South Africa possesses a highly fragmented health system with wide disparities in health spending and inequitable distribution of both health care professionals and resources. The national health system (NHI) of South Africa consists of a large public sector and small private sectors which are overused and under resourced and a smaller private sector which is underused and over resourced. In broad terms, the NHI promises a health care system in which everyone, regardless of income level, can access decent health services at a cost that is affordable to them and to the country as a whole. The relevance of this study is to contribute to the NHI debate while simultaneously providing insights from other countries which have implemented national health care systems. As such, the South African government can then appropriately implement as well as finance the new NHI system specific to South Africa’s current socio-economic status. The objective of this study was to examine health care financing models in different countries in order to draw lessons for South Africa when implementing the NHI. A case study was conducted by examining ten countries with a national health insurance system, in order to evaluate the health financing models in each country. The following specific objectives are pursued: firstly, to review the current health management system and the policy proposed for NHI; secondly, to examine health financing models in a selected number of countries around the world and lastly to draw lessons to inform the South African NHI policy debate. The main findings were firstly, wealthier nations tend to have a much healthier population; this is the result of these developed countries investing significantly in their public health sectors. Secondly, the governments in developing nations allocate a smaller percentage of their GDP and government expenditure on health care. Lastly, South Africa is classified as an upper middle income developing country; however, the health status of South Africans mirrors that of countries which perform worse than South Africa on health matters. In other words the health care in South Africa is not operating at the standard it should be given the resources South Africa possesses. The cause of this may be attributed to South Africa being stuck in what is referred to as the “middle income trap” amongst other reasons.

Thesis (Ph.D.)--University of the Witwatersrand, Faculty of Commerce, Law and Management, Wits School of Governance, 2016 / CEOs of public hospitals in South Africa are often held responsible when their institutions fail to deliver good quality care and are associated with poor health outcomes. Negative perceptions prevail and particularly in the National Department of Health it is held that the CEOs are generally not adequately qualified, inexperienced, incompetent and often inappropriately appointed. This study attempts to articulate the CEOs views (their side of the story) and in particular how they perceive the challenges that they face and what solutions they proffer in improving the running of their institutions. This research is viewed through the lens of the New Public Management paradigm (NPM), in terms of Public Sector Reform and in particular Health Sector Reform in South Africa. Thirty CEOs of public hospitals in South Africa responded to a survey of their opinions. The majority (86%) of them felt they were unable to manage their institutions effectively. A subsequent qualitative study of CEOs and experts in public management using in depth interviews and further focus group discussions with CEOs and senior hospital managers revealed that the major challenges that the CEOs faced were financial, human resources and operational management issues. Procurement and information challenges were linked to financial and human resources deficiencies, lack of accountability mechanisms and the presence of corruption. The Performance Management System currently in place did not work appropriately and was driven by perverse incentives. Political interference was also a pervasive problem. Their recommendations were that they needed clear and unambiguous delegations and the appropriate resources so that they can take full responsibility of their institutions. Clear accountability structures were paramount in achieving better health service management and care according to the advice of experts in public management as well as that of senior hospital managers. This requires the creation of enabling legislation and an appropriate accountability framework. The blanket application of NPM principles is also questioned. Selective application of the tools of NPM should be tested and consideration be given to the dimension of added public value in the South African public hospital context. / GR2018

Submitted in partial fulfilment of the requirements for the degree of Master of International Relations in the Faculty of Humanities Department of International Relations, 2016 / A feud between the African Union (AU) and the International Criminal Court (ICC) has been dragging for a while now. The indictment of President Omar Hassan Ahmad alBashir of Sudan and President Uhuru Kenyatta and his deputy president William Ruto in Kenya altered the cosy relations between the two organisations. Firstly, the AU contends that the ICC cannot prosecute heads of states that have immunity under international law. Secondly, the ICC disturbs the ongoing peace processes with its investigations. The AU accused the ICC of selecting African states for prosecution; as a protracted form of imperialism by prevailing western powers. Withstanding, some of the AU member states that are party to the ICC have willingly signed up to its jurisdiction. Besides, the AU’s founding documents support the fight against grave atrocities. Nonetheless, the AU has failed dismally to live up to the principles it endorses- which tantamount to hypocrisy. The contradictory rhetoric of the AU towards the ICC is not exclusive to the AU, but to international organisations due to conflicting pressures in external environments. The paper explains this empirical phenomenon by applying Organised Hypocrisy (OH) to capture such contradictory behaviour prone to international organisations. / XL2018

