Background: Forty-nine million people or 83 per cent of the entire population of 59 million rely on the public healthcare system in South Africa. Coupled with a shortage of medical professionals, high migration, inequality and unemployment; healthcare provision is under extreme pressure. Due to negligence by the health professionals, provincial health departments had medical-legal claims estimated at R80 billion in 2017/18. In the same period, provincial health spending accounted for 33 per cent of total provincial expenditure of R570.3 billion or 6 per cent of South Africa's Gross Domestic Product. Despite this, healthcare outcomes are poor and provinces are inefficient in the use of the allocated funds. This warrants a scientific investigation into the technical efficiency of the public health system. Methods:The study uses data envelopment analysis (DEA) to assess the technical efficiency of the nine South African provinces in the provision of healthcare. This is achieved by determining, assessing and comparing ways that individual provinces can benchmark their performance against peers to improve efficiency scores. DEA compares firms operating in homogenous conditions in the usage of multiple inputs to produce multiple outputs. Therefore, DEA is ideal for measuring the technical efficiency of provinces in the provision of public healthcare. In DEA methodology, the firms with scores of 100 per cent are technically efficient and those with scores lower than 100 per cent are technically inefficient. This study considers six DEA models using the 2017/18 total health spending and health staff as inputs and the infant mortality rate as an output. The first three models assume the constant returns to scale (CRS) while the last three use the variable return to scale (VRS) both with an input-minimisation objective. Results:The study found the mean technical efficiency scores ranging from 35.7 to 87.2 per cent between the health models 1 and 6. Therefore, inefficient provinces could improve the use of inputs within a range of 64.3 and 20.8 per cent. The Gauteng province defines the technical efficiency frontiers in all the six models. The second-best performing province is the North West province. Other provinces like KwaZulu-Natal, Limpopo and the Eastern Cape only perform well under the VRS. The other three provinces are inefficient. Conclusions:Based on the VRS models 4 to 6, the study presents three policy options. Policy option 1 (model 4): the efficiency gains from addressing health expenditure wastage in four inefficient provinces amounts to R17 billion. Policy option 2 (model 5): the potential savings from the same provinces could be obtained from reducing 17,000 health personnel, advisably, in non-core areas. In terms of Policy option 3 (model 6), three inefficient provinces should reduce 6940 health workers while the same provinces, inclusive of KwaZulu-Natal could realise health expenditure savings of R61 million. The potential resource savings from improving the efficiency of the inefficient provinces could...

This paper evaluates a South African rural telecentre that may serve as a 'best practice' model. The paper first provides a brief literature review of telecentres and the role of information and communication technology in economic development. A qualitative evaluation of a case study is presented within the context of sustainability considerations and development outcomes; that is, showing how the telecentre has improved the lives of the rural community at Thabina. Some of the observed economic development impacts are listed in the paper and an attempt is made to capture the essence of the vital links between the use of information and communication technology (technology transfer), human development, education and economic development.

The scale of impact of the COVID-19 pandemic on society and the economy globally provides a strong incentive to thoroughly analyze the efficiency of healthcare systems in dealing with the current pandemic and to obtain lessons to prepare healthcare systems to be better prepared for future pandemics. In the absence of a proven vaccine or cure, non-pharmaceutical interventions including social distancing, testing and contact tracing, isolation, and wearing of masks are essential in the fight against the worldwide COVID-19 pandemic. We use data envelopment analysis and data compiled from Worldometers and The World Bank to analyze how efficient the use of resources were to stabilize the rate of infections and minimize death rates in the top 36 countries that represented 90% of global infections and deaths out of 220 countries as of November 11, 2020. This is the first paper to model the technical efficiency of countries in managing the COVID-19 pandemic by modeling death rates and infection rates as undesirable outputs using the approach developed by You and Yan. We find that the average efficiency of global healthcare systems in managing the pandemic is very low, with only six efficient systems out of a total of 36 under the variable returns to scale assumption. This finding suggests that, holding constant the size of their healthcare systems (because countries cannot alter the size of a healthcare system in the short run), most of the sample countries showed low levels of efficiency during this time of managing the pandemic; instead it is suspected that most countries literally “threw” resources at fighting the pandemic, thereby probably raising inefficiency through wasted resource use.

The extant literature has produced mixed evidence on the relationship between financial development and ecological sustainability. This work addresses this conundrum by investigating financial development’s direct and indirect consequences on ecological quality utilizing the environmental Kuznets curve (EKC) methodological approach. Our empirical analysis is based on the novel dynamic autoregressive distributed lag simulations approach for South Africa between 1960 and 2020. The results, which used five distinct financial development measures, demonstrate that financial development boosts ecological integrity and environmental sustainability over the long and short terms. In the instance of South Africa, we additionally confirm the validity of the EKC theory. More importantly, the outcomes of the indirect channels demonstrate that financial development increases energy usage’s role in causing pollution while attenuating the detrimental impacts of economic growth, trade openness, and foreign direct investment on ecological quality. Moreover, the presence of an inadequate financial system is a requirement for the basis of the pollution haven hypothesis (PHH), which we examine using trade openness and foreign direct investment variables. PHH for both of these variables disappears when financial development crosses specified thresholds. Finally, industrial value addition destroys ecological quality while technological innovation enhances it. This research provides some crucial policy recommendations and fresh perspectives for South Africa as it develops national initiatives to support ecological sustainability and reach its net zero emissions goal.

The argument over fiscal decentralization and carbon dioxide emission (CO2) reduction has received much attention. However, evidence to back this claim is limited. Economic theory predicts that fiscal decentralization affects environmental quality, but the specifics of this relationship are still up for debate. Some scholars noted that fiscal decentralization might lead to a race to the top, whereas others contended that it would result in a race to the bottom. In light of the current debates in environmental and development economics, this study aims to provide insight into how this relationship may function in South Africa from 1960 to 2020. In contrast to the existing research, the present study uses a novel dynamic autoregressive distributed lag simulation approach to assess the positive and negative changes in fiscal decentralization, scale effect, technique effect, technological innovation, foreign direct investment, energy consumption, industrial growth, and trade openness on CO2 emissions. The following are the main findings: (i) Fiscal decentralization had a CO2 emission reduction impact in the short and long run, highlighting the presence of the race to the top approach. (ii) Economic growth (as represented by the scale effect) eroded ecological integrity. However, its square (as expressed by technique effect) aided in strengthening ecological protection, validating the environmental Kuznets curve hypothesis. (iii) CO2 emissions were driven by energy utilization, trade openness, industrial value-added, and foreign direct investment, whereas technological innovation boosted ecological integrity. Findings suggest that further fiscal decentralization should be undertaken through further devolution of power to local entities, particularly regarding environmental policy issues, to maintain South Africa’s ecological sustainability. South Africa should also establish policies to improve environmental sustainability by strengthening a lower layer of government and clarifying responsibilities at the national and local levels to fulfill the energy-saving functions of fiscal expenditures.