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Elevating Substance Use Treatment Quality: A Closer Look at South Africa's SQM Initiative

Updated: Jan 27

Elevating Substance Use Treatment: South Africa's SQM Initiative

Uncover South Africa's commitment to elevating substance use treatment quality through the Service Quality Measures (SQM) initiative. Modelled after high-income countries, SQM introduces a structured framework for monitoring and enhancing services, emphasizing continuous evaluation. This initiative, initiated by the South African Medical Research Council, signifies a leap forward in aligning practices with international standards, aiming to set a model for other nations seeking to improve substance use treatment systems.



Ensuring the quality of substance use treatment services is a crucial aspect of healthcare delivery. High-income countries (HIC) have implemented performance measurement systems to monitor service quality, set improvement targets, and evaluate performance-enhancing activities. In this exploration, we delve into the landscape of substance use treatment quality, particularly focusing on performance measurement systems in high-income countries and South Africa's unique context.

1. Performance Measurement Systems in High-Income Countries

Purpose of Performance Measurement:

In high-income countries, performance measurement systems play a pivotal role in monitoring health service quality. These systems are designed to track and assess various aspects of treatment services, with a primary focus on enhancing overall performance.

Data Source and Process Indicators:

Data Source: Process data sourced from administrative databases are predominantly used. This is often due to the cost implications and inconvenience associated with collecting outcome data directly from individuals undergoing treatment.

Examples of Process Indicators: Common process indicators include treatment engagement, retention rates, and other factors that can predict treatment outcomes.

2. South Africa's Context

Historical Absence of Monitoring System:

South Africa has historically lacked a systematic approach to monitoring the quality of substance use services. This absence has posed challenges in evaluating and improving the effectiveness of treatment interventions.

Initiative to Address Gaps:

Recognizing the need for a comprehensive monitoring system, the South African Medical Research Council took a proactive step in developing the Service Quality Measures (SQM) initiative. This initiative represents a significant leap forward in aligning South Africa's substance use treatment practices with international standards.

3. Service Quality Measures (SQM) Initiative

Purpose and Significance:

Purpose: The SQM initiative was crafted as a performance measurement system tailored specifically to South Africa's Substance Use Treatment System.

Significance: It holds a pivotal role within the spectrum of services offered to individuals undergoing substance use treatment. The initiative aims to provide a structured and comprehensive approach to evaluating and enhancing service quality.

Structured Monitoring for Enhancement:

The SQM initiative introduces a structured framework for monitoring and improving substance use treatment services. By focusing on process indicators, aligns with the practices observed in high-income countries, emphasizing the importance of continuous evaluation and refinement.


In conclusion, the introduction of the SQM initiative in South Africa represents a significant commitment to elevating the quality of substance use treatment services. By drawing inspiration from performance measurement systems in high-income countries, South Africa aims to create a structured and efficient approach to monitoring and improving service quality. The emphasis on process indicators underlines a dedication to continuous evaluation, ensuring that substance use treatment services evolve to meet the changing needs of individuals seeking support. As the SQM initiative takes root, it has the potential to serve as a model for other nations seeking to enhance the quality of their substance use treatment systems.

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