South Africa

Lean Management in the South African Public Health Sector: A Case Study

This chapter gives an account of one relatively modest but effective intervention in an orthopaedic outpatient clinic at the New Somerset Hospital (NSH) in Cape Town in 2013. This project aimed to reduce patient waiting times in the clinic, and improve patient satisfaction.

The Use of ICT Tools (Mobile Phones) to Improve Awareness of Pregnancy Danger Signs among Pregnant Women in Rural Communities of South Africa

he present study investigated awareness of pregnancy danger signs, symptoms and associated factors among a group of South African pregnant women attending prenatal care clinics in rural setting. [from abstract]

The Factors that Attract Healthcare Professionals to and Retain Them in Rural Areas in South Africa

Attracting healthcare professionals (HCPs) to rural areas and retaining them there remains a challenge. Current retention strategies focus on the factors that cause people to leave rural areas, but these strategies continue to fail to retain HCPs in these areas, and the situation in which there is a lack of quality and inadequacy of the type of health services is perpetuated. The literature describes factors that attract healthcare workers to work in rural areas, and this study contributes to a deeper understanding of this. [from abstract]

The Self-Reported Learning Needs of Primary Care Doctors in South Africa: A Descriptive Survey

Strengthening primary health care in South Africa is a prerequisite for the successful introduction of National
Health Insurance. Primary care doctors from both the public and private sectors are an essential contributor to achieving this goal. In order to prepare these doctors for their future role, a national diploma training programme is being developed. This study aimed to evaluate the learning needs of primary care doctors and to assist with the design of the diploma. [from abstract]

Mobile Application Design for Health Intermediaries: Considerations for Information Access and Use

This paper employs a qualitative meta-analysis in unpacking the dynamism of intermediary practice in South Africa. The authors consider mobile application design in accessing and using health information. A number of critical design considerations are presented, including the role of context as a static and dynamic modality. The authors ultimately derive an information model, which assimilates four intersecting dimensions of context. [from abstract]

The Role of the District Family Physician

District clinical specialist teams were formed in 2012. One member of the team is the family physician. The role of the district family physician is discussed and the case made for focusing on the organisational health of the medical teams practising family medicine within the district as an effective way to improve the quality of medical care delivered in the district. [from abstract]

Rural-Proofing for Health: Guidelines

A guide to accounting for rural contexts in health policy, strategic planning and resourcing. Addressing the
specific rural health context in policy design, budget allocations and implementation plans is not yet a standard process in South Africa. This guide addresses that, to ensure that “the rural health context” is addressed adequately
when new policies and budgets are drawn up and implemented in the beautiful rural parts of our country. [adapted from resource]

Aligning Vertical Interventions to Health Systems: A Case Study of the HIV Monitoring and Evaluation System in South Africa

Since responsibility for health services management lies at the district (sub-national) level, this study aimed to assess the extent to which the HIV M&E system is integrated with the overall health system M&E function at district level. This study describes implementation of the HIV M&E system, determines the extent to which it is integrated with the district health information system (DHIS), and evaluates factors influencing HIV M&E integration. [from abstract]

Public Health Care for South African Lesbian, Gay, Bisexual and Transgender People: Health Rights Violations and Accountability Mechanisms

This study aimed to document LGBT people’s experiences in SA public sector health care, including access to HIV counselling, testing and treatment, to analyse to what extend LGBT people’s right to health is actioned. It also investigates strategies for LGBT people to seek resolution and create accountability when experiencing health rights violations. [from abstract]

Conceptualizing the Impacts of Dual Practice on the Retention of Public Sector Specialists - Evidence from South Africa

‘Dual practice’, or multiple job holding, generally involves public sector-based health workers taking additional work in the private sector. There has been little conceptual or empirical development of the relationship between dual practice and retention. This article helps begin to fill this gap, drawing on empirical evidence from a qualitative
study focusing on South African specialists. [from abstract]

