Barlilal played a very important role in the library, helping me find material and use modern research tools. Dr. Linda Mtshali provided crucial input in the preparation of the research proposal and the formulation of questionnaires.
NHI Censuses: Fix The Existing System or Risk Failure 57
Redirecting Resources and Identification of Cost Drivers 58
Linking HRD to Effective Service Delivery in SA Public Sector
Developing Human Resources Training Needs 66
Criteria For Selection of Research Assistant 88
Nonparametric , Parametric Tests and Pearson’s Correlation 89
Preparations, Coding, Entering and Cleaning Data 93
INTRODUCTION
Therefore, as consumers of health services, outpatients can draw conclusions about the quality of services based on their experiences with such services. In line with key service delivery priorities, the South African government issued the White Paper on Public Service Delivery Transformation (WPTPSD) in 1997.
NEED FOR THE STUDY
In the current information age and knowledge economy, it is increasingly necessary for organizations to prioritize service delivery in order to gain a competitive advantage and function efficiently. The report indicated that although systems and structures in the civil service have been transformed, there is little improvement in terms of changes in relation to the organizational culture and values that align with Batho Pele requirements.
OBJECTIVES OF THE STUDY
Does the service delivery of provincial hospitals meet the expectations of patients in their interaction with these provincial hospitals. What are patients' perceptions of the performance of provincial hospitals in their efforts to provide health services.
RESEARCH METHODOLOGY AND DATA PRESENTATION
Is the government doing enough to ensure that the quality of services in provincial hospitals meets the Batho Pele principles? The answers to the key questions should provide an indication of the extent to which patients are satisfied with the specific quality of the services provided by the provincial hospitals.
RESEARCH DESIGN AND METHODOLOGY
- POPULATION AND SAMPLING
- PRIMARY DATA
- SECONDARY DATA
- DATA COLLECTION
- DATA ANALYSIS
- SURVEY TOOL
An analysis was performed to check the validity and reliability of the questionnaire. This measures the expectations and perceived performance of the various service quality items that were measured and included in the questionnaire.
LIMITATIONS OF STUDY
- STRENGTHS TO OVERCOME LIMITATIONS
- PUBLIC SERVICES AND SERVICE DELIVERY: Public service delivery is defined as services rendered by government to its citizens either directly or
- IN-PATIENT: In order to understand the content of this research, an in-patient is defined as an officially registered patient admitted to a particular hospital
- OUTPATIENT: Is someone who attends the hospital to see the doctor and receive medication, but is not admitted
- QUALITY OF SERVICE DELIVERY:Hiidenhovi, Nojonen and Laippala (2002:60), define quality of service delivery as “to act or multiphase interactive
In the context of this study, patient rights refer to the care that a patient can expect from health professionals in accordance with the Bill of Rights and the BPP. In the context of this study, it refers to health care provided in a public hospital in accordance with official government and hospital policy.
OVERVIEW OF CHAPTERS
- CHAPTER ONE - STUDY OVERVIEW This chapter is divided into three parts
- CHAPTER TWO (part 1) –THE PUBLIC SERVICE AND DELIVERY IN SOUTH AFRICA- AN OVERVIEW
- CHAPTER TWO (PART 2)
- CHAPTER THREE: SERVICE DELIVERY IN LOCAL GOVERNMENT
- CHAPTER FOUR- NATIONAL HEALTH INSURANCE
- CHAPTER FIVE- RESEARCH METHODOLOGY
- CHAPTER SEVEN - GENERAL CONCLUSIONS AND RECOMMENDATIONS This chapter draws conclusions and recommendations from the findings of the empirical research
As the focus of this research is service delivery, this chapter also focuses on the problems experienced in provincial hospitals in South Africa both in terms of provincial hospital management and total hospital services. This chapter also examines the human resources (HR) aspect of effective service delivery in South African public hospitals.
SUMMARY
It is hoped that these recommendations will assist the eThekwini Metro and iLembe Regional Hospitals in addressing the challenges they face in terms of hospital service delivery and monitoring and evaluation of BPP in these provincial hospitals in pursuit of more efficient and effective delivery. A number of important terminologies were defined and limitations of the study were described.
