South Africa has a complex healthcare system. The provision and financing of health care in South Africa occur within two fundamentally different systems: the public healthcare sector and non-governmental not-for-profit organisations, on the one hand, and the private healthcare system, on the other hand. The socioeconomic status of an individual in South Africa is the primary determinant of the system through which he or she will receive access to healthcare. The healthcare services provided by the public and private sectors are perceived to be unequal. The introduction of healthcare reforms by the South African government through the National Health Insurance (NHI) aims to address these disparities. The primary objective of this study was to contribute to the successful implementation of the proposed South African NHI by identifying critical success factors that would impact such implementation. A sample of managerial representatives of the following healthcare institutions in the Nelson Mandela Bay Municipality (NMBM) was drawn: Large private hospitals groups; Eastern Cape Department of Health; Independent medical practitioners groups; South African Dental Association; Pharmacy Association of South Africa; Optometrist Association of South Africa. A total of 250 questionnaires were distributed among these institutions and approximately 233 usable questionnaires were returned (response rate 93.2 percent). A literature review was conducted to identify the various viewpoints (critical success factors, as well as positive and negative perceptions) on NHIs in other countries, as well as the proposed one in South Africa. About 43 of such viewpoints were identified. The 233 respondents were surveyed on these 43 viewpoints. The empirical results revealed the following three critical success factors for the successful implementation of the South African NHI: The projected benefits for stakeholders, with specific reference to medical aid schemes; the projected benefits to the private healthcare sector in servicing the public sector; and strategic leadership. The empirical results also showed that the healthcare managers, who serve the poor versus the affluent geographical areas of the NMBM, differ with regard to their projected success of the NHI. Finally, the study highlighted these health managers’ general perceptions about the envisaged benefits and shortcomings of the NHI.

This study is an assessment of the effect of absenteeism on service delivery in the Eastern Cape Department of Health: Nelson Mandela Bay District Municipality. The work was a corollary of repetitive negative feedback from the press that the researcher was concerned and embarked to investigate possible causes of these allegations by the press. The Department of Health being a public entity has a responsibility to provide quality health services to the community. Government introduced a service delivery mechanism which is enshrined in the White Paper on the Transformation of the Public Service in 1997, through the Batho Pele principles. The researcher argued that if the Batho Pele principles were practiced in the delivery of services the aforementioned repetitive feedback on health services would be minimal. Among a variety of possibilities that could cause the Batho Pele principles not to be practiced the researcher was interested to ascertain if absenteeism could be among them. The researcher asserted that, if human capital is the delivery tool of services, the absence of the human capital therefore posed a negative effect on the delivery of such services. Therefore an inverse relationship exists between absenteeism and service delivery. This relationship was affirmed by the responses of participants through the analysis of questionnaires on absenteeism and service delivery. Absenteeism is a management aspect that has a negative effect in both the financial and delivery aspect of the organisational performance. It is therefore the researchers’ sincere hope that the Department of Health will consider the deductions drawn from this study and recommendations thereof. The researcher further hopes that this study contributes to the existing body of knowledge in relation to organisational behaviour and becomes employer ammunition for service delivery.

Public institutions have the responsibility to deliver various services to the public in the most effective and efficient manner. In South Africa, many public sector reforms were instituted after 1994. The main reasons for these reforms were to improve the access of the historically disadvantaged to public services, to increase efficiencies, to reduce costs and to reduce public debt. Despite improvements to the policy framework that underpins service delivery by the public sector, however, there are still many challenges in the delivery of public services. An improved public policy to deliver service alone is not enough if not supported by effective systems and processes for actual delivery, as well as effective leadership that leads and ensures the delivery of such services. Improving the organisational effectiveness of public institutions is therefore important in South Africa. The present study explores the role that leadership plays in the pursuit of organisational effectiveness in a selected public institution, namely the South African Police Service (SAPS). The primary objective of this study is to improve the organisational effectiveness of SAPS in the Nelson Mandela Bay municipal area by investigating the influence of leadership style (transactional and transformational) and personality (Machiavellian, narcissistic, collectivistic, masculine and feminine) on organisational effectiveness of SAPS (as measured by overall organisational performance and the individual job performance intentions of police officers). The research design is positivistic, as the relationships among the above-mentioned variables are statistically tested. The sample consisted of 90 police officers of senior rank drawn from five police stations in the Nelson Mandela Bay. The empirical results were reported and interpreted. These results revealed that constructive narcissistic and collectivistic leadership personality traits, as well as transformational leadership style exert a positive influence on the organisational performance of the Nelson Mandela Bay police precincts. The empirical results also showed that collectivistic leadership personality traits influence the performance intent of these police officials positively. These results are discussed in terms of the implications they hold for the managers of police precincts. The limitations of the study are reported which provide areas for future research.