Challenges Faced by Traditional Healers When Treating People Living with HIV and AIDS: The Case of Intsika Municipality, Eastern Cape Province of South Africa

The aim of the present study was to examine the procedures followed by traditional healers treating people living with HIV and AIDS in the Intsika Municipality and the challenges faced by them during this endeavour. [from abstract]

An Integrative Review of the Role of Remittances in International Nurse Migration

This review seeks to understand the role of remittances in international nurse migration within the context of three theories of international migration: equilibrium approaches, social networks, and globalization. [from abstract]

The Drivers of Universal Health Care in South Africa: The Role of Ideas, Institutions and Actors

This paper outlines the opportunities and challenges posed by the proposed NHI [National Health Insurance] reforms in South Africa. It begins by explaining the country’s current system of health care provision including its human resource structure, functions and cost implications. It then summarizes the deficits and limitations of the current two-tiered health system and discusses what NHI is trying to achieve within this context and how it hopes to address the problems. [from summary]

Whole-System Change: Case Study of Factors Facilitating Early Implementation of a Primary Health Care Reform in a South African Province

Whole-system interventions are those that entail system wide changes in goals, service delivery arrangements and relationships between actors, requiring approaches to implementation that go beyond projects or programmes. Drawing on concepts from complexity theory, this paper describes the catalysts to implementation of a whole-system intervention in the North West Province of South Africa.

Interest In and Willingness to Use Complementary, Alternative and Traditional Medicine Among Academic and Administrative University Staff in Bloemfontein, South Africa

Healthcare systems worldwide are changing and the use of complementary, alternative and traditional medicine (CAM) form part of this transformation. South Africa has a large number of CAM practitioners, but they are not included in the official healthcare system. The aim of this study was to determine the perception and usage of CAM among the academic and administrative staff of the University of the Free State (UFS) in Bloemfontein, South Africa. [from abstract]

Lean Management in the South African Public Health Sector: A Case Study

This chapter gives an account of one relatively modest but effective intervention in an orthopaedic outpatient clinic at the New Somerset Hospital (NSH) in Cape Town in 2013. This project aimed to reduce patient waiting times in the clinic, and improve patient satisfaction. [from introduction]

National Health Insurance and South Africa’s Private Sector

As limited information has emanated from government as to the role of the private health sector in the National Health Insurance (NHI), this chapter directs the enquiry towards the private health sector in order to establish what it perceives as its role in a post-reform healthcare industry. [from abstract]

The eHealth Strategy for South Africa 2012-2016: How Far Are We?

This chapter reviews progress made by the health sector in implementing the eHealth Strategy 2012–2016, which was approved by the Ministry of Health and published in July 2012. The finalisation of this Strategy following
several attempts, and its placement in the public domain, created optimism that a clear vision for improving health information systems in South Africa had been successfully articulated. [from introduction]

District Health Management Information System (DHMIS) Standard Operating Procedures: Provincial Level

These Standard Operating Procedures aim to clarify the responsibilities and procedures for effective management of aggregated routine health services. These SOPs for provinces present basic and practical steps to be followed by
provincial health information management personnel, programme/line managers and clinic supervisors at provincial level to ensure that data is appropriately handled and used to improve service delivery at local level, prior
to submission to next level of the health system, within the specified time frames.

District Health Management Information System (DHMIS) Standard Operating Procedures: National Level

These Standard Operating Procedures aim to clarify the responsibilities and procedures for effective management of aggregated routine health services. These SOPs for the National DoH present basic and practical steps to be
followed by national health information management personnel, programme/line managers and clinic supervisors at national level to ensure that data is appropriately handled and used to improve service delivery at local level, prior
to submission to next level of the health system, within the specified time frames.