LITERATURE REVIEW
THE PUBLIC SERVICE AND DELIVERY IN SOUTH AFRICA- AN OVERVIEW INTRODUCTION
- The Public Service Commission (PSC)’s role was defined by Section 196 of the 1996 Constitution as follows
Encouraging ethics and values (stated in the Constitution and section 195) through public service and governance; Investigating, monitoring and assessing the administrative and personnel practices of the public service; And.
SERVICE DELIVERY IN THE PUBLIC SECTOR IN SOUTH AFRICA .1 Definition of Service Delivery
- THE ROLE OF KNOWLEDGE MANAGEMENT IN ENHANCING GOVERNMENT SERVICE DELIVERY
- Knowledge Management
- Bureaucracy
- The civil service in a changing world
- Knowledge management and government service delivery
The MKP management model advocates a series of reforms aimed at remaking the public sector in the image of the private sector. In Kenya and other countries in the sub-Saharan region, members of the public are rarely involved or consulted on matters of public policy formulation or implementation.
KNOWLEDGE AND MANAGEMENT IN THE PUBLIC SECTOR
Weber's bureaucratic model has been a leading force in the development of government structures and research. Wilson and Malik (1995) and Hughes (2003) pointed out that there has been significant criticism of this design, which focuses on creating stable and specific goals characterized by a high degree of formal definitions and written rules.
THE PRACTICAL EXECUTION OF ORGANIZING
These relationships and partnerships in the public, private and non-profit sectors are becoming increasingly blurred, raising questions about the role and responsibilities of each sector, particularly in policy development and accountability (Tushman, 1997; O'Neill, 2000; Levy and Tapscott , 2001).
CUSTOMER ORIENTATED SERVICE DELIVERY
- Citizens as effective policy partners
- E-government and a customer-centred public administration
- Cultural factors
- South Africa and Kenya’s level of preparedness to become knowledge societies According to the World Bank (2007), for a country or a region to harness its human and
Knowledge management is said to be one of the pillars for improving service delivery in the South African and Kenyan government services. It is clear that knowledge management has the potential to improve services within the government service.
SERVICE DELIVERY IN LOCAL GOVERNMENT AND NATIONAL DEPARTMENTS
SERVICE DELIVERY IMPROVEMENT STRATEGIES
To improve the organizational structuring and planning of the South African government, the provincial sphere of government should be merged with the national and local sphere and the functions and legislative powers of municipalities should be expanded to create a more effective and efficient larger city government bring (Craythorne 2006:42). Better access to service buildings and services should be arranged, as well as a holistic approach to more effective and user-friendly customer service (e.g. senior seating and adequate toilet facilities) to minimize queuing.
SERVICE DELIVERY IN PUBLIC AND PROVINCIAL HOSPITALS
- Organization of Work and Outcomes in Healthcare
- The Effects of Patient-Centred Care on Quality of Care and Patient Satisfaction The overarching goal of the patient-centred care model is to provide care that is the most
- The Role of Employee Turnover
The primary mechanism used to deliver patient-centered care is the organization of work around interdisciplinary teams (Wolf et al., 2008; Lemieux-Charles and McGuire, 2006). Despite the increased use of patient-centred care methods, empirical research has not kept pace with them, and the evidence regarding their effectiveness is limited (Charmel and Frampton 2008; Wolf et al., 2008).
PROBLEMS EXPERIENCED BY PROVINCIAL HOSPITALS IN SOUTH AFRICA
Huselid (1995) provided strong empirical support for the mediating role of turnover in the relationship between high performance work systems and financial performance. A patient's perception of a hospital's performance in their efforts to provide services defines their raison d'être.
Taken together, the above measures provide an indication of the extent to which patients are satisfied with specific service quality attributes. They are in line with the Batho Pele White Paper and the aims of the Patients' Bill of Rights; therefore, they also inform the settings of the current study.