Literature indicates that the sustainability of Non-Profit Organisations (NPOs) is important as they provide pivotal services to the community. In this study, the researcher investigates common problems associated with strategy formulation and implementation in NPOs in the Nelson Mandela Metropole. The researcher reports on the importance of strategy within all organisations and outlines a strategy process that can be used as a guide to measure strategic planning in NPOs. In pursuit of conducting qualitative research, a self-constructed questionnaire was used to perform telephonic interviews with managers of NPOs. The study yielded a low response rate, but based on the analysis of the data collected, findings indicate that the main problem is not with strategy formulation or implementation, but with the understanding of the concept of strategic planning. During the interview process, it became evident that there is a common misconception that the annual operations planning constitutes a strategic plan. A major limitation to this study was the absence of a benchmark against which to measure success. Unlike a for-profit organisation where success is measured by profit margins, NPOs have different priorities and therefore successful strategic planning differs from one organisation to another. A recommendation for managers at NPOs is that they start thinking strategically about their organisation, its planning, and methods for doing so (which is discussed in Chapter Five).

The Nelson Mandela Bay area will be used to investigate the ethical and moral considerations faced by the informal sector. It is generally believed that informal sector businesses are characterised by high levels of unethical behaviour. The informal economy in many developing and under developed countries is large in terms of contribution to GDP and number of participants. The informal economy is largely composed of very small businesses that are not registered. They are not operating from suitable premises but run from homes, street pavements and other informal arrangements. In developing countries, self-employment has a greater share of informal employment than wage employment. It represents 70 percent of informal employment in Sub-Saharan Africa (if South Africa is excluded, the share is 81 percent), 62 percent in North Africa, 60 percent in Latin America and 59 percent in Asia. Consequently, informal wage employment in the developing world constitutes 40 percent of the informal employment outside of agriculture (Becker, 2004). The informal economy is as high as 56 percent of GDP in countries such as Georgia, Zimbabwe and Bolivia, where as it represents about 8 to 12 percent of economic activity in advanced or developed economies (Becker, 2004). In South Africa, informal businesses provide a viable alternative for many who are unable to find jobs in the formal sector of the economy.

Income-generating projects represent one strategy adopted by the Eastern Cape Department of Social Development (DoSD) to alleviate poverty. The purpose of this study was to evaluate the impact of an income-generating, or poverty alleviation, project funded by the DoSD in New Brighton, Port Elizabeth, in the Eastern Cape Province of South Africa. A sample of ten respondents was drawn from the project. The sampling method of this study was purposive sampling. Data was gathered through semi-structured questionnaires. Related literature focusing on income-generating projects for poverty alleviation was reviewed. Various recommendations have been made, based on the findings of the study. The findings of the study indicated the need for regular visits from Department officials to conduct monitoring and evaluation. Project members also need training in financial management as they cannot manage their finances. The research findings indicated clearly that strategies used by the Department were not effective enough to achieve the desired goals of an income-generating project.

