Africa’s ‘quiet innovation’ and passion for quality offer lessons to the world, panel hears

The panel discussion on reciprocal knowledge between Africa and the rest of the world in the quest to improve health care. From left: Sabelile Tenza, associate professor of patient safety and healthcare quality at North-West University, Ms Sue Pos, independent healthcare quality specialist, Ms Jacqui Stewart, CEO of Cohsasa, Mr Simon Manaka, quality manager at Life Healthcare and Ms Jennifer Moodley, quality improvement specialist.

Held in Sandton, panellists agreed that while resource constraints are real, they often drive creativity and commitment to patient care. At the same time, stronger leadership, standardised processes and better use of technology – including AI – are critical areas where Africa can improve.

Professor Tenza set the tone, urging speakers to share success stories: Africa, she said, has “not been loud enough” about its achievements in quality improvement and patient safety.

Passion and structure drive quality

Simon Manaka, at the time an independent healthcare quality specialist but currently the Quality Manager at Life Healthcare, emphasised that quality begins with a simple principle: “the willingness to do things right.” Standards, he said, are “the minimum guarantee for patient safety,” and when applied systematically, they make compliance easier.

Drawing on his experience in the Middle East, he described how he led the accreditation of a point-of-care testing department in a 650-bed hospital in under a year. The key, he said, was a structured approach: “If you have a structured approach to quality, it is going to be the easy way but if you just go in without direction, it’s going to be very difficult.”

Building quality from the ground up

Ms Jennifer Moodley, a quality improvement specialist, shared a contrasting experience in Ghana, where she led accreditation efforts at The Bank Hospital in Accra. The challenge was significant: “More than 90% of the staff had never travelled out of Ghana,” and many did not understand quality improvement concepts.

Despite this, the hospital achieved accreditation within a year. Moodley credited structured standards and staff engagement: “Taking the staff on the journey has been one of my biggest success stories.” She described how staff “took ownership” and grew both personally and professionally through the process.

She added that the hospital later secured a further three-year accreditation, calling it “a great achievement on all accounts,” despite entering “waters that I had never chartered before”.

Resource gaps vs. system strength

Comparing Ghana with Saudi Arabia, Moodley highlighted stark differences. Saudi facilities, she said, are “like walking into a palace,” with abundant resources and access to top-tier international accreditation. Ghana, by contrast, was “humble, simple, a lack of resources… very tough and very difficult.”

Yet she stressed that accreditation standards are fundamentally similar across systems: “The service elements are absolutely the same. They are just worded differently.” She argued that more affordable, locally relevant accreditation models like COHSASA are crucial for African healthcare. She also added that, although Saudi Arabia is rich with resources, the work culture in Africa is better.

Leadership shapes culture — for better or worse

Ms Sue Pos, an independent quality and safety consultant, warned that leadership style can make or break quality systems. Reflecting on her experience in Saudi Arabia, she described an autocratic environment where incident reporting was suppressed: “There were no incidences; it seemed that nothing ever went wrong.”

In reality, she said, staff were afraid to report them. “If staff were not following procedures, they just got sent home.” This created a culture where “creative thinking was wiped out altogether,” ultimately harming both patient and staff satisfaction.

“Leadership drives quality,” she said. “If you have a leader that is non-supportive it shows.”

Africa’s strength: innovation, Ubuntu and resilience

Despite challenges, panellists repeatedly returned to Africa’s strengths. Pos highlighted “quiet innovation” in resource-limited settings, where staff improvise solutions such as makeshift hand-washing stations to maintain care standards.

Manaka argued that Africa’s defining advantage is passion: “In Africa anything we do is infused with passion and so excellence becomes the order of the day.”
Moodley pointed to the philosophy of Ubuntu – “I am because we are” – as a powerful cultural foundation for care, emphasising community, empathy and human connection. The broad message was that social cohesion and resilience remain key African strengths.

She added that despite historical and economic pressures Africa has demonstrated extraordinary resilience.

Telling Africa’s story — and learning from others

A recurring theme was the need for Africa to better showcase its successes. Manaka urged healthcare professionals to present their work internationally: “Sometimes we do good work, but we keep it to ourselves.”

Professor Tenza reinforced this, calling for a stronger culture of writing and publication. Too often, she said, African knowledge remains confined to verbal storytelling. Journals and open-access platforms offer opportunities to share quality improvement work more widely.

At the same time, Pos cautioned against insularity: “We must also learn from outside.” She pointed to the need for stronger clinical governance, standardised processes and better incident reporting systems.

AI: promise depends on foundations

On technology, the panel was cautiously optimistic. Moodley described AI as “an amazing tool,” particularly for tracking incidents and analysing data, but warned that it cannot compensate for weak systems: “AI only helps and enhances what has already been put in place.”

She stressed that leadership buy-in is essential, and that staff must still engage actively with data.

Teamwork and leadership remain central

Returning to fundamentals, Manaka quoted quality pioneer William Edwards Deming: “Quality is in the doorstep of management.” Leadership endorsement, he said, is critical to building effective teams and achieving accreditation.

He illustrated this with another Middle East project, where leadership support enabled rapid progress after years of stagnation.

Moodley added a practical example from Ghana, where shifting from verbal to electronic communication created unintended consequences. Staff initially resisted documentation, then over-corrected, relying solely on electronic records and stopping verbal handovers.

She also highlighted cultural and language barriers, including staff discomfort with written reporting: “They thought they were in trouble; they did not know how to write.”

A balanced path forward

The panel concluded that Africa’s healthcare systems stand at a crossroads: rich in human strengths – passion, innovation, community – but needing stronger systems, governance and global visibility.

As Professor Tenza put it, the world has a lot to learn from Africa, we need to blow our own trumpet and publish the quality improvement work and innovations from Africa.