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Initiative for Sub-District Support (ISDS)Improving Quality of CareThe Initiative for Sub-District Support (ISDS) improves the quality of primary health care by empowering both clients and providers through facilitation and support. Starting with a few fledgling sites in 1996, the ISDS now works in over 20 districts throughout South Africa and currently focuses mainly in the 13 most disadvantaged rural districts in South Africa, designated as part of the Presidential Lead Project to improve the lives of the most disadvantaged. The work of ISDS has highlighted critical issues at district level, for example the importance of support services such as transport in the management of priority health problems. The ISDS continues to gives confidence and mentoring support to local district managers and health workers to enable them to do their work effectively. The ISDS provides an entry point into the entire health system for demonstrating systems and strategies to improve the quality of health care, based upon a &ldquobottom-up&rdquo approach and the Primary Health Care values and principles One of the key roles of ISDS is to evaluate the process, document and share lessons learnt with relevant stakeholders such as sub-district, district and provincial managers in order to assist policy and implementation. Another important role is monitoring improvements at district level in key focus areas such as HIV, Sexually Transmitted Infections, TB, Mother and Child Health (MCH) and nutrition. ISDS Sites
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