The EQUITY Project Final Report

Strengthening Equitable Access to Quality Health Services for All South Africans

In 1997, just three years after South Africa’s first democratic elections, the aptly named EQUITY in Integrated Primary Health Care Project opened its first office in Bisho, capital of the newly-formed Eastern Cape Province.  

A USAID–funded partnership between the Department of Health (DOH) and MSH, The EQUITY Project aimed to bring relevant international experience and assist the new DOH to implement primary health care, focusing its work on the Eastern Cape Province and later expanding to additional provinces. 

Conceived in a political context rarely encountered by USAID or its contractors, the Project supported the establishment of new health districts, management decentralization, empowerment of health workers, and dismantling of vertical and centrally-controlled health programs under the umbrella of “transformation.” Amidst an environment rife with both promise and challenges, USAID and the DOH designed a complex project to address the basic health needs of the country’s black majority. The initiative worked to strengthen management systems, thereby enabling the government to respond more effectively to the priority concerns of its population. 

This report contains in-depth stories covering the Project’s main technical areas-from quality assurance and drug management to HIV/AIDS and TB-highlight the year’s key successes while reflecting on lessons learned and remaining challenges.