A full research dissertation submitted to the Faculty of Commerce, Law and Management, University of the Witwatersrand, in fulfilment of the requirements for the degree of Master of Management by research and dissertation, March 2016 / In an effort to improve performance, efficiency, accountability and effectiveness of public sector organisations, the Government of Lesotho has adopted a variety of reforms; one of these is the Performance Management System. However, despite its implementation more than a decade ago, the Performance Management System in the Ministry of Health in Lesotho is not producing the anticipated results. Performance management is a tool designed to improve organisational performance by channelling the tasks and activities of employees towards the goals of the organisation. Therefore the overarching purpose of the study is to describe and explain the reasons why the Performance Management System in the Ministry of Health in Lesotho is not producing the anticipated results. Through the qualitative approach, interviews and focus groups were used to collect data from the purposely selected sample of Ministry of Health employees. In addition, documents relating to the Performance Management System in the Ministry of Health have been used as data collection methods. Among other reasons, the study found that the Performance Management System (PMS) in the Ministry of Health in Lesotho is not producing the expected results because of lack of knowledge about the PMS by lowerlevel employees, absence of individual work plans, lack of feedback and lack of integration of Performance Management systems. In conclusion, the study found that the core reason for PMS not producing the anticipated results in the Ministry of Health in Lesotho is its misapplication and a lack of adherence with the legal framework on PMS. The study identified a series of concepts related to performance management, such as the setting of the organisational goals, planning, ii monitoring, evaluation, feedback and rewards, and improvement programmes. However, it has been discovered that in the Ministry of Health in Lesotho, some performance management concepts such as feedback and improvement programmes are not used, whereas some, such as performance evaluations and rewards, are wrongly applied. The theoretical and conceptual implication of this for the study is that there is little integration between the PMS processes and employees’ activities in the Ministry of Health in Lesotho / GR2018