Health sector reforms and policy implementation in South Africa:

IntroductionEarly childhood is a critical time when the benefits of early interventions are intensified, and the adverse effects of risk can be reduced. For the optimal provision of early intervention, professionals in the field are required to have specialised knowledge and skills in implementing these programmes. In the context of South Africa, there is evidence to suggest that therapists are ill-prepared to handle the unique challenges posed in neonatal intensive care units and wards with at-risk infants in the first few weeks of life. This is attributed to several reasons; however, irrespective of the causative factors, the need to bridge this knowledge-to-practice gap remains essential.Methods and analysisThis study is a multimethod stakeholder-driven study using a scoping review followed by an appreciative inquiry and Delphi process that will aid in the development, implementation and evaluation of a knowledge translation intervention to bridge knowledge-gaps in occupational and physiotherapists working in the field. Therapists currently working in the public health sector will be recruited for participation in the various stages of the study. The analysis will occur via thematic analysis for qualitative data and percentages and frequencies for descriptive quantitative data. Issues around trustworthiness and rigour, and reliability and validity, will be ensured within each of the phases, by use of a content validity index and inter-rater reliability for the Delphi survey; thick descriptions, peer debriefing, member checking and an audit trail for the qualitative data.Ethics and disseminationThe study has received full ethical approval from the Health Research and Knowledge Management Directorate of the Department of Health and a Biomedical Research Ethics Committee. The results will be published in peer-reviewed academic journals and disseminated to the relevant stakeholders within this study.

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Community health worker models in South Africa: a qualitative study on policy implementation of the 2018/19 revised framework

Health Policy and Planning ◽

10.1093/heapol/czaa172 ◽

2020 ◽

Author(s):

Joshua P Murphy ◽

Aneesa Moolla ◽

Sharon Kgowedi ◽

Constance Mongwenyana ◽

Sithabile Mngadi ◽

...

Keyword(s):

South Africa ◽

Qualitative Study ◽

Policy Implementation ◽

Community Health ◽

Resource Constraints ◽

Health Workers ◽

Healthcare Providers ◽

Successful Implementation ◽

Programme Implementation ◽

Healthcare Facilities

Abstract South Africa has a long history of community health workers (CHWs). It has been a journey that has required balancing constrained resources and competing priorities. CHWs form a bridge between communities and healthcare service provision within health facilities and act as the cornerstone of South Africa’s Ward-Based Primary Healthcare Outreach Teams. This study aimed to document the CHW policy implementation landscape across six provinces in South Africa and explore the reasons for local adaptation of CHW models and to identify potential barriers and facilitators to implementation of the revised framework to help guide and inform future planning. We conducted a qualitative study among a sample of Department of Health Managers at the National, Provincial and District level, healthcare providers, implementing partners [including non-governmental organizations (NGOs) who worked with CHWs] and CHWs themselves. Data were collected between April 2018 and December 2018. We conducted 65 in-depth interviews (IDIs) with healthcare providers, managers and experts familiar with CHW work and nine focus group discussions (FGDs) with 101 CHWs. We present (i) current models of CHW policy implementation across South Africa, (ii) facilitators, (iii) barriers to CHW programme implementation and (iv) respondents’ recommendations on how the CHW programme can be improved. We chronicled the differences in NGO involvement, the common facilitators of purpose and passion in the CHWs’ work and the multitude of barriers and resource limitations CHWs must work under. We found that models of implementation vary greatly and that adaptability is an important aspect of successful implementation under resource constraints. Our findings largely aligned to existing research but included an evaluation of districts/provinces that had not previously been explored together. CHWs continue to promote health and link their communities to healthcare facilities, in spite of lack of permanent employment, limited resources, such as uniforms, and low wages.

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Policy implementation and financial incentives for nurses in South Africa: a case study on the occupation-specific dispensation

Global Health Action ◽

10.3402/gha.v6i0.19289 ◽

2013 ◽

Vol 6 (1) ◽

pp. 19289 ◽

Cited By ~ 14

Author(s):

Prudence Ditlopo ◽

Duane Blaauw ◽

LaetitiaC. Rispel ◽

Steve Thomas ◽

Posy Bidwell

Keyword(s):

South Africa ◽

Policy Implementation ◽

Financial Incentives

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Reversing the trend of weak policy implementation in the Kenyan health sector? – a study of budget allocation and spending of health resources versus set priorities

Health Research Policy and Systems ◽

10.1186/1478-4505-5-3 ◽

2007 ◽

Vol 5 (1) ◽

Cited By ~ 10

Author(s):

Anna H Glenngård ◽

Thomas M Maina

Keyword(s):

Policy Implementation ◽

Health Sector ◽

Health Resources ◽

Budget Allocation

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Book Review: Globalisation, Educational Transformation and Societies in Transition, Operation Blackboard: Policy Implementation in Indian Elementary Education, Education in Germany since Unification, State of Transition: Post-Apartheid Educational Reform in South Africa

European Educational Research Journal ◽

10.2304/eerj.2002.1.2.12 ◽

2002 ◽

Vol 1 (2) ◽

pp. 393-399

Author(s):

Lynn Davies ◽

Alan Rogers ◽

Edwin Keiner ◽

Simon McGrath

Keyword(s):

South Africa ◽

Elementary Education ◽

Policy Implementation ◽

Educational Reform ◽

Educational Transformation

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POLICY IMPLEMENTATION OF A HEALTHY INDONESIA PROGRAM WITH A FAMILY APPROACH IN BANDUNG DISTRICT

Advances in Social Sciences Research Journal ◽

10.14738/assrj.84.9828 ◽

2021 ◽

Vol 8 (3) ◽

pp. 143-155

Author(s):

Uri Zaenuri ◽

Ria Arifianti ◽

Ratna Meisya Dai

Keyword(s):

Policy Implementation ◽

Community Health ◽

Community Health Center ◽

Health Sector ◽

Training Methods ◽

Implementation Model ◽

Family Approach ◽

The Social ◽

Healthy Family ◽

Policy Measures

The purpose of this study was to determine the implementation of the Healthy Indonesia Program with a Family Approach which is indispensable as a determinant of the success of the Bandung Regency Government's performance in the health sector. The Healthy Indonesia Program with a Family Approach is a priority program of the Ministry of Health which is implemented by the Center for Community Health. The implementation of the Healthy Indonesia Program with a Family Approach in Bandung Regency was only carried out in 2017 with program socialization activities at the Health Office and Community Health Center levels. The research method used is descriptive qualitative with the approach of Donald van Meter and Carl van Horn's policy implementation model. The findings from the implementation of the Healthy Indonesia Program with a Family Approach in Bandung Regency have been implemented but have not yet reached the target of total coverage. The Bandung Regency Healthy Family Index is included in the unhealthy assessment (<0.8). So that the success of implementation will be achieved when making improvements from deficiencies, both in terms of standards and policy targets or policy measures and objectives, resources, characteristics of the implementing organization, attitudes of the implementers, communication between organizations and implementing activities, and the social, economic and political environment. Suggestions from this study are to improve the empowerment of family roles and community potential with training methods for community cadres, continue the enumerator recruitment program to assist with home visits and data collection and data input, advocate for budget allocations sourced from regional revenue and expenditure budgets.

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