In 1994, the Pilot Accreditation Programme for South African Health Services was launched as a research and development programme in the Faculty of Medicine at the University of Stellenbosch under the directorship of Professor Stuart Whittaker. The programme grew rapidly and evaluation research showed that it was well received and perceived to be of considerable value to participating facilities.

The rapid expansion of the programme resulted in the perception that it was too big for a single department and not an appropriate function of the University.

The emergence of COHSASA as an independent, non-partisan unit was a logical development. In 1995, in a memorandum of agreement, the University of Stellenbosch transferred the accreditation copyright and obligations to COHSASA, which was registered as a not-for-profit organisation. It started operations from a small office in Pinelands, Cape Town in 1996.

Over the past 26 years, COHSASA has developed healthcare accreditation programmes for hospitals, primary health care clinics, hospices, environmental offices, day surgeries, subacute care facilities and general practitioners.

The SafeCare Foundation


The aim of SafeCare is to ensure Africans and others in resource-restricted countries have access to safe, quality health care. Through the SafeCare Foundation, primary healthcare providers – even those with very few resources – will be able to improve their service delivery and, in so doing, reach international standards of care for patients.

SafeCare was established following a landmark two-day conference on basic healthcare standards in Cape Town on March 9 and 10, 2011.

It is a partnership between COHSASA, PharmAccess Foundation of the Netherlands and the Joint Commission International, the United States-based quality standards authority.

The SafeCare Foundation, which has evolved out of the SafeCare Initiative, is a repository of methods, tools and research – as well as an information-sharing platform, which has as its basis, the object of providing a feasible model whereby patients in less developed countries will be able to access quality health care. It is, in part, a quality improvement and accreditation system that will work with district hospitals and clinics across the continent to offer basic acceptable healthcare standards. Tertiary level hospitals will not form part of the initiative in the short term. It is not a quick fix but an incremental process of improving quality towards excellence.

The healthcare facilities, some of them coming in at very poor baselines, gradually improve their ability to provide safe and quality healthcare and along the way – as a means of encouragement – are awarded certificates that mark their progress towards achieving excellence.

Several facilities in Tanzania, Kenya, Nigeria and Ghana are undergoing SafeCare interventions.

SafeCare is now poised to be rolled out across Africa. It offers a comprehensive toolkit to make a real difference: a set of standards tried and tested instruments, innovative training methods and financing incentives and monitoring and reporting tools that can be used by assessors to help healthcare facilities provide safe and quality care to patients.

View the SafeCare website at www.safe-care.org

Certificates of Improvement