Social Audit of Health Services in Gauteng
Name of Organization:
Geographical Scope:
Regions:
Country:
Purpose:
The social audit of health services in Gauteng began in December 2003. Its key aims were to strengthen service delivery in the province by evaluating the availability, accessibility, acceptability and quality of health services; assemble evidence for better planning and delivery of health programmes (in particular those related to HIV/AIDS prevention and health communication); and contribute to a supportive, rights-based environment (through identification of best practices) at provincial level.
Data from an intensive household-level survey of service users and non-users, together with information retrieved from institutional reviews of government health facilities, informed preliminary analysis. Fieldworkers raised key issues with gender-stratified focus groups with a view towards developing community-led solutions.
Website of initiative:
Publications:
Andersson N, Paredes S, Ngxowa N, Matthis J., "Social audit of provincial health services: Building the community voice into planning in South Africa", Journal of Interprofessional Care 2004; 18(4): 381-390.
Funding sources:
Provincial Health Services Authority
Source of Data:
Own source of data
Type of Data Collection:
Administrative Data
Focus groups
Random sample population survey
Specifications of type of data collection:
CIETmethods:
The cross design of social audit and evaluation techniques known as the CIETmethod, also known as sentinel community surveillance (SCS) or service delivery surveys (SDS) tries to maintain epidemiological coherence while introducing the results of surveys for discussion between communities and planners.
The method relies on a panel of sentinel communities chosen and weighted to link the sample to the universe it represents. Cyclical contacts with these sentinel sites are effectively a concentration of measurement resources in time and place, an intense focus of quantitative and qualitative methods in a panel of mini universes. The ability to repeat measurement in the same place makes impact estimation relatively straightforward.
These households can be contacted in successive cycles, perhaps a year or two years later, to measure differences over the period. These differences can be related to programmatic input and other factors that might be vary across different sites. The impact assessment is based on the time sequence and the heterogeneity between sites.
The CIET cross-design usually involves 120 contiguous households in each site to permit the analysis of local factors in the context of household-level occurrences. Some environmental factors might be quantified easily (for example, presence of school, cost of drugs) or they may be more qualitative (adequacy of sanitation, level of participation in community affairs). If these factors affect the whole cluster, comparisons can be made between clusters or groups of clusters.
Levels of indicators and epidemiological analysis for planning Different levels of indicators summarise what planners need to know, progressing from simple description, through analysis of causality to modelling programme investment. A basic indicator gives a bland description of occurrence, the corollary of an opinion prevalence in an opinion poll (Level 0 in CIET nomenclature).
Measurement Methods / Tools Generated or Used :
SEE CIET methods
List of Indicators:
- availability
- accessibility
- acceptability
- quality of health services
- identification of best practices
Main Users:
Civil society
Donor agencies
International agencies
Media
Policy makers
Researchers