In recent years, an increasing number of people move into cities to search for better opportunities for themselves and their families. This movement is known as urbanisation and makes it difficult for the local government to fully understand citizens’ needs particularly pertaining to public safety matters. During the first phase of the Public Safety Smart City project, it was identified that there is a need for feedback loop to facilitate effective communication of public safety issues between citizens and local government. This means that EL citizens do not have a better channel in place to address their public safety issues to the local government. This could lead to the decisions made by the local government in public safety not fully communicated back to the citizens. The primary objective of the study is to develop a feedback loop model that will assist in more effective reporting of public safety issues between citizens and the local government. The study followed an interpretivism paradigm and the research methodology employed is the qualitative approach. This was influenced by the existing De Fleur model of communication, secondary data and also semi-structured interviews. The interviews were conducted with eleven citizens and four managers from the Department of Public Safety. It was ascertained that the lack of a feedback loop about public safety issues between citizens and local government is likely to increase public safety issues. Findings revealed that this is because citizens are not continuously updated about their reports and also about the state of public safety matters. Furthermore, the methods of communication utilised lead to poor communication of public safety issues. The study concludes that the introduction of an Information and Communication Technology enabled feedback loop between citizens and local government can help in reducing public safety issues and make public safety officials proactive rather than reactive.

The negotiation process in South Africa did, by 1993, lead to change in inputs in policy-making, and led to change in political relations with specific reference to norms of equality and respect for human rights. Significantly, these changes imposed obligations on the public service on issues of transformation, amongst others: service delivery, restructuring, democratisation of the policy-making process, and representativity and equity. This study was undertaken to examine the latter two namely, to determine the policy-making mechanisms by which the public service seeks to legitimise the policy-making process by involving a wider populace in participation; and to examine legislation that exists on representativity and equity and their consequent implementation. In support of the empirical research, use and analysis of a theoretical study of public policy in Public Administration were undertaken. The analysis showed that the theoretical distinction in the roles of political office-bearers and appointed public officials in the policy-making process, was incorrect. Rather, the empirical study supported a close co-operation of the functionaries in the process, including implementation. Further, it was found that the various models for analysing public policy had all been applicable at different periods in the South African political system. For the purpose of this study, the hypotheses are formulated that the new political dispensation that ushered South Africa into a popular constitutional democracy impacted on the functioning of the public service, amongst others: • an obligation to involve a wider population in the policy-making process to achieve legitimacy; and • an obligation to enforce norms of representativity and equity through legislation and the implementation thereof. In the study of the policy-making process, it was empirically established that the public service does possess comprehensive mechanisms to engage the wider populace in consultation and negotiation on public policy-making. Yet, public participation was found to be thin. Further, it was established that elaborate legislation exists to change the demographic face of the public setvice, and there is progress on implementation of representativity and equity legislation with reference to target quotas, time frames and the control thereof. Proposals for further study on effects of change, are made. / Public Administration / D. Litt et Phil (Public Administration)

Submitted in accordance with the requirements for the Doctors Degree of Technology: Business Administration, Durban University of Technology, 2009. / Although there is an abundance of health care waste information in South Africa, not enough studies have been done in public district hospitals particularly in rural areas. Hospitals find it difficult to comply with the minimum requirements of health care waste management guidelines, such as segregation of waste. If hazardous waste gets mixed with non-hazardous waste, waste disposal and treatment become costly. Furthermore, there has been a sharp increase in the amount of waste generated from health facilities. However, there seem to be uncoordinated efforts in each province in dealing with waste problems. The purpose of this study was to evaluate the process of operational and administrative procedures of health care waste management in hospitals. The study was conducted to facilitate the optimisation of waste management. A quantitative approach was chosen for this study because cause and effect relationships can more easily be identified, and the research is more structured and controlled. The project involved an enquiry into the perception of respondents on the procedures used in managing health care waste. Data was collected from 270 respondents out of 27 hospitals in nine provinces of South Africa. The informants were health care waste workers who were either directly or indirectly involved in waste management. A questionnaire was used as a research instrument. Results were analysed statistically using a special package for scientific studies. It has been found that in the midst of financial challenges, hospitals are unable to prioritise and rank absolutely important activities that are necessary to be undertaken to meet minimum requirements of health care waste management as laid out in the health care waste guidelines and directives. Shortages of waste equipment such as trolleys, waste containers, and temporary storage areas were the main challenges facing hospitals. The recommendations set the tone and provide a blueprint that health care managers may consider in facilitating improvement in the management of health care waste.

