The White Paper on Health System Transformation in South Africa, tabled by the Department of Health in Parliament in April 1997, reaffirms the Government's commitment to Primary Health Care as a basis for the new unified National Health System (Health Systems Trust , Issue No. At the municipal level, all primary health care services are freely provided to children and adults. This transformation process occurring in local government will have an impact on the staff working in primary health care clinics because these are constitutional requirements and communities have the right to demand them.
The study therefore critically evaluates the impact of transformation processes on the staff of the primary health clinics in the eThekwini Municipality area. It is an undeniable fact that transformation occurring in the South African healthcare system is associated with many challenges.
MOTIVATION OF THE STUDY
OBJECTIVES OF THE STUDY
RESEARCH METHODOLOGY
SAMPLING
LIMITATIONS
STRUCTURE OF THE STUDY
Other categories excluded include doctors, registered nurses, registered nursing assistants, clerks, cleaners and security guards. In this chapter, the history of City Health Department, changes brought about by transformation of the public service and the situation after 1994, which led to the establishment of eThekwini Municipality, with one eThekwini Health for the city of Durban, are discussed in detail.
A CONCEPTUAL AND THEORETICAL UNDERSTANDING OF TRANSFORMATION IN SOUTH AFRICA
- INTRODUCTION
- TRANSFORMATION AND CHANGE
- Lewin's Model
- TRANSFORMATION IN THE ETHEKWINI HEALTH DEPARTMENT
- MANAGEMENT OF CHANGE
- CONCLUSION
One set is primarily associated with the transactional level of human behavior and the other relates to the human transformation process necessary for genuine change in an organization's culture (French and Bell. It was only after 1996 local authorities that the transformation process started in earnest in Health Department The change process in the City's Health Department started in 1997, it involved training the top management in the change process.
The training was critical so that managers could buy into the change process and reduce staff resistance to change. This chapter focused on understanding the process of change within local government, and the different strategies that can be used by organizations undergoing transformation.
THE CONSTITUTIONAL AND LEGISLATIVE FRAMEWORK FOR TRANSFORMATION OF HEALTH CARE SERVICE
INTRODUCTION
Legislators have made important decisions regarding local government that have very critical implications for health delivery, therefore the following laws and policies have been promulgated and have a major impact on the delivery of health services by local government (Nicholson.
LEGISLATION IMPACTING ON LOCAL GOVERNMENT
The new local government system is in line with national government policy, which emphasizes that local government will be responsible for the delivery of municipal health care services, and that changes in local government directly affect the proper functioning of the district health system. In 1996, the role and function of local government were formally established in the 1996 Constitution. Accordingly, local government is no longer subordinate to provincial and national government, but has legislative and fiscal capacity (South African Health Review.
This White Paper reaffirmed the government's commitment to Primary Health Care (PHC) as a basis for the new Unified National Health System (Health Systems Trust, Issue No. The health system will focus on the district system as the main locus of implementation, and will emphasize the Primary Health Care Approach This Law set the stage for the beginning of real restructuring and transformation of local government.
It is a framework for addressing the apartheid system of local government which was characterized by unequal provision of municipal services. Therefore, the eThekwini Municipality is expected to provide health care services because it is a metropolitan. The remaining issue to be clarified is that of health services versus municipal health services, because it is not clear what health services local governments and provinces will be responsible for.
Some local governments believe that health services should mean all primary health care services (Nicholson. 34; constitutionally, primary health care services are a function of local government, so the provincial route is temporary) (Health Systems Trust, Issue No. This act provides for the creation of systems that will enable the success of the development of local self-government a) prioritize the basic needs of the local community;
CONCLUSION
A CASE STUDY PROFILE OF ETHEKWINI HEALTH DEPARTMENT
- TRANSFORMATION OF CITY HEALTH DEPARTMENT AFTER 1994
- TRANSFERRING PRIMARY HEALTH CARE TO PROVINCIAL GOVERNMENT
- CONCLUSION
- INTRODUCTION
- DATA COLLECTION
These factors influence the way healthcare is delivered (South African Health Review). Primary health care is the first-line contact of individuals, families and the community with the national health care system (Dennill et al. The implementation of primary health care by eThekwini Health Department has brought health care to the local communities where they live and work.
At the beginning of the 1980s, a minor change was introduced to the healthcare system with the creation of a national healthcare plan. The success of the provision of health care depends on the competence of the staff in the outpatient clinics. The primary health care program in the local government is facing an increasing demand for individual health care provided by the district.