Decentralisation of the multidrug resistant tuberculosis (MDR TB) programme to primary health care (PHC) facilities in the Nelson Mandela Metropolitan was implemented in order to improve the effectiveness of MDR TB services. This study explored the knowledge gaps of nurses at PHC facilities as regards MDR TB. A quantitative, cross-sectional descriptive study was conducted; data was collected using a structured questionnaire. Non-probability sampling was applied in this study. A convenient sampling technique was used and 25 of the 42 facilities were selected. Thirty-two respondents completed the questionnaire with a response rate of 64%. Descriptive statistics were used to describe the data. Only 38% of the nurses had been trained on MDR TB. Overall scores were high with a mean knowledge score of 61%. However there were knowledge gaps regarding side effects of MDR TB medication. This study revealed gaps in knowledge of certain areas of MDR TB management / Health Studies / M.A. (Public Health)

Decentralisation of the multidrug resistant tuberculosis (MDR TB) programme to primary health care (PHC) facilities in the Nelson Mandela Metropolitan was implemented in order to improve the effectiveness of MDR TB services. This study explored the knowledge gaps of nurses at PHC facilities as regards MDR TB. A quantitative, cross-sectional descriptive study was conducted; data was collected using a structured questionnaire. Non-probability sampling was applied in this study. A convenient sampling technique was used and 25 of the 42 facilities were selected. Thirty-two respondents completed the questionnaire with a response rate of 64%. Descriptive statistics were used to describe the data. Only 38% of the nurses had been trained on MDR TB. Overall scores were high with a mean knowledge score of 61%. However there were knowledge gaps regarding side effects of MDR TB medication. This study revealed gaps in knowledge of certain areas of MDR TB management / Health Studies / M.A. (Public Health)

The aim of this study was to investigate the causes of the housing backlog in the Nelson Mandela Bay Municipality from 2000 to 2014. Fifty participants which were two ward councilors and two PR councilors, four community development members, four ward committee members , twenty backyard dwellers from ward 17 and ward 18 and eighteen senior officials (project managers) from the Department of Human Settlement in the Nelson Mandela Metropolitan Municipality were purposively sampled for the study. A qualitative design was used. In-depth interviews were conducted to collect data to enable the researcher to ask open ended questions and explore the participants’ perspectives about the causes of housing backlog. The study revealed that the factors which are playing a role in this regard include the role played by the Eastern Cape Province in housing, the large portion of land which is privately owned, beneficiary management by municipal officials and political interference on the waiting list Metropolitan subsequently, recommendations for further research were made.

The purpose of this study was to investigate community development through the ward committee structures in the Northern Areas of the Nelson Mandela Bay Municipality. Community development through the ward committees is the key principle in the democratisation process, as well as the promotion of good governance. Community development is an opportunity for both local government and the community to strengthen the democracy that is being enjoyed; and simultaneously to promote accountability. In terms of the Local Government: Municipal Systems, 2000 (Act 32 of 2000), the role of local communities in the particular interests of their municipality must take place, among other things, by the ward councillor – as well as all other suitable procedures, mechanisms and processes set up by the municipality. Ward committees have the power to advise the ward councillor; and as municipal structures, they must ensure that there is always community participation in the sphere of local government. Community participation gives communities the opportunities to express their views, as well as giving them a sense of ownership. The objectives of the study were: - To determine the roles and responsibilities of the ward councillors in terms of the new developmental mandate (the need to encourage the involvement of communities and organisations in local government matters). - To investigate the relations between ward councillors and their ward committees, and between the offices of ward councillors and the general public. - To examine the extent to which ward councillors in the northern areas of the Nelson Mandela Bay Municipality understand the policy and administrative procedures and processes in the municipality, when addressing issues that affect the community. In order to achieve these objectives, it was necessary to review literature on community participation. An empirical search was conducted in wards 10 and 11 in the Northern Areas of Nelson Mandela Bay Municipality. Recommendations were provided which could assist the municipality to effectively make use of the ward committees and the ward councillors. If implemented, these recommendations could also enhance community development through the ward committee structures. Thus, the relationship between the ward committees and the ward councillor should be harmonious; and subsequently, they should also strengthen trust between them. Then the flow of communication will improve.