Achievements and challenges in developing health leadership in South Africa: the experience of the Oliver Tambo Fellowship Programme 2008–2014

Doherty, Jane; Gilson, Lucy; Shung-King, Maylene

doi:10.1093/heapol/czx155

Cited by 29 publications

(52 citation statements)

References 20 publications

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“…45 Addressing DHS is of utmost importance if UHC is to become a reality. 27 , 43 , 49 A DHS with power could also plan and allocate resources according to contextual needs, as the current conditional grants not only came late but are also attached with conditions making it difficult to deal decisively with priorities. The government still needs to invest significantly in strengthening PHC.…”

Section: Different Actor Perceptions Of Powermentioning

confidence: 99%

How and why policy-practice gaps come about: a South African Universal Health Coverage context

Michel

Chimbindi

Mohlakoana

et al. 2019

Journal of Global Health Reports

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Back Background ground South Africa, like many other countries is currently piloting National Health Insurance (NHI) reforms aimed at achieving Universal Health Coverage (UHC). Existing health policy implementation experience has demonstrated that new policies have sometimes generated unexpected and negative outcomes without necessarily explaining how these came about. Policies are not always implemented as envisioned, hence the importance of understanding the nature of policy implementation. Methods Methods Qualitative data were collected during three phases: 2011-2012 (contextual mapping), 2013-2014 (phase 1) and 2015 (phase 2). In-depth face-to-face interviews were held with key informants (n=71) using a theory of change interview guide, adapted for each phase. Key informants ranged from provincial actors (policy makers) district, subdistrict and primary health care (PHC) facility actors (policy implementers). All interviews were audio-recorded and transcribed. An iterative, inductive and deductive data analysis approach was utilized. Transcripts were coded with the aid of MAXQDA2018 (VERBI software GmbH, Germany). R Results esults Five groups of factors bringing about policy-practice gaps were identified. (i) Primary factors stemming from a direct lack of a critical component for policy implementation, tangible or intangible (resources, information, motivation, power); (ii) secondary factors stemming from a lack of efficient processes or systems (budget processes, limited financial delegations, top down directives, communication channels, supply chain processes, ineffective supervision and performance management systems); (iii) tertiary factors stemming from human factors (perception and cognition) and calculated human responses to a lack of primary, secondary and or extraneous factors, as coping mechanisms (ideal reporting and audit driven compliance with core standards); (iv) extraneous factors stemming from beyond the health system (national vocational training leading to national shortage of plumbers); and (v) an overall lack of systems thinking. C Conclusions onclusions South Africa needs to be applauded for adopting UHC. Noteworthy among factors fueling policy-practice gaps are human factors, perception and responses of actors in the system to a lack of resources, processes and systems, through among others, ideal reporting and audit driven compliance with core standards, bringing about an additional layer of unintended consequences, further widening that gap. Utilizing a systems approach to address challenges identified, could go a long way in making UHC a reality.

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Section: Different Actor Perceptions Of Powermentioning

confidence: 99%

How and why policy-practice gaps come about: a South African Universal Health Coverage context

Michel

Chimbindi

Mohlakoana

et al. 2019

Journal of Global Health Reports

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“…The other three papers in this edition offer insights into health leadership development needs and strategies: Agyepong et al (2018) report on needs assessment and other preparatory work undertaken in Ghana, South Africa and Uganda, towards the development of a pan-African professional Doctorate in Public Health (DrPH), as a professional, interdisciplinary terminal degree focussed on strategic health leadership; Doherty et al (2018) present an evaluation of a well-established South African public sector health leadership development programme offering a combination of residential training plus workplace-based learning activities, at the level of a post-graduate Diploma in Health Management; Cleary et al (2018) detail the experience of developing tailor-made leadership development (LD) processes to support relational ( Cummings et al 2010 ) and distributed ( Gronn 2002 ) leadership within a sub-district setting in Cape Town, South Africa. …”

Section: What Do the Papers Presented Here Consider?mentioning

confidence: 99%

Strengthening health system leadership for better governance: what does it take?

Gilson

Agyepong

2018

Health Policy and Planning

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This editorial provides an overview of the six papers included in this special supplement on health leadership in Africa. Together the papers provide evidence of leadership in public hospital settings and of initiatives to strengthen leadership development. On the one hand, they demonstrate both that current leadership practices often impact negatively on staff motivation and patient care, and that contextual factors underpin poor leadership. On the other hand, they provide some evidence of the positive potential of new forms of participatory leadership, together with ideas about what forms of leadership development intervention can nurture new forms of leadership. Finally, the papers prompt reflection on the research needed to support the implementation of such interventions.

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“…Such trainings are improtant because they provide opportunities for promoting stakeholder buy-in. Several studies suggest that PHC facility management training before initiating innovative healthcare programmes is beneficial to their success as it increases their buy-in and support [71][72][73][74][75].…”

Section: Discussionmentioning

confidence: 99%

User-provider experiences of the implementation of KidzAlive-driven child-friendly spaces in KwaZulu-Natal, South Africa

2020

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Background: KidzAlive is a child-centred intervention aimed at improving the quality of HIV care for children in South Africa. Through this intervention, 10 child-friendly spaces were created in 10 primary healthcare centres (PHCs) in KwaZulu-Natal to enhance child-centred HIV care. However, the user-provider experiences of these childfriendly spaces in these facilities have not been explored. This paper addresses this gap. Methods: We conducted qualitative interviews with children (n = 30), their primary caregivers (PCGs) (n = 30), and KidzAlive trained healthcare workers (HCWs) (n = 20) using and providing child-friendly spaces, respectively. Data were generated, using a semi-structured interview guide printed in both English and IsiZulu. The interviews were audio-recorded transcribed and translated to English by a research team member competent in both languages. Data were imported to NVivo 10 for thematic analysis. The COREQ checklist was used to ensure that the study adheres to quality standards for reporting qualitative research. Results: Child-friendly spaces contributed to the centredness of care for children in PHCs. This was evidenced by the increased involvement and participation of children, increased PCGs' participation in the care of their children and a positive transformation of the PHC to a therapeutic environment for children. Several barriers impeding the success of child-friendly spaces were reported including space challenges; clashing health facility priorities; inadequate management support; inadequate training on how to maximise the child-friendly spaces and lastly the inappropriateness of existing child-friendly spaces for much older children. Conclusion: Child-friendly spaces promote HIV positive children's right to participation and agency in accessing care. However, more rigorous quantitative evaluation is required to determine their impact on children's HIV-related health outcomes.

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Achievements and challenges in developing health leadership in South Africa: the experience of the Oliver Tambo Fellowship Programme 2008–2014

Cited by 29 publications

References 20 publications

How and why policy-practice gaps come about: a South African Universal Health Coverage context

How and why policy-practice gaps come about: a South African Universal Health Coverage context

Strengthening health system leadership for better governance: what does it take?

User-provider experiences of the implementation of KidzAlive-driven child-friendly spaces in KwaZulu-Natal, South Africa

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