Glob Health Action. No names or other identifying information are disclosed in the reporting of the findings. World Health Organization. Government gazette. To fully understand the functioning of the referral system throughout the DHS, 22 separate group discussions were also conducted by the DCSTs with subdistrict managers, clinic supervisors, PHC managers and the CEOs and clinical managers of district, regional, tertiary and academic hospitals covering all districts. Leadership and governance (or stewardship) of health systems is a complex yet critical building block of any health system [9]. She has been ill from last year May or June and was at some point admitted to hospital. The OSD was implemented in South Africa with the intention to increase the retention of HCWs in remote and rural areas through improved remuneration. Improving health system efficiency as a means of moving towards universal coverage. World rugby faces landmark class action over neurological damage, SCA opens the door to curbing malicious HPCSA complainants, CMS fails to place medical fund under curatorship, NHLS executives suspended following PwC audit, Landmark UK ruling on puberty blockers for under-16s, COVID-19: SA imposes stricter international visitor requirements, SIU briefs media on health sector corruption cases, R173m annual SAPS healthcare tender is challenged, Surveillance Officer (Professional Nurse/Registered Nurse or Staff Nurse) (6 Months FTC), Medical Laboratory Technician x 2 (12 Month FTC). This state of affairs was exacerbated by unnecessary hospital admissions and over-prescriptions of medicines by medical doctors, particularly those who were inexperienced. South Africa: Covid-19 - How the Lockdown Has Affected the Health of the Poor in South Africa. JCH, PC, NGK and WHK reviewed and helped to revise the manuscript. The results were presented to the provincial health department’s top management and it was recommended that a health system strengthening strategy should be developed. The research was designed and executed and the first draft was prepared by BM. This, in turn, caused staff shortages, truancy, and misuse of public service equipment due to pursuit of additional remuneration by professionals. It is a strength of the study that it is one of the first to assess whole-system (as opposed to programme) related challenges using the WHO building blocks framework and the CLD methodology. South African health review 2013/14. Firstly, two coders independently reviewed each report and identified and grouped similar responses into subcategories. Leadership and governance is however one of the most difficult functions of health systems to define, measure and monitor. 2. The WHO defines a well-functioning health system as one that guarantees access to “essential medical products, vaccines and technologies of assured quality, safety, efficacy and cost-effectiveness, and their scientifically sound and cost-effective use” [9], p. 20. Over a period of four years, there was R24bn in “irregular provincial expenditure” but it is hard to measure whether this was due to corruption or incompetence, says Rispel, who heads the Centre for Health Policy . Parsons AN, Mathole T, Sanders D. The impact of global health initiatives on access to antiretroviral therapy in South Africa. Leadership and governance within the South African health system. 2018;11:1461338. Google Scholar. Nicholson A, Lowe MC, Parker J, Lewis SR, Alderson P, Smith AF. Health and health care in South Africa. Thirdly, the first author used the consolidated list of generic categories to independently code the data. 2016;6:e012582. 2016;4:e642–53. 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