The aim of the study is to establish how clients of the Germiston police station experience service delivery from personnel at their local police station and how police officials perceive their service delivery. This research wants to determine the extent of knowledge skills and attitude within the SAPS. The main objective was to evaluate services delivered by SAPS personnel. A qualitative research approach was chosen because it is flexible. The results of the study identified gaps. A significant shortage of personnel in the client service centre was noted. Furthermore, the results revealed that there is poor management and evaluation of the service delivery process. To have an effective and efficient service delivery process, it is recommended that the management of Germiston police station re-enforce legislation on service delivery and human resource capacity with the introduction of a customer service agent in the client service center and implement a monitoring and evaluation strategy. / Inhloso yocwaningo ngukubheka ukuthi abahlinzekwa usizo esiteshini samaphoyisa saseGermiston baluthola kanjani usizo esiteshini samaphoyisa sendawo nokuthi amaphoyisa akubona kanjani ukuhlinzeka kwawo usizo. Lolu cwaningo luhlose ukuveza izinga lamakhono olwazi kanye nokuziphatha ophikweni lamaphoyisa iSAPS. Injongo enkulu kwakuwukuhlaziywa usizo oluhlinzekwa abasebenzi bakwaSAPS. Kwakhethwa indlela yocwaningo ebheka amaqiniso ngoba iyaququleka. Imiphumela yocwaningo yaveza izindawo okungenzeki kahle kuzona. Kwabonakala ukuntuleka okukhulu kwabasebenzi esikhungweni sosizo okuhlinzekwa kubantu. Phezu kwalokho, imiphumela yaveza ukuthi kunokungaphathwa ngendlela nokungahlaziywa kahle kohlelo lokuhlinzekwa kosizo. Ukuze kube khona uhlelo lokuhlinzekwa kosizo olusebenza ngempumelelo nangokonga, kunconywa ukuba abaphathi besiteshi samaphoyisa saseGermiston baphoqe iqoqomthetho maqondana nokuhlinzekwa kosizo, mayelana nabasebenzi abanele kanye nokulethwa komuntu ozobhekana nezindaba zokugculiseka kwamakhasimende esikhungweni sosizo oluhlinzekwa kubantu futhi kuqale kulandelwe isu lokuqapha nokuhlaziya. / Maikemišetšo a thutelo ye ke go hlagiša ka moo badirelwa ba seteišene sa maphodisa sa Germiston ba itemogelago kabo ya ditirela go tšwa go bašomedi ba seteišeneng sa maphodisa sa tikologong ya bona le ka moo bahlankedi ba maphodiša ba bonago kabo ya ditirelo tša bona ka gona. Nyakišišo ye e nyaka go laetša bogolo bja go ba le tsebo le boitshwaro ka go SAPS. Maikemišetšo a magolo e be e le go lekola ditirelo tšeo di abilwego ke bašomedi ba SAPS. Mokgwatebelelo wa dinyakišišo ka go rerišana le banyakišišwa ore o be le kwešišo ya seo o se nyakišišago o kgethilwe ka gobane o ka fetolwa gabonolo. Dipoelo tša thutelo tlhokego ya tshedimošo ye e lekanego. Tlhaelo ye e bonagalago ya bašomedi senthareng ya go direla badirelwa e lemogilwe. Godimo ga moo, dipoela di utollotše gore go na le tshepedišo ye e fokolago ya taolo le tshekatsheko ya kabo ya ditirelo. Gore go be le tshepedišo ye e kgontšhago ya kabo ya ditirelo, go eletšwa gore bolaodi bja seteišene sa maphodisa sa Germiston bo tlaleletše maatla a melao ya kabo ya ditirelo le bokgoni bja dithuši tša batho ka godira gore go be le Modiri wa kabo ya ditirelo senthareng ya dirirelo tša badirelwa le go phethagatša maanotshepetšo a go lebeledišiša le tekolo. / Criminology and Security Science / M. A. (Criminal Justice)

The use of Public-Private Partnerships (PPPs) by governments on all continents has been rapidly growing as government departments and their agencies continue to look for improvised means of providing high quality services. In South Africa, the demand for the replacement of the aging government infrastructure has led to the increase in the use of PPPs. The PPPs are not only used for the improvement of roads, but also in the provision of social services and many other services that are traditionally a responsibility of government. Government institutions typically enter into relationships with PPPs to address their needs and to meet specific objectives. It is, therefore, up to these institutions to choose an ideal model of procurement that best addresses their objectives of delivering effective services (Palmer, 2009:Online). Government institutions will, however, only enter into relationship with PPPs if the services can be transferred in a responsible way and if the risks for failure are limited. Inefficiencies in the disbursement of social assistance grants by the South African Social Security Agency (SASSA) has received much attention and criticism from the stakeholders as the company contracted to perform the work on behalf of SASSA continues to provide poor quality services. In assessing a PPP, countries providing social security transfers need to take into consideration a partner that will assist in establishing and implementing the payment design and distribution mechanism that is capable of facilitating the cost effective, reliable and practical delivery of cash to the grant beneficiaries. A comprehensive review of literature and empirical investigation was carried out to respond to the research study’s set objectives. The study explored a wide-ranging survey of PPP projects in developed and developing countries focusing on the use of the PPP model in the South African context with specific reference to the disbursement of social grants by the SASSA. Alternative procurement methodologies in government were also reviewed. An analysis of relevant procurement theories was undertaken to form the basis of the research study. The mini-dissertation explores if there are any advantages for the government, and more specifically the SASSA, in using PPPs as opposed to traditional procurement methods. The study attempts to establish if a private partner can be encouraged to provide long-term investment in terms of expertise; well qualified staff; technology; infrastructure; and creation of an environment conducive for highly effective service delivery where the return on such investment is not guaranteed. / MA (Public Administration), North-West University, Potchefstroom Campus, 2015

