Establishing a good practices repository to support health system learning in South Africa: methods, implementation processes and lessons learnt
Mashudu Mthethwa, Maryam B Rumaney, Michael Burnett, Ntombifuthi Blose, Zinhle Mtwane, Noluthando NdlovuAim
Health systems generate substantial knowledge through routine service delivery and local problem-solving, but effective practices are often poorly documented and shared. A mechanism for systematically identifying, documenting and disseminating such practices may strengthen health system learning. This paper describes the processes used to identify, assess and document good practices across South Africa’s health system, and the establishment of a national digital repository.
Method
A descriptive implementation study was undertaken from September 2024 to October 2025. A multi-source approach was used to identify and document good practices through: (1) a national call for submissions; (2) stakeholder engagement meetings in seven of the nine provinces; and (3) analysis of 20 routine district health indicators over six years (2018/19 to 2023/24) to identify districts demonstrating sustained improvement. Submitted practices were assessed against adapted World Health Organization good practice criteria. Districts whose indicators showed sustained improvement were contacted for follow-up interviews to identify activities contributing to improved performance. Validated practices were documented using standardised templates and uploaded to an open-access digital repository hosted on Scholastica.
Results
Overall, 58 good practices met the core assessment criteria. Of these, 16 met all nine of the adapted criteria and were selected for the inaugural release of the repository. Eight of the 20 routine indicators showed sustained improvement in one or more districts, and 17 interviews were conducted across those districts. The review process highlighted substantial implementation knowledge within facilities, districts, and programmes, but also revealed challenges related to documentation quality and limited cross-provincial knowledge sharing.
Conclusion
Systematically identifying and documenting good practices in an accessible national repository is an important first step towards strengthening South Africa’s learning health system. The repository has the potential to enable health system learning; however, its longer-term contribution will depend on the active sharing, adaptation and uptake of the documented practices.