An analysis of South African district health system interaction using an improvement framework.
South Africa currently has a knowledge gap for assessing the effect of its district health system. By conducting an assessment of the current state of the district health management structures, this research aims to understand the interactions between the district and the various levels of the South African health system. The work presented is a starting point to understanding key areas of health system management structures in order to address the current knowledge gap in South Africa. Semi-structured interviews and thematic content analysis were chosen as the preferred method for data collection and analysis. The key themes that emerged included the lack of authority provided to the management at district level, the communication gap across all levels and human resources capacity issues within the system. The assessment of the research districts against the research frameworks ties into these three themes. A major observation from the analysis is the differing abilities of districts to address inherent issues due to the constraints faced within and outside the systems. Furthermore, the need to ensure standardisation of the district system is required to mitigate this difference. In conclusion, this research provides a potential starting point for further research into the district health care system and determines that changes in the delegation of authority could have the potential to streamline processes and information transfer within the district system.
A dissertation submitted to the Faculty of Engineering and the Built Environment, University of the Witwatersrand, in fulfilment of the requirements for the degree of Master of Science in Engineering.