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How did the Ideal Clinic programme came about………

Since the launch of the government's green paper on National Health Insurance, various reforms and initiatives are underway to improve services to be provided under the future National Health Insurance. The Ideal Clinic programme is another initiative that was started by South Africa in July 2013 as a way of systematically improving the quality of care provided in Primary Health Care facilities.

How was the implementation of the Ideal Clinic programme fast tracked – Operation Phakisa

To fast track the implementation of the Ideal Clinic programme, the Department of Performance Monitoring and Evaluation, the National Planning Commission in the Presidency and the National Department of Health are spearheading the use Operation Phakisa which is an 8-step methodology that facilitates the development of detailed plans to ensure successful implementation and effective monitoring of national priorities. Operation Phakisa for health was launched by President Jacob Zuma on the 18th of November 2015. A key step in the Operation Phakisa approach is the Delivery Labs that commenced on the 12th of October until 21 November 2014. Further details on Operation Phakisa can be obtained by downloading the documents on Operation Phakisa under the document tab.

The National Health Council gave a directive that all Primary Health Care facilities must be Ideal within the next three years, starting in April 2015. Therefore every province had to compile a scale-up plan that indicates in which year each clinic will reach Ideal Clinic status.

To further fast track the implementation of the programm, every district appointed a Perfect Permanent Team for Ideal Clinic Realization and Maintenance. The teams are responsible to conduct a status determination at all the clinics and assist the clinics to improve the quality of care that they deliver.

How is a clinic evaluated to determine whether it obtained Ideal Clinic status?

The Ideal Clinic dashboard is used to determine the status of a clinic. Version 15 is currently in use. The dashboard comprised of 212 elements, categorized into 10 components and 32 Sub-components.( Download: Ideal Clinic Definition and Components Booklet). Each element on the dashboard is weighted as vital, essential or important and scored as green (achieved), amber (partially achieved) or red (not achieved). The average score according to the weights assigned to the 212 elements determines whether a clinic has qualified for one of the four Ideal Clinic categories; silver, gold, platinum or diamond. An Ideal Clinic status is achieved when a clinic obtained one of these categories. Note that a clinic can obtain a high average score example 80% but not qualify for an Ideal Clinic category because the minimum percentages according to the weight categories were not obtained. For further details on the percentages per weight category required to achieve one of the four categories, see the last page of the Ideal Clinic Definition and Components Booklet. The Ideal Clinic manual was developed to assist facilities to achieve Ideal Clinic status. The manual describes step-by-step how the clinic should go about to achieve every elements on the dashboard.

How is progress monitored?

A web based application is used to monitor the various elements on the dashboard. The application allows managers on all levels (district, provincial and national) to monitor the progress made. To access the application and obtain information on how to register go to the documents tab. The Snapshot of progress made tab gives a National overview to the public on the progress made with the Ideal Clinic dashboard.

ACKNOWLEDGMENTS

The National Department of Health would like to thank the following organisations for contributing to the Ideal Clinic Realisation and Maintenance programme: Centre for Disease Control and Prevention (CDC), USAID, Health Systems Trust (HST), European Union (EU), USAID and UKaid.