CORRESPONDENCE

Health technology assessment - a new initiative in South Africa

To the Editor: From a clinical perspective, technology is expected to reduce the risk of disease, reduce duration of illness, improve quality of care, increase access and restore, or limit the decay of, a person's quality of life. Technology is also expected to contain costs and improve interventional risk management through enhancement of service efficiency and productivity of health care professionals. As health technology evolves, so does the need to assess its impact on patients' health outcomes, hospital operations, and financial resources. This process leads to the evolution of health technology assessment (HTA), which is a systematic evaluation of properties, effects and other consequences of health care technology. Its purpose is to provide objective information for supporting health care decisions and policy-making at international, national, provincial and health facility levels. An effective HTA programme produces good-quality information and analysis, and then effectively uses this information and knowledge to influence decision-makers in health care systems.¹

The South African National Department of Health (DoH) published a policy paper on HTA in 1997. A steering committee was formed to drive the HTA agenda in South Africa, and a regulatory framework has been established under the National Health Act (Act No. 61 of 2003). Since then, little has been achieved in this field, although the importance of HTA was highlighted 10 years ago.² Currently, only two universities in the country offer formal HTA programmes.

Against this backdrop, the Clinical Epidemiology Unit of the University of the Witwatersrand has initiated a translational research project to introduce HTA to public hospitals in South Africa. These hospitals spend a significant amount of resources, and there is an urgent need to develop their evidence based decision-making processes in view of the impending introduction of national health insurance. The unit has established links with international organisations involved with HTA to create best practices in this field.

The unit has been working with several public hospitals' chief executive officers, who have been conducting research for their master's degrees in hospital management. Their areas of research include various components of HTA such as assessment of medical equipment, pharmaceuticals, blood and blood products, practice of clinical procedures, clinical governance and risk assessment (Fig. 1). These reports will be submitted to the national and provincial departments of health for the purposes of improving service delivery in South Africa's public hospitals.

Moreshnee Govender
School of Public Health
University of the Witwatersrand
Johannesburg and
Warmbaths Hospital

Motlatso Elias Letshokgohla
School of Public Health
University of the Witwatersrand

Debashis Basu
Department of Community Health
University of the Witwatersrand and
Charlotte Maxeke Johannesburg Hospital
Debashis.Basu@wits.ac.za

1. International Network of Agencies for Health Technology Assessment. A Checklist for Health Technology Assessment Reports, 2001. http://www.inahta.org (accessed 12 March 2010).         [ Links ]

2. Kachieng'a MO, Boonzaier DA. Health care technology assessment - the South African health care system in transition. S Afr Med J 1999; 89(2): 149-155.         [ Links ]