M. Tech. Business Administration / The South African National Department of Environment Affairs (DEA) in Pretoria has been experiencing a high vacancy rate of 20%, 18% and 26% in the financial years 2008/9, 2009/10, and 2010/11 respectively against a target of 16% . The vacancy rate for 2013/14 financial year has increased to 24.5% against a target of 10%. The Department is struggling to meet its own set target by end of financial year. The current recruitment method utilised by DEA is too slow and tedious, takes time to appoint and has human elements as some documents get lost and does not promote efficiency and value for money. The study was aimed at assessing the degree to which e-recruitment methods were used in the Department of Environmental Affairs. The study was conducted in line with the objective of the DEA to reduce the existing vacancy rate at the DEA to at least 10% by 31 March 2014. This study assessed and evaluated the impact of implementing the online recruitment process in the Department and the contributing factors to a high vacancy rate such as the long waiting process.

No description available.

Thesis (MPA)--Stellenbosch University, 2008. / ENGLISH ABSTRACT: Having just celebrated ten years of democratic rule, South Africa, as a young democracy, is an emerging country in the international world. It is also emerging, from a history of police brutality in apartheid South Africa, towards embracing human rights, accountability, police-community relations and a people-orientated approach to safety issues. It is this young democratic country that is paving the way for metropolitan policing on the African continent, by setting the example in South Africa. Metropolitan/ Municipal police has found its legislative mandate through the South African Police Amendment Act (Act No. 83 of 1995). It provides an opportunity to enable positioning of local government policing in a manner that will ensure that ‘quality of life’ for all is achieved through effective, efficient and sustainable policing. This study aims to give essence to a governance model as a strategy for sustainable metropolitan policing. The research provided for the following concepts of sustainable governance as a basis or foundation to build metropolitan policing: • Institutional/ Managerial/Leadership/Sustainability; • Political Sustainability; • Representivity; • Development and Growth; • Equitable Allocation and Distribution Resources; • People-centred Approaches; • Democratic Rights; • Professionalism and Ethics; • Financial sustainability; • Effective and Efficient Processes; • Co-ordination and Integration; • Sustainable decision making; • Sustainable results The framework for sustainable governance in Metropolitan Policing is broad and key aspects that influence the main objective of this research, namely co-ordination and integration have been included, for the purpose of this study. The study provides opportunity for deep reflection on how future policing at local government level in this country is structured, shaped and managed. The international basis of the study provides lessons conceptualised within a ‘learning organisation’ context. Metropolitan police services can enrich their organisation through learning from their international counterparts and sister organisations, inclusive of the South African Police Service (SAPS). It is also the relationship with the SAPS that will be the most challenging for the metropolitan police service. A key element that shapes the interaction between the Metropolitan Police organisations and the South African Police Services is based on sharing of policing power and distribution of resources. A sustainable relationship between the SAPS and metropolitan police services is important. It directly impacts on how policing is executed. It also requires consideration when co-ordination and integration processes in metropolitan police organisations are considered. The study aims to prove the importance and necessity of integration and co-ordination; however, it also emphasises the relevance of proper systems, processes and structures within an environment prior to embracing co-ordination and integration initiatives. It binds the concept of co-ordination and integration into all facets of organisational life, arguing the basis for technological assistance to consolidate such transformation. The study brings metropolitan policing into a transit from a ‘local government traffic organisation linked to council policies’ to a modern-day police organisation that embraces the complexities within which such organisations exist, both externally and internally, finding sustainable solutions and strategies for service delivery that fits our young democratic heritage of a single decade. The challenge to shape metropolitan