The use of Public-Private Partnerships (PPPs) by governments on all continents has been rapidly growing as government departments and their agencies continue to look for improvised means of providing high quality services. In South Africa, the demand for the replacement of the aging government infrastructure has led to the increase in the use of PPPs. The PPPs are not only used for the improvement of roads, but also in the provision of social services and many other services that are traditionally a responsibility of government. Government institutions typically enter into relationships with PPPs to address their needs and to meet specific objectives. It is, therefore, up to these institutions to choose an ideal model of procurement that best addresses their objectives of delivering effective services (Palmer, 2009:Online). Government institutions will, however, only enter into relationship with PPPs if the services can be transferred in a responsible way and if the risks for failure are limited. Inefficiencies in the disbursement of social assistance grants by the South African Social Security Agency (SASSA) has received much attention and criticism from the stakeholders as the company contracted to perform the work on behalf of SASSA continues to provide poor quality services. In assessing a PPP, countries providing social security transfers need to take into consideration a partner that will assist in establishing and implementing the payment design and distribution mechanism that is capable of facilitating the cost effective, reliable and practical delivery of cash to the grant beneficiaries. A comprehensive review of literature and empirical investigation was carried out to respond to the research study’s set objectives. The study explored a wide-ranging survey of PPP projects in developed and developing countries focusing on the use of the PPP model in the South African context with specific reference to the disbursement of social grants by the SASSA. Alternative procurement methodologies in government were also reviewed. An analysis of relevant procurement theories was undertaken to form the basis of the research study. The mini-dissertation explores if there are any advantages for the government, and more specifically the SASSA, in using PPPs as opposed to traditional procurement methods. The study attempts to establish if a private partner can be encouraged to provide long-term investment in terms of expertise; well qualified staff; technology; infrastructure; and creation of an environment conducive for highly effective service delivery where the return on such investment is not guaranteed. / MA (Public Administration), North-West University, Potchefstroom Campus, 2015

Thesis (PhD)--Stellenbosch University, 2011 / ENGLISH ABSTRACT: The Public-Private Partnership (PPP) is a popular instrument for public service delivery. It is important that public managers will be able to recognize when a PPP would be an appropriate service delivery option, and will be able to maximize a PPP‘s chances of success when it is the chosen service delivery instrument. The research question addressed in this dissertation is: ―What are the critical factors that can be replicated that separate successful PPPs from PPPs that do not deliver or that collapse? In this dissertation critical success factors for PPPs are identified through a step-by-step process in which different sources of success factors are analysed and where successively identified sets of success factors are compared and combined in a repetitive layered process of synthesis. A list of success factors is created and expanded through an iterative process of evaluation, removal of duplications, combination of related success factors and listing of unique success factors. Success factors are found in literature while describing the PPP concept and partnership mechanics and management. Success factors are identified in partnership literature, in public governance literature, in private sector collaboration literature, in entrepreneurial studies and in a collection of perspectives on success. These perspectives include those of stakeholders, of private operators, of the third sector as well as perspectives from disciplines and knowledge and practice frameworks such as project management, corporate governance, enterprise risk management and organisational design. Additional success factors are identified in a discussion on the evaluation of partnerships, where it is shown that success factors can be derived from evaluation based on characterization, from partnership definitions, from the perspective of programme evaluation, from measuring the performance of business improvement districts, from alternating focus partnership evaluation (sector by sector, theme-based, local-level) and from service delivery evaluation. The evaluation of partnership examples also provides insight into success factors. The final filtering and synthesis of evidence uses the results of questionnaires, from which success factors are derived, to conduct a final distillation and produce the final list of success factors identified. A total of 466 individual success factors are identified in this dissertation, these factors are grouped into 43 distinct categories. The two most critical success factors for PPPs are identified as firstly delivering a publicly needed service and secondly achieving the objectives of the partnership. The answer to the research question