A new foundation aims to improve healthcare delivery in African countries, with a long-term aim of reducing the need for Africans to travel to India or South Africa. Three organisations from three different continents have combined to improve the safety and quality of health care provided in resource-restricted countries.
The South African-based Council for Health Service Accreditation of Southern Africa (COHSASA), the PharmAccess Foundation of the Netherlands, and US-based Joint Commission International (JCI) have establish the SafeCare Foundation.
SafeCare has grown out of a global initiative, launched in March 2011 in Cape Town, South Africa, to introduce a comprehensive quality improvement program using internationally recognised standards to improve health care delivery. The SafeCare Foundation is designed for health care providers in resource-poor settings to assist them in step-wise quality improvement and the delivery of safer care to their patients. The new foundation has an international board and is based in Amsterdam.
The SafeCare programme has been successfully initiated in more than 107 clinics in six countries - Kenya, Nigeria, Tanzania, Ghana, Lesotho and South Africa.
The clinics participating in SafeCare have committed to improve the quality of their services as part of their participation in various insurance and medical credit programmes. The first 10 clinics recently obtained certificates of improvement, which were awarded based on reaching pre-defined levels of standard compliance. Placed in the African context, where many facilities face resource challenges and a high disease burden, this establishes the principle of graded improvement that many African facilities will follow in the years to come.
The analysis of SafeCare certification data will allow governments, investors, insurers and donors in developing countries to support feasible, cost-effective and structured quality improvements. The foundation will build and maintain a database of organisations using its standards and keep track of their progress as well as the progress of the clinics.
SafeCare will collaborate with other organisations to apply for the funding of quality improvements in resource-poor areas.
A SafeCare Knowledge Institute will be set up to provide health intelligence data on health care quality improvement in Africa, provide benchmarks, perform gap analyses, and study the associations between quality improvement certification and medical output and outcome. These vital analyses can be used to inform donors and governments about the status of health care in specific regions or countries.
The SafeCare methodology combines the respective knowledge, expertise, skills, tools and experience of all three organisations - COHSASA, JCI and PharmAccess - to issue a graded certificate of improvement to different categories of health care facilities ranging from nurse-driven health clinics to district hospitals. Certificates range from level 1 to 5, which allows for demonstrating incremental achievement in compliance with the SafeCare Foundation Standards.
Health care facilities are rewarded with a certificate of improvement every time they reach the next pre-defined SafeCare step. If executed completely (SafeCare Level 5), this qualifies a facility for formal accreditation through COHSASA or JCI. The uniqueness is that the SafeCare route is all about relative improvement and does not demotivate African facilities with unreachable international absolute quality norms. SafeCare offers a step-wise approach, confronting facilities with incremental challenges with respect to quality and patient safety and eventually rewarding and motivating these facilities with recognition through its certification system. SafeCare can be offered in combination with affordable loans through the Medical Credit Fund or inclusion in innovative insurance programs like those supported by the Health Insurance Fund.