policing to be different from the historic apartheidstyle municipal police force will eventually be a task for leadership of the metropolitan police organisation (across all levels) in its responses to society in terms of service delivery outcomes, which will be determined by how the organisation has shaped its future (vision), what it presents to society in terms of service delivery and the measures taken to achieve sustainability. The latter refers, in principle, and for purposes of this study, to good governance and sustainable development, both of which form the cornerstone of effective and efficient policing. / AFRIKAANSE OPSOMMING: Teen die agtergrond van die onlangse viering van ‘n dekade van demokrasie, staan demokratiese Suid Afrika as ‘n opkomende land op die wêreldhorison. Die land is ook besig on weg te beweeg vanaf ‘n geskende verlede wat gekenmerk was deur polisiebrutaliteit in apartheid-Suid-Afrika na die omhelsing van menseregte, verantwoordelikheid, polisie-gemeenskaps verhoudinge en ‘n mensgeoriënteerde benadering tot veiligheidsaspekte. Dit is hierdie jong demokrasie wat leiding in Afrika neem met die konsep van metropolitaanse polisiëring. Die Metropolitaanse/ Munisipale polisie verkry wettige bestaansreg in die Suid Afrikaanse Polisie Wysigingswet, (Wet Nr 83 van 1995). Dit voorsien die geleentheid om polisiëring deur middel van plaaslike regering tot reg te laat kom op ‘n manier wat verseker dat “lewenskwaliteit” vir almal deur effektiewe , doeltreffende en volhoubare polisiëring verwesenlik kan word. Hierdie studie beoog om ‘n basis te vind vir volhoubare beheer in metropolitaanse polisiering, te wete deur: • Institutionele / bestuur/ leierskap/ volhoubaarheid; • Politieke volhoubaarheid; • Verteenwoordiging; • Ontwikkeling en groei; • Gelyke verspreiding en toekenning van hulpbronne; • Mens-georiënteerde strategieë; • Demokratiese regte; • Professionalisme en etiek; • Finansiële volhoubaarheid; • Effektiewe en doeltreffende prosesse; • Ko-ordinering en integrasie; • Volhoubare besluitneming; • Volhoubare resultate. Die raamwerk vir volhoubare beheer in metropolitaanse polisiëring is wyd. Kernaspekte wat die hoofdoelwit van hierdie ondersoek affekteer, naamlik ko-ordinering en integrering, word vir die doeleindes van hierdie studie ingesluit om die argument te versterk. Die studie bied geleentheid vir nabetraging oor hoe die toekoms van polisiëring op plaaslike regeringsvlak gestruktureer, geposisioneer en bestuur word. Die internasionale grondslag van die studie bied lesse wat binne ‘n ‘lerende organisasie’ beslag gekry het. Metropolitaanse polisie-organisasies kan hul organisasies bemagtig deur van hul internasionale eweknieë en susterorganisasies soos die nasionale Suid-Afrikaanse Polisiediens. (SAPD) te leer. Dit is ook die verhouding met die SAPD wat die meeste uitdagings meebring. Naas die verhouding met die publiek, blyk dit die belangrikste te wees as gevolg van die polisiëringsmagte en standaarde wat op beide organisasies van toepassing is. Volhoubaarheid in die verhouding tussen die SAPD en die metropolitaanse polisiedienste is belangrik aangesien dit ‘n direkte impak op dienslewering asook integrasie en ko-ordinering kan hê. Hierdie studie beoog om die belangrikheid en noodsaaklikheid van integrasie en koordinering te toon. Dit beklemtoon egter ook die noodsaaklikheid daarvan dat behoorlike stelsels, prosesse en strukture in organisasies geïmplimenteer word voordat koordinering en intergrasie aangepak word. Die studie verbind die konsepte van koordinering en intergrasie met alle ander fasette van ‘n organisatoriese stelsel, met ‘n sterk fokus op die rol van tegnologie ten einde transformasie te bewerkstellig. Die studie beoog om die transformasie van ‘verkeersdienste-organisasies wat met raadsbeleid skakel’ na ‘n metropolitaanse polisiëringsdiens te vergemaklik, ten einde ‘n moderne organisasie daar te stel wat in staat is om kompleksiteit, as ‘n integrale deel van die interne en eksterne omgewing, deur middel van volhoubare strategieë te bestuur en aan die vereistes van dienslewering in ‘n jong demokrasie van tien jaar te voldoen. Die uitdaging om metropolitaanse polisiedienste in ooreenstemming met hedendaagse demokratiese en konstitutionele beleid te vestig, berus op die leierskap (op alle vlakke) in die organisasie. So ook is daar die verantwoordelikheid om te verseker dat metropolitaanse polisiedienste die diensleweringsuitkomstes behaal deur middel van ‘n volhoubare visie, die tipe en gehalte van dienste wat gelewer word en die prosesse/strategieë wat gevolg word ten einde volhoubaarheid te bereik. Laasgenoemde (volhoubaarheid) verwys, vir die doeleindes van hierdie studie, na goeie beheer en volhoubare ontwikkeling, beide deel van die hoeksteen van effektiewe en doeltreffende polisiëring.