The community is now aware that in terms of the constitution and health policy requirements, primary health care service must be provided equally throughout the eThekwini Municipality. The department is slowly improving in terms of transformation especially in health care services. In the Primary Health Care service workload is also controversial, as views about what constitutes an appropriate workload continue to vary.
Most South Africans believe that free primary health care is one of the government's best health policies. This will pave the way for the transition of primary health care to provincial government. Currently, the Primary Health Care Services provided by eThekwini Health are under.
PERSONAL HEALTH STRUCTURE NO. OF RESPONSES
DATA PRESENTATION
The data presentation is organized according to the broad research questions, namely general impression of transformation process, provision of services, impact of transformation on staff roles, outcome of transformation and beneficiaries of transformation. The main themes that emerged characterize transformation and change as the best thing to happen in the Health Department. To this question, approximately 98% of respondents felt that there were visible and positive changes in the provision of health services.
The other major improvement is in the area of integration of health services under eThekwini Health Department. In the past, it was the mandate of the hospitals to provide treatment to patients with chronic diseases. In response to a question about the impact of transformation on staff roles, the majority of respondents (approximately 78%) indicated.
Staff are no longer segregated in clinics along racial lines and that the issue of nurses of certain racial groups having to work in clinics serving their own racial groups has been stopped. It is important to note that the issues of increased workload and acute shortage of staff are consistent with the results of the transformation of the local government and the health sector in general, which was characterized by. HIV/AIDS is directly affecting only because of the transformation in the national health system, especially the decentralization of health services at the primary health care level.
Respondents were asked what they see as the most important results of the transformation in their organization. The question here was who are the beneficiaries of the transformation in the health department. The white color represents respondents who believe that management is the sole beneficiary of transformation as they are promoted to higher positions.
EVALUATION
The gray color on the pie chart indicates respondents who believed that the previously disadvantaged community, employees and management benefited from transformation. The second respondent believed that the management and councilors were the only ones who benefited from the transformation process. Management as a role player ensured that the process was managed sensitively and in an evolutionary way.
Although the transformations and changes were slow, the study showed that they were well managed. This was important as service delivery had to continue, so it was vital that management ensured sufficient consultation and open and honest communication. An organizational culture in which different departments operated separately has been replaced by service integration.
Nurses from other racial groups are now working in clinics located in villages as well as in informal settlements such as Besteri Camp and lnanda areas just to name a few. Most respondents are satisfied with the transformation process despite the fact that there are still many challenges facing the eThekwini Health Department. What is interesting is that they do not see this as a problem, but as a challenge.
This is in line with the elements of a learning organization that has developed the ability to adapt and change. Management must ensure that the achievements they have made and the ability to adapt are consolidated by improving staffing levels in order to impact the challenges identified in this study.
CONCLUSION
CONCLUSION AND RECOMMENDATIONS
- GENERAL CONCLUSIONS
- RECOMMENDATIONS
- LIMITATIONS
- GENDER
- AGE ( IN YEARS)
- HOME LANGUAGE
- TOTAL COMPLETED YEARS OF SERVICE
- HIGHEST EDUCATIONAL QUALIFICATION OBTAINED
- DISABILITIES
This led to an increased demand for health services in the newly incorporated areas, as most of them were marginalized and had no health services. The integration of voluntary counseling and testing and prevention of mother-to-child transmission into primary health care is the positive step in the right direction. The majority of patients who contracted HIY infection in the early 1990s reached the terminal stage of their diseases.
The nurses must participate in an ongoing staff development course so that they are competent enough to handle these chronic conditions, especially in the absence of medical staff. The Constitution, the Kwa-Zulu Natal Health Act and the Municipal Systems Act emphasize that communities must be actively involved in their development processes. They must be involved in the activities that happen in their clinics through clinic committee structures.
The transformation process in local government is taking place simultaneously with the transformation of health services into a district health care system. The eThekwini Health Department should do its utmost to promote the establishment of a District Health System (DHS). The national health policy for a district health system was adopted by the African National Congress (ANC) Health Plan in the early 1990s. It has been expressed in a number of different documents, such as the Reconstruction and Development Programme. It is therefore important to highlight the issue of managing change in the context of the complexity of the human dimension.
CI Thank you for your participation in completing this questionnaire, it is greatly appreciated. Has there been change(s) in the provision of health services in your organization as a result of transformation. Were there any areas of conflictI hiccups in the implementation of transformation in the Health Department.
Are there any significant results/results of Affirmative Action / Employment Equity in the transformation of your organization. In your opinion, what would be the appropriate method of implementing transformation in the eThekwini Health Department.
