Health managers and community representatives' views of a system-wide intervention to strengthen public healthcare in the Free State, South Africa.
Afr Health Sci
; 23(1): 747-764, 2023 Mar.
Article
in En
| MEDLINE
| ID: mdl-37545955
ABSTRACT
Background:
A system-wide health system strengthening (HSS) initiative, the Health Systems Governance and Accountability (HSGA) intervention, was developed, translated to policy, and implemented in the Free State province. This study assessed health managers (HMs) and community representatives' (CRs) views of the intervention and whether it improved integration and performance.Method:
A questionnaire survey among 147 HMs and 78 CRs and 14 focus group discussions (FGDs) with a mean of 10.3 participants and a total of 102 HMs and 42 CRs, were conducted. The questionnaire and FGD data were descriptively and thematically analysed to triangulate findings.Results:
Many HMs (44%) mostly positioned at the operational levels indicated that implementation of the HSGA intervention did contribute to integration of health services. Most CRs (54%) believed that communities were actively involved in the intervention. However, both the self-administered questionnaire and the FGD data evidenced lack of policy awareness among, especially, operational-level HMs.Conclusion:
From the perspectives of HMs and CRs, the implementation of the intervention was viewed as a step forward in strengthening public healthcare to respond to system deficiencies in the Free State province. Earlier engagement of especially operational-level HMs during reforms may be beneficial in successfully implementing HSS interventions.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Public Health Administration
/
Attitude of Health Personnel
/
Community Health Workers
/
Delivery of Health Care, Integrated
Type of study:
Qualitative_research
Aspects:
Determinantes_sociais_saude
Limits:
Humans
Country/Region as subject:
Africa
Language:
En
Journal:
Afr Health Sci
Journal subject:
MEDICINA
/
SERVICOS DE SAUDE
Year:
2023
Document type:
Article