Publications
HST provides free electronic access to over 500 health systems research related reports, publications and papers. Close to 300 of these are publications that have been commissioned and funded by the Trust. Topics include among others district systems development, drug supply management, human resource development, informatics, legislation, finance, environmental health, mental health, lessons learnt, nutrition and sexually transmitted diseases / HIV/AIDS. The main publication of the HST is the annual South African Health Review. From 2005 all HST publications will be available in low resolution only. To explore the range of publications HST offers use the Advanced search to search using a variety of criteria.

Highlights of the year include the launch of the 2003/04 edition of the South African Health Review, which provides a 10 year perspective on progress in the health system since democracy, and a data driven framework against which future achievements in the health system can be assessed. Other achievements include the release of the National Primary Health Care Facilities Survey (2003) Report, and Community Developments Impumulelo Award for its Integrated Nutrition Project which has established a sustainable model of nutrition support in communities.

HST has also established several new projects including the District Barometer, which focuses on monitoring key indicators across districts, and shifts the focus of earlier equity work to a district level. The organisations expansion into regional work has continued gradually, with the strengthening of projects with SADC, and a range of new partnerships across the region.

The promulgation of the National Health Act in 2004 provided clarity on the delegations to different levels of government, and enabled planning and financing arrangements for the District Health System to proceed. Along with this, the ending of a three year European Union project supporting district health development in the 13 rural nodes, marked a watershed for the Initiative for Sub District Support (ISDS) programme, and the role it has fulfilled thus far in district health development.

ISDS, first established in six sites in 1996, to support implementation of the District Health System has over the past eight years provided direct support to district management teams and staff in more than 20 sites throughout the country. ISDS also developed a range of guidelines and tools to support district planning, management and delivery of services. These tools and lessons learnt were widely disseminated and used, and have subsequently been integrated into national policy and guidelines for district development. The ISDS model of site facilitation earned many accolades for the successes achieved. With the wealth of experience and skills gained, ISDS continues to lead and participate in several district development projects with a range of different partner organisations. The end of the EU project has however presented an opportunity to re-examine ISDSs role and the nature of support needed for district health systems development in the future. It also provides an opportunity to develop new strategies and appropriate skills to meet the challenges of ISDSs changing role, and in the next year we hope to see this taking shape in HST more clearly.