Status of a health care quality review programme in South Africa

This paper provides an overview of an accreditation programme for health ca re facilities in South Africa. It traces the origin of COHSASA (The Council for Health Service Accreditation of Southern Africa) which began as a pilo t programme in 1992, to its current status as the only accreditation body i n the country. There are brief descriptions of its structure, how it is gov erned, and how standards were developed and organized. The authors sketch a background of the unique sociopolitical contest and legal developments wit hin which the programme operates in South Africa and how the programme is c ontributing towards the new government's intention to provide equitable and quality health care to all its citizens. There is an outline of the princi ples on which the COHSASA programme is based and the structure and process of the programme. The programme incorporates an integrated, multi-disciplin ary continuous quality improvement approach with special emphasis on capaci ty building of hospital staff when necessary. The paper refers to groundbre aking research in Kwa-Zulu Natal where the impact of accreditation is being measured in a randomized control trial. It points to the benefits of accre ditation being perceived in both public and private sectors of health care in South Africa and outlines some of the results of the program's implement ation.