattle and Witwatersrand, Johannesburg.

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