Why does South Africa perform badly in health when compared to other African countries, despite good policies, adequate amounts of money and more skilled workers? One of the reasons is that there are many examples of policies and programmes that aim for an unrealistic gold standard (with its unnecessary and unhelpful complexity) and which, as a result, undermine the provision of good healthcare to as large a population as possible, e.g. the new Road to Health Booklet and the District Health Information System. Many people balk at the idea of not aiming for a “gold standard” at a policy level. In this article the author argues that it might be better to aim for a “silver standard”.
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