Health care workers’ experiences of the implementation of the national core standards at Bernice Samuel District Hospital in Mpumalanga province

Abstract

Background Quality of care is fundamental to the attainment of universal health coverage (UHC). In South Africa, the National Core Standards (NCS) set the expected level of performance for health establishments. The aim of the study was to explore the experiences of health care workers with the implementation of the NCS at the Bernice Samuel district hospital in Mpumalanga province. Methods This was a qualitative case study at the Bernice Samuel district hospital. Following informed consent, in-depth interviews were conducted with all health care workers (HCWs) who had experience of at least one NCS inspection. The questions focused on the context and process of implementation; knowledge of the NCS; HCWs’ experiences of NCS implementation, and the factors that influenced the implementation of the NCS. The interviews were analysed using thematic analysis, supported by MaxQDA (Student Version). Results Sixteen in-depth interviews were conducted at the hospital. The context was influenced by the proposed national health insurance (NHI) system, community dissatisfaction with quality of care, and health ministerial priorities. Health care workers reported learning opportunities and role clarity as positive aspects. However, they highlighted the burden and perceptions of flawed implementation processes, exacerbated by insufficient district and provincial health support, financial and human resource constraints, and infrastructural challenges. Conclusion The implementation challenges need to be addressed to ensure the successful implementation of the NCS at hospital level