A South African Public-Private Partnership HIV Treatment Model: Viability and Success Factors

The increasing number of people requiring HIV treatment in South Africa calls for efficient use of its human
resources for health in order to ensure optimum treatment coverage and outcomes. This paper describes an innovative
public-private partnership model which uses private sector doctors to treat public sector patients and ascertains the
model’s ability to maintain treatment outcomes over time. [from abstract]

Exploring the Nature of Governance At The Level of Implementation For Health System Strengthening: The DIALHS Experience

This article presents a South African case study of an intervention to address conflict in roles and responsibilities between multiple actors supporting service delivery at the local level, and explores the broader insights this experience generates about the nature of local health system governance. [from abstract]

Health and Health Care in South Africa — 20 Years After Mandela

In the 20 years since South Africa underwent a peaceful transition from apartheid to a constitutional democracy, considerable social progress has been made toward reversing the discriminatory practices that pervaded all aspects of life before 1994.1-5 Yet the health and well-being of most South Africans remain plagued by a relentless burden of infectious and noncommunicable diseases, persisting social disparities, and inadequate human resources to provide care for a growing population with a rising tide of refugees and economic migrants. [from abstract]

Views of Pharmacists on Involvement in Ward Rounds in Selected Public Hospitals in Limpopo Province

Pharmacist participation in ward rounds is of increasing interest for better pharmaceutical care, yet most pharmacists do not engage in this activity. The objective was to obtain public sector pharmacists’ views and perceptions on their involvement in ward rounds. [from abstract]

The Effect of Primary Health Care Learning Programme in Health Care Service Delivery: Case Study of Ehlanzeni Health District in Mpumalanga Province

This research was aimed mainly at determining the significance of the primary health care learning programme in health care service delivery, focusing mainly in the Ehlanzeni Health district of Mpumalanga Province [South Africa]. The focus was on how professional nurses trained in the Primary Health Care programme confidently apply the skills and expertise to the benefit of clients in community health facilities. [from abstract]

Considerations for Linking South Africa’s Youth-Friendly Services to its Community Health Worker Programme

In this article, we open the debate on whether or not South Africa’s Youth-friendly Services (YFS) programmes should be linked to community health worker (CHW) programmes. Both are important in South Africa’s efforts to re-engineer primary healthcare in the country. This article presents the pros and cons of linking the two programmes by incorporating YFS into the current list of CHW competencies. Also, we explore the alternative of training specialist CHWs to deliver YFS. [from abstract]

The Linkage Between Work-Related Factors, Employee Satisfaction and Organisational Commitment: Insights from Public Health Professionals

The public health sector in South Africa faces a number of human resource–related inundations. Solving these challenges requires the provision of empirically derived information on these matters. This study investigated the relationship between three work-related factors, person-environment fit, work-family balance and perceived job security, and employee satisfaction and organisational commitment. A conceptual framework that links these factors is proposed and tested. [from abstract]

Intimate Partner Violence: How Should Health Systems Respond?

IPV is important to health systems because of the wide-ranging and serious health effects experienced by exposed women, as well as the unique opportunity afforded to healthcare providers to enquire about violence. [from introduction]

Factors Influencing Job Satisfaction and Its Relationship on Career Development Among Nursing Staff within a Public Hospital in South Africa

South Africa has a dual health system, namely, the public health sector that includes government health institutions, serving mostly the lower income population and the private health sector that serves those who can afford care from their own income. The public sector is responsible for 82 percent of the population and only accounts for 40 percent of the government health expenditure. The purpose of this study was to evaluate job satisfaction levels among nursing staff within a public hospital in Southern Gauteng. [adapted from abstract]

Early Implementation of WHO Recommendations for the Retention of Health Workers in Remote and Rural Areas

This paper presents experiences with local and regional adaptation and adoption of WHO recommendations. It highlights challenges and lessons learnt in implementation in two countries – the Lao People’s Democratic Republic and South Africa – and provides a broader perspective in two regions – Asia and Europe. At country level, the use of the recommendations facilitated a more structured and focused policy dialogue, which resulted in the development and adoption of more relevant and evidence-based policies. [from abstract]