Obstacles to the implementation of lean process improvements at primary health care centres in South Africa

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Date

2016

Authors

Chetty, Uthestra

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Abstract

South Africa’s public health care has changed significantly since changing leadership in 2009. Since then ‘PHC Re-engineering’ has been identified as a key step in providing efficient and equitable public health care. Almost simultaneously, Lean management has grown in popularity in both public and private health care due largely to research conducted in the US and UK. In particular, Lean process improvements have provided rapid yet isolated results. The study is therefore significant in its potential to investigate an aspect of a possible solution to a current problem. Specifically, the study seeks to identify obstacles to implementing Lean process improvements in South Africa. An inductive approach was adopted using qualitative research centred around a single case study of a process improvement workshop at a PHC facility in Gauteng. There were multiple sources of data, however, the mainstay was twelve individual interviews from three groups of respondents, providing multiple perspectives on the same experience. Data was gathered and then analysed using qualitative data analysis software. The findings show a great degree of congruency with international research findings, but also reveal South African experiences in the primary health care environment. The obstacles can be grouped into those arising from the environment in which the implementation took place and those related to the type of implementation. There were no obstacles related to Lean itself. The study finds that although there were several challenges, the overall experience with Lean was positive and that the obstacles identified can all be addressed to improve the success of the implementation. The study thus recommends the continued use and experimentation with Lean to address South African primary health care challenges.

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MBA

Keywords

Health facilities, Clinics, Primary health care, Health services administration -- South Africa.

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