EXPECTATION MANAGEMENT AND RATING IN PROVINCIAL HOSPITALS Consumers‟ experience of service quality may be assessed by comparing what they want,
The outcome of the process, viz. consumer satisfaction or consumer dissatisfaction, will vary from person to person, making measurement of the phenomena an increasingly complex matter. The expectations that such a consumer may have about that specific attribute can be deduced from the resulting rating. Kotler and Andreasen confirm that any attempt to measure satisfaction must assume that both importance and expectations are valid and therefore must be measured around the variables of the service rendered.
It is against the above background that the aims and principles of the BathoPele White Paper are relevant for the improvement of the NHS in SA. Powerlessness Lack of information or choice Violence Anger, aggression and frustration Non-enabling environment Unkindness, lack of.
OUTPATIENTS’ ANGER, AGGRESSION AND FRUSTRATION RELATED TO POOR SERVICES IN PROVINCIAL HOSPITALS
Violence is a message that something is out of balance between the individual's internal and external environments. As a language of aggression, frustration and feelings of powerlessness, violence is loaded with meaning.
NATIONAL HEALTH INSURANCE
NHI CONSENSUS: FIX THE EXISTING SYSTEM OR RISK FAILURE
TREATMENT PLAN
Eager to illustrate how far his government had come from the denial and obfuscation policies of the Mbeki/Tshabalala-Msimang era, Motsoaledi said the overall plan was aimed at combating a quadruple epidemic of HIV/TB, maternal, newborn and child mortality . and morbidity, non-communicable diseases, and injury and violence. Worse still, South Africa is responsible for 17% of the world's HIV pandemic (while affecting only 0.7% of the world's population) – 23 times the global average.
REDIRECTING RESOURCES AND IDENTIFICATION OF COST DRIVERS The chairperson of the 23-person NHI Ministerial Advisory Task Team, Dr Olive Shisana
Tuberculosis prevalence was the worst in the world at seven times the global average, while HIV/TB infection was 73%. Economist and government ad hoc adviser Alex van der Heever parodied the NHS committee's commitment in 1995 to rapidly build a district health system, which it claimed was the highest priority and at the heart of the whole health strategy. The 1997 White Paper outlined a primary health care package that put communities at the center of delivery, choosing people to advocate for them in health matters.
REFORM TRACK RECORD BODES ILL
When it comes to healthcare financing, no developing country spends 8% of its gross domestic product (GDP) (projected for South Africa, an increase from the current 3.4%) through the public sector. In an apparent response to Van den Heever's criticism of the district health system, Shisana said her team had based their proposals on a systematic review of 85 studies of primary care models worldwide.
CONCLUSION
If GDP growth remains as low as 2% per year, as was the case for 20 years between 1975 and 1995, the NHI would simply be unaffordable,” Twine warned, adding that his realistic forecast could be affordable, but would cause deep friction with other countries. high priority government goals (education, housing and productive infrastructure). Twine said raising the overall tax burden “too much” (as proposed) would simply burden the economy, limiting growth and job creation.
LINKING HUMAN RESOURCES DEVELOPMENT TO EFFECTIVE SERVICE DELIVERY IN SOUTH AFRICAN PUBLIC SECTOR HOSPITALS
- INTRODUCTION
- DEVELOPING HUMAN RESOURCES IN THE PUBLIC SECTOR
- HUMAN RESOURCES DEVELOPMENT STRATEGY
- THE GOVERNMENT AS A VEHICLE FOR REFORM AND ENHANCING HUMAN RESOURCES
- EFFECTIVENESS OF THE HUMAN RESOURCES TRAINING PROGRAMME IN PUBLIC HOSPITALS
The Human Resource Development Strategy (HRDS) was adopted to support a holistic approach to training and development in the public sector. The strategies put in place to deal with the development of human resources and their results;.
DEVELOPING HUMAN RESOURCES TRAINING NEEDS .1 Organizational Development
- Training and Development
- Organizational Analysis
- Operational Analysis
- Personal Analysis
According to Wade (1995:22), personal analysis focuses on the application of the skills and knowledge acquired by the trainee during training. Help employees become familiar with the requirements of their specific position and those of the organization.