Thesis (MPA)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: The goal of this research was to investigate effective leadership that drives organisational change in the public health sector to meet the changing environmental needs to improve service delivery within the Western Cape Department of Health. Organisational change in the public health sector must lead to improved public health service delivery. The role of leadership is to deal with incompetent personnel as they are the cause of problems regarding inadequate service delivery. Leadership must contribute to the main areas where competency development needs to take place. Healthcare 2030 requires transformational leadership from the ranks of managers and clinicians for collective and distributed leadership across all levels of organisations. The research methodology used in this study was a combination of qualitative and quantitative research methodologies. The methodology included an empirical investigation in the form of a literature review and a preliminary semi-structured interview as well as a nonempirical investigation. The empirical investigation was conducted by using semi-structured interviews as well as a survey questionnaire which was designed to gather information focussing on leader personality traits, task-related traits and understanding the organisation. This study specifically focussed on effective public leadership to drive organisational change in the health sector and to improve service delivery. The results provide support for a cohesive trait-behavioural model of leadership effectiveness. In general, leadership traits associated with task competence are related to task-oriented leadership behaviours, which improve performance-related leadership outcomes. Effective leadership in the public health sector that drives organisational change is based on the general personality traits of a leader, task-related traits and understanding the organisation. These are the elements that are important for effective public leadership to improve service delivery. / AFRIKAANSE OPSOMMING: Die doel van hierdie navorsing was om doeltreffende leierskap, wat organisatoriese verandering in die openbare gesondheidsektor teweeg kan bring, te ondersoek. Sodoende kan in die veranderende omgewingsbehoeftes voorsien word en kan die Wes-Kaapse Department van Gesondheid verbeter. Organisatoriese verandering in die openbare gesondheidsektor moet tot verbeterde openbare gesondheidsdienslewering lei. Die rol van leierskap is om onbekwame personeel te hanteer omdat hulle die oorsaak van probleme met betrekking tot onvoldoende dienslewering is. Leierskap speel ‘n sleutelrol in die bevordering van bevoegdheidsontwikkeling. Healthcare 2030 vereis transformerende leierskap uit die geledere van bestuurders en dokters oor alle vlakke van organisasies heen. Die navorsingsmetodologie wat in hierdie studie gebruik is, was ’n kombinasie van kwalitatiewe en kwantitatiewe navorsingsmetodologieë. Die metodologie het ’n empiriese ondersoek in die vorm van ’n literatuuroorsig en ’n voorafgaande semi-gestruktureerde onderhoud asook ’n nie-empiriese ondersoek, ingesluit. Die empiriese ondersoek is uitgevoer deur van semi-gestruktureerde onderhoude en ’n opnamevraelys gebruik te maak. Die vraelys is ontwerp om inligting met betrekking tot leiers se persoonlikheidseienskappe, taakverwante eienskappe en ’n begrip van die organisasie te ondersoek. Hierdie studie het spesifiek op doeltreffende openbare leierskap gefokus om organisatoriese verandering in die gesondheidsektor te bewerkstellig en dienslewering te verbeter. Die resultate ondersteun ’n samehangende eienskapgedragmodel van leierskapdoeltreffendheid. Oor die algemeen is leierskapeienskappe wat met taakbevoegdheid geassosieer word, verwant aan taakgeöriënteerde leierskapgedrag wat prestasieverwante leierskapuitkomste verbeter. Doeltreffende leierskap in die openbare gesondheidsektor wat organisatoriese verandering dryf, is gegrond op die algemene persoonlikheidseienskappe van ’n leier, taakverwante eienskappe en ’n begrip van die organisasie. Dit is die elemente wat belangrik is vir doeltreffende openbare leierskap om dienslewering te verbeter.