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Facility standards and the quality of public sector primary care: Evidence from South Africa's “Ideal Clinics” program

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  • Nicholas Stacey
  • Andrew Mirelman
  • Noemi Kreif
  • Marc Suhrcke
  • Karen Hofman
  • Ijeoma Edoka

Abstract

Primary healthcare systems are central to achieving universal healthcare coverage. However, in many low‐ and middle‐income country settings, primary care quality is challenged by inadequate facility infrastructure and equipment, limited human resources, and poor provider process. We study the effects of a recent large‐scale quality improvement policy in South Africa, the Ideal Clinics Realization and Maintenance Program (ICRMP). The ICRMP introduced a set of standards for facilities and a quality improvement process involving manuals, district‐based support, and external assessment. Exploiting differential prioritization of facilities for the ICRMP's quality improvement process, we apply differences‐in‐differences methods to identify the effects of the program's efforts on standards scores and primary care quality indicators over the first 12 months of implementation. We find large and statistically significant increases in standards scores, but mixed effects on care outcomes—a small magnitude improvement in early antenatal care usage, null effects on childhood immunization and cervical cancer screening, and small negative effect of human immunodeficiency virus (HIV) care. While the ICRMP process has led to significant improvements in facilities' satisfaction of the program's standards, we were unable to detect meaningful change in care quality indicators.

Suggested Citation

  • Nicholas Stacey & Andrew Mirelman & Noemi Kreif & Marc Suhrcke & Karen Hofman & Ijeoma Edoka, 2021. "Facility standards and the quality of public sector primary care: Evidence from South Africa's “Ideal Clinics” program," Health Economics, John Wiley & Sons, Ltd., vol. 30(7), pages 1543-1558, July.
  • Handle: RePEc:wly:hlthec:v:30:y:2021:i:7:p:1543-1558
    DOI: 10.1002/hec.4228
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    References listed on IDEAS

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    1. Powell-Jackson, Timothy & Mazumdar, Sumit & Mills, Anne, 2015. "Financial incentives in health: New evidence from India's Janani Suraksha Yojana," Journal of Health Economics, Elsevier, vol. 43(C), pages 154-169.
    2. Samantha Y Rowe & David H Peters & Kathleen A Holloway & John Chalker & Dennis Ross-Degnan & Alexander K Rowe, 2019. "A systematic review of the effectiveness of strategies to improve health care provider performance in low- and middle-income countries: Methods and descriptive results," PLOS ONE, Public Library of Science, vol. 14(5), pages 1-29, May.
    3. Martina Björkman & Jakob Svensson, 2009. "Power to the People: Evidence from a Randomized Field Experiment on Community-Based Monitoring in Uganda," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 124(2), pages 735-769.
    4. de Walque, Damien & Gertler, Paul J. & Bautista-Arredondo, Sergio & Kwan, Ada & Vermeersch, Christel & de Dieu Bizimana, Jean & Binagwaho, Agnès & Condo, Jeanine, 2015. "Using provider performance incentives to increase HIV testing and counseling services in Rwanda," Journal of Health Economics, Elsevier, vol. 40(C), pages 1-9.
    5. Government of India, 2017. "National Health Policy 2017," Working Papers id:11664, eSocialSciences.
    6. World Health Organization & World Bank Group & OECD, 2018. "Delivering Quality Health Services," World Bank Publications - Books, The World Bank Group, number 29970.
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