SQM project

Dr Bronwyn Myers
T: +27 21 938-0350 / F: +27 21 938-0342

Measuring up to excellence in
substance abuse treatment


This section describes the phases of this project and key project activities for each of these phases.

Project phases and activities

This project is divided into five phases: conceptualization, measurement specification, pilot-testing, implementation, and dissemination. We have already completed phase one of the project and are currently busy with phase two.  Key activities and outcomes of these first two project phases are described below:

  1. Conceptualisation phase (Year One)  Status: Complete

A project steering committee was formed that consists of representatives from key stakeholder groups drawn from the policy, practice, client/consumer and research communities of South Africa. Stakeholders include government representatives at the provincial and national level (from Departments of Health and Social Development), as well as representatives from the NGO and private sectors and academic institutions. The role of this steering committee is to provide advice and guidance to the project team, to ensure that the selected SQMs are relevant to the needs of South Africa’s behavioural healthcare system and sensitive to cultural differences, and to ensure that efforts to develop service quality measures dovetail with policy and advocacy efforts to improve the quality of substance abuse treatment in the country.  A list of members is displayed on this website.

During this phase, one face to face steering committee meeting was held and various virtual committee meetings were held. During these meetings a small number of explicit goals and domains for the South African substance abuse treatment system were identified. The project team in conjunction with the steering committee also identified potential SQMs addressing each of the stated goals, taking into account current data and infrastructure capabilities in the country. A list of these domains and indicators is available on the website under documents.

Another outcome of this phase was the formation of two working groups to aid in the development of service quality measures.  The first, a consumer survey work group is tasked with advising the project team on the selection of key indicators for a survey on clients’ perceptions of substance abuse treatment, developing measures for these indicators and ensuring these measures are appropriate and feasible for the South African context.  The second group, the administrative data work group, is tasked with advising the project team on the selection of administrative data elements that are feasible to collect from substance abuse treatment services (such as number of clients served, treatment completion rates). These groups will play an important role in the subsequent phases of the project.

  1. Measurement specification phase (Year 2) Status: Current

At present, potential measures for each indicator are being identified from multiple sources, including existing measures from South Africa (e.g., survey tools used for health services research) and from other countries in the same region and/or with similar cultures, and those developed within other initiatives (e.g., the US Forum on Performance Measurement, National Committee for Quality Assurance and the National Quality Forum). These measures include measures based on administrative data and measures based on primary data from clients.   Where measures do not already exist, new measures will be developed.  The two work groups are assisting the project team with measure selection and development.  A measurement matrix has been developed that specifies where items already exist for each indicator and where new measures need to be developed.  (This is available in the documents section). The work groups are also reviewing these measures to  determine their feasibility and appropriateness.

Finally, the various work groups are developing a plan for pilot-testing these measures (during phase 3).  We hope to pilot-test the use of these measures in treatment services in three key provinces: the Western Cape, KwaZulu-Natal, and Gauteng.  A broad spread of services will be chosen, including in and outpatient services in both the for-profit and non-profit treatment sectors.