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Author: search.filters.author.Madela, NoxoloSubject: search.filters.subject.SDG-8: Decent work and economic growth

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    Public Hospital Employees’ Experiences of Working Under Austerity in the Eastern Cape Province, South Africa
    (University of the Witwatersrand, Johannesburg, 2024) Madela, Noxolo; Goudge, Jane
    Introduction: Following the 2008 global economic downturn and the more recent COVID-19 pandemic, many countries have experienced austerity, often through cost-containment strategies and budget cuts. Despite South Africa’s efforts to protect spending on social services like healthcare and education, the public healthcare system has faced numerous challenges, partly due to reduced budgets, cost containment measures including centrally controlled expenditures. Aim: The aim of this study is to explore the perceptions and experiences of public hospital employees of the impact of austerity on their well-being and the delivery of healthcare services. Methods: This qualitative secondary analysis examines data from two public hospitals in South Africa. The dataset includes 22 interview transcripts and 4 focus group transcripts, featuring responses from clinical staff, non-clinical staff, and senior management. Facilities and participants were selected using purposive and convenience sampling techniques. An interpretative epistemological approach in the analysis was employed to gain an in-depth understanding of healthcare workers’ experiences under austerity. Results: The results show that the most immediate consequence of cost containment has been staff shortages, increased workload, burnout, absenteeism, and compromised quality of patient care. The approach adopted for cost containment, which involved centralisation decisions on expenditure, has been criticized for its ineffectiveness. It failed to address the urgent needs of facilities and was not representative enough. This issue was exacerbated by poor financial management, misclassification of hospitals, and medico-legal claims against the state, which have intensified the effects of austerity. Conclusion: The implementation of austerity measures has adversely impacted the well-being of healthcare workers and the quality of healthcare service delivery. This study underscores the necessity for strategies aimed at bolstering hospital resilience by enhancing leadership and management during periods of austerity. Additionally, it identifies key areas for further research, ensuring that future studies build upon these findings and contribute to the continuous improvement of healthcare delivery.