LEARNING APPROACHES (Creating a learning environment) .1 Strategic Learning
This means that learning in action has an impact on self-development and organizational growth and development (see figure 4). Action learning enables people to determine the nature and cause of the problem and then reflect on and identify possible solutions.
Reaction
Hendricks (2005:21) states that training managers, practitioners and institutional bodies charged with capacity building initiatives must continuously monitor and evaluate the impact of training in an effort to align organizational and performance objectives. Kirkpatrick, an American training specialist, defines training and development evaluation as "the determination of the effectiveness of training." He designed an evaluation system that addresses evaluation at four levels, namely (Coetzee, Botha, Kiley and Truman.
Learning
Behaviour
ANALYSIS OF RESEARCH
The letters 'SPSS' mean something different today than what they meant when the product was invented. When analyzing data, one of the most important aspects is testing the statistical accuracy of models.
RESEARCH METHODOLOGY
SAMPLING PROCEDURE
- Non-probability sampling
- Probability sampling
- Stratified random sampling
- Sample size for correlation with acceptable absolute precision
This method ensures that the probability of each component of the population being included in the sample can be determined. This sampling system is intended to ensure that the sample has clear descriptions, which are often representative of the population in terms of key variables.
DESCRIPTION OF TARGET POPULATION
- Data collection using personal interviews
- DESIGN OF THE QUESTIONNAIRE
The researcher had an opportunity to interview and interact with KZN MEC for Heath, Dr SibongiseniDhlomoin October 2011 regarding the challenges that provincial hospitals are facing in terms of service delivery and effective implementation of BPPs. Given the focus of this study, the researcher examined the interdependence of key factors of public sector service delivery through the eyes of patients and public sector workers.
CRITERIA FOR SELECTION OF RESEARCH ASSISTANTS
Bless and Higson-Smith state that "an independent variable is that factor that is measured, manipulated, or selected by the researcher to determine its relationship to an observed phenomenon that constitutes the dependent variable." Dependent variables included current trends in (Batho Pele principles, service delivery, service standards, levels of acuity, courtesy assurance, provision of better information to patients by hospital officials, treatment received, hospital facilities and access in hospital facilities).
RESPONSE RATE
NONPARAMETIC, PARAMETIC TESTS AND PEARSON’S CORRELATION
- Parametric tests
SAMPLE
Content validity concerns the representativeness of the concept in the measuring instrument of the variable being measured (Brink et al. Polit& Beck, 2004:423). In this study, content validity was achieved by including all aspects relevant to hospital service delivery and the BPPs in the questions.
TECHNIQUES USED
- Pearson’s Product Method
Accessible language was used in the interview schedules to ensure that respondents understood the questions. The (p) value is the probability of achieving a correlation that is large or larger if the correlation in the population were actually zero.
FREQUENCY
If the probability is low, it means that there is little chance that the population correlation is zero, and we can conclude that there is a relationship between these variables in the population from which the sample was drawn. It is then said that the correlation is significant or that there is a statistically significant correlation to describe the situation.
PIE CHARTS
It displays data using a number of rectangles of the same width, each representing a separate category. Since there is no uniform distance between the levels of a qualitative variable, the discrete nature of the individual bars are appropriate for this type of independent variable.
STATISTICAL SOFTWARE
It is a way of summarizing a set of categorical data and illustrates the main features of the data distribution in a convenient form. Bar charts allow trends to be drawn between the bars (eg, showing that they are gradually getting longer or shorter).
PREPARATION, CODING, ENTERING AND CLEANING DATA
LIMITATIONS OF THE EMPIRICAL SURVEY
This form was obtained from the university and enabled the researcher to obtain the necessary consent from study participants after informing them of the aims and objectives of the research. The involvement of both the researcher and the volunteers eliminated any form of manipulation of responses.
CONCLUSION
The administration and monitoring of the questionnaire was done by the researcher personally, assisted by the field workers who volunteered to participate in this study. The analysis of the questionnaires is carried out by the researcher and a professional statistician under the watchful eye of the researcher's supervisor appointed by the university.
INTRODUCTION
METHODOLOGY ADOPTED
STATISTICS – AN OVERVIEW
