Health Information Systems, eHealth Strategy, and the Management of Health Records: The Quest to Transform South Africa's Public Health Sector

Health Information Systems, eHealth Strategy, and the Management of Health Records: The Quest to Transform South Africa's Public Health Sector

Shadrack Katuu (International Atomic Energy Agency, Austria & University of South Africa, South Africa)
DOI: 10.4018/978-1-5225-6915-2.ch024
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South Africa's health sector faces two main transformation challenges: inequity and a legacy of fragmentation. This chapter traces the history of health policy development in the country in seven phases from the 17th century to the present time. It describes the efforts in transformation made through the promulgation of the National Health Act in 2003 and the eHealth Strategy in 2012. The chapter explores the utility of maturity assessment in assessing whether transformation goals through an analysis of five maturity models: Digital Preservation Capability maturity model, eHealth maturity model, Enterprise Content Management maturity model, Health Normative Standards Framework maturity model, and Records Management Capacity Assessment System. South Africa is already using two of the five models demonstrating that is not just reliant on technology but has developed strategies and principles to guide the transformation process. The chapter argues for more expansive adoption of maturity assessment to cover the full records lifecycle.
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Historical Background

This section outlines the history of South African health sector and policy, the challenges of transforming the sector and the contributions towards this process from the implementation of Health Information Systems (HIS).

Health Sector History

The history of the health sector in South Africa dates back long before the British occupation of the Cape in the early 19th century (Katuu, 2011; Laidler & Glefand, 1971). At present, South African health care is characterised by its mixed and pluralistic flavour. This pluralism had its origins in the early Western settlements period and was expanded and consolidated during the subsequent colonial period. According to Van Rensburg (2004, pp. 68-69), it started specifically with the importation of ships’ surgeons from the 17th century. The pioneer was surgeon Jan van Riebeeck who founded the settlement at Cape of Good Hope or now known as Cape Town in 1652 (Bruijn, 2009, p. 85). This was followed in subsequent decades and centuries with the establishment of private practitioners among free burghers (who were independent famers that supplied fresh produce to passing ships) as well as the expanding settlements (Ward, 2015). Later saw the appointment of district surgeons, resident doctors and a growing corps of medical officialdom (Van Rensburg, Fourie, & Pretorius, 1992, p. 54). Hospitals and other types of health care facilities were first established to cater for company officials and for some time had close military ties. Civilian and public hospitals were later developments (Van Rensburg, 2004, pp. 68-69).

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