The functioning and perceived effectiveness of district health system governance structures in Gauteng province

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dc.contributor.authorTshabalala, Khanyisile
dc.date.accessioned2020-10-16T10:56:53Z
dc.date.available2020-10-16T10:56:53Z
dc.date.issued2019
dc.descriptionA research report submitted in partial fulfilment of the requirements for the degree of Master of Medicine (Public Health Medicine) in the School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa September 2019en_ZA
dc.description.abstractLeadership and governance are critical for achieving universal health coverage (UHC). In South Africa, aspirations for UHC are expressed through the National Health Insurance policy, which underscores the importance of primary health care, delivered through the district health system (DHS). In light of this, the aim of this study was to determine the existence of legislated District Health Councils (DHCs) in Gauteng Province, and the perceptions of members on the functioning and effectiveness of these structures. Methods: The study was done in all five districts in Gauteng. The population of interest was members of existing governance structures. Members completed an electronic-self-administered questionnaire (SAQ), which collected perceptions on the functioning and effectiveness of the governance structures, using a seven point Likert scale. STATA® 13 was used to analyse the survey data. In-depth interviews with the chairpersons of the DHCs and the District Health Council Technical Committees complemented the survey. Interviews were analysed using thematic content analysis. Results: Only three districts had constituted DHCs. The survey response rate was 73%. The mean score for perceived functioning of the structures was 4.5 (SD=0.7) and 4.8. (SD=0.7)for perceived effectiveness. The interviews found that enabling legislation and a shared vision on DHS facilitated governance. In contrast, the complexity of two spheres of government, political differences, difficult interpersonal relationships, lack of orientation and insufficient resources constrained governance. The survey and interviews identified gaps in accountability to communities. Conclusion: The governance gaps identified need to be addressed to ensure the successful implementation of UHC reforms.en_ZA
dc.description.librarianNG (2020)en_ZA
dc.facultyFaculty of Health Sciencesen_ZA
dc.format.extentOnline resource (94 leaves)
dc.identifier.citationTshabalala, Khanyisile Maureen (2019) The functioning and perceived effectiveness of District Health System Governance Structures in Gauteng Province, University of the Witwatersrand, Johannesburg, <http://hdl.handle.net/10539/29867>
dc.identifier.urihttps://hdl.handle.net/10539/29867
dc.language.isoenen_ZA
dc.subject.meshPublic Health Services
dc.subject.meshHospital Administraction
dc.titleThe functioning and perceived effectiveness of district health system governance structures in Gauteng provinceen_ZA
dc.typeThesisen_ZA
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