1. MEASURING HEALTHCARE ACCOUNTABILITY: ACCOUNTABILITY MATRIX Dr Ali Hamdulay - Head of Clinical Risk Solutions Metropolitan Health Risk Management

2. Accountability 1 How do we define it? 2 How do we assign responsibility? 3 Can we/how do we measure?

3. Definition of Accountability AnswerabilityJustificationSanction

4. Types of Accountability Financial Sustainability Rules Cost containment Performance Utilisation Quality Satisfaction Political/ Democratic Access Advocacy Care Coordination

5. Strengthening the Health Citizens voice and power The health sector role players are specifically accountable to this stakeholders. How strong is the level of accountability in the health sector to this stakeholder? All consumers are not patientsConsumers are confusedEach consumer has different needs Limited power and voice to articulate their needs and demands Medical schemes represents an opportunity to articulate and contextualise the needs of a Health Citizen cohort. BenefitsAdvocacy Access to Quality Health Outcomes

6. How does stronger accountability improve health system performance and sustainability? Increases the understanding of the health system operations and processes System-wide perspective on health sector reform Identify connections among individual improvement interventions Translate priorities into action Enhance process performance Reduce Waste and Abuse Ensure Compliance Improve Quality & Performance

8. Academia Unions Health Citizens Associations NGO's Managed Care Administrators Funders Health Facilities Practitioners Actuaries Hospitals Broker s Employers HPCSA CMS Government Health sector ecosystem and accountable role players

9. Accountability Mapping

10. Accountability linked to Health Interventions Within a population health approach, a much greater emphasis is placed on accountability for health outcomes and determining the degree of change that can actually be attributed to interventions. Process evaluations to determine whether a policy or program is reaching its target population Impact evaluations to measure the immediate results of a program or policy.

11. What are the principles we need to apply to measure accountability? Who demonstrates - Who measures? Stakeholder relationships Data quality Expertise Collaboration and consensus Incentives, information

12. Breadth and Depth of Accountability National Health Private Sector Terms of Employment HEALTH ECOSYSTEM Sustainability FINANCIAL Health outcomes Satisfaction PERFORMANCE Access Advocacy DEMOCRACY MEASURE

13. Public Private Partnerships: The Metropolitan Health Risk Management (MHRM) HIV YourLife Programme has partnered with government to assist in the achievement of the National Strategic Plan (NSP) goals. HCT CampaignCircumcision TrainingDecisions support toolsHIV NetworkWoman's Health

14. “The roadmap will take into account issues such as the need for a unified approach, greater alignment and a common purpose to ensure greater access, social solidarity, affordability and quality. The overarching goal is to build a sustainable, integrated, patient-centric healthcare system. “

15. THANK YOU