described above is that critically, two conditions must be met to make a PPP successful, and that is that the goals of the PPP must be achieved and that a public need must be satisfied. There are many additional success factors which can further define success and degrees of success, all of which are descriptions of desired conditions from the perspective of stakeholders. The exploratory and hypothesis-generating study culminates in a hypothesis that states that if public managers are faced with a choice of service delivery options, and the use of a PPP is one option, and if the manager applies the categories of recommended critical success factors identified in this dissertation, the manager will be able to determine whether a PPP would be an appropriate service delivery vehicle, and furthermore, if PPP is chosen as service delivery vehicle, the public manager would, through the application of the success factors identified in this dissertation, have a greater chance of successful implementation of the PPP through purposeful collaboration. The study contributes to the public management body of knowledge by covering new ground in terms of the evaluation and management of public-private partnerships. / AFRIKAANSE OPSOMMING: Publiek-Privaat Vennootskappe (PPVe) is 'n gewilde instrument vir die lewering van openbare dienste. Dit is belangrik dat openbare bestuurders sal weet wanneer 'n PPV 'n goeie opsie sal wees vir openbare dienslewering en hoe om 'n PPV se geleentheid vir sukses te verhoog as dit die gekose dienslewerings-instrument is. Die navorsings-vraag wat in hierdie proefskrif aangespreek word is: Wat is die kritieke sukses-faktore wat gerepliseer kan word wat suksesvolle PPVe onderskei van PPVe wat nie presteer nie of wat ineenstort? In hierdie proefskrif word kritieke suksesfaktore vir PPVe geïdentifiseer deur 'n stap-vir-stap proses waardeur verskillende bronne van suksesfaktore ge-analiseer word en agtereenvolgende stelle van suksesfaktore vergelyk en gekombineer word in 'n herhalende, gelaagde proses van sintese. 'n Lys van suksesfaktore word geskep en uitgebrei deur ‗n iteratiewe proses van evaluasie, die verwydering van herhalings, die kombinasie van verwante faktore en die lys van unieke faktore. Suksesfaktore word gevind in literatuur terwyl die PPV konsep en vennootskap meganismes en -bestuur beskryf word. Suksesfaktore word geïdentifiseer in vennootskap literatuur, in openbare bestuur literatuur, in privaatsektor samewerkingsliteratuur, in entrepeneur studies en in 'n versameling perspektiewe op sukses. Hierdie perspektiewe sluit in die van belanghoudendes, van private operateurs, van die derde sektor sowel as perspektiewe van dissiplines en kennis en praktyk raamwerke soos projekbestuur, korporatiewe bestuur, ondernemingsrisikobestuur en organisatoriese ontwerp. Bykomende suksesfaktore word geïdentifiseer in 'n bespreking oor die evaluasie van vennootskappe, waar dit aangedui word dat suksesfaktore afgelei kan word van karakter-gebaseerde evaluasie, van die prestasiemeting van besigheidsverbeteringsdistrikte ("Business Improvement Districts"), van alternatiewelik-fokusende vennootskap-evaluasie (sektor-vir-sektor, tema-gebasseerd, plaaslike vlak) en van dienslewerings-evaluasie. Die evaluering van vennootskap voorbeelde voorsien ook insig in suksesfaktore. Die finale filtrasie en sintese van bewyse gebruik vraelyste, waarvandaan suksesfaktore afgelei word, vir 'n finale distillasie en die saamstel van 'n finale lys van geïdentifiseerde suksesfaktore. In totaal word 466 indiwiduele suksesfaktore in hierdie proefskrif geïdentifiseer, wat in 43 aparte kategorieë gegroepeer word. Die twee mees kritieke suksesfaktore wat uitgewys word is om eerstens 'n benodigde publieke of openbare behoefte te bevredig of diens te lewer, en tweedens om die doelwitte van die vennootskap te bereik. Die antwoord op die navorsings-vraag wat hierbo beskryf word is dat daar krities aan twee voorwaardes voldoen moet word om 'n PPV susksevol te maak, en dit is dat die vennootskap se doelwitte moet bereik word en dat ‗n openbare behoefte bevredig moet word. Daar is verskeie bykomende suksesfaktore wat sukses en die mate van sukses verder kan definieer, waarvan almal beskrywings is van verlangde toestande uit die oogpunt van belanghebbendes. Die uitset van die verkennende en hipotese-vormende studie is 'n hipotese wat lei dat, indien openbare bestuurders met 'n keuse van dienslewerings opsies gekonfronteer word, en indien die gebruik van 'n PPV een van hierdie opsies is, en indien die bestuurder dan die kategorieë van voorgestelde suksesfaktore wat in hierdie proefskrif geïdentiseer is toepas, sal dit vir die bestuurder moontlik wees om te bepaal of 'n PPV 'n toepaslike diensleweringsvoertuig kan wees, en verder dat, indien 'n PPV die gekose diensleweringsvoertuig is, die openbare bestuurder deur die toepassing van die susksesfaktore wat in hierdie proefskrif geïdentifiseer is 'n groter kans sal hê vir suksesvolle implementering van die PPV deur doelgerigte samewerking.

For some considerable time, client satisfaction has been a problematic issue in the UK construction industry with many projects failing to satisfy the client needs and meet or exceed the client expectations. Client satisfaction is, however, a key performance measure and a major determinant of project success. There is a common belief that strategic decisions made by clients have a significant impact on the levels of client satisfaction. Strategic decisions in the context of construction projects are often associated with project stages including pre-design, design, tender, construction, occupancy & maintenance and disposal and vary in nature. Consequently the impact of strategic decisions on client satisfaction depends as much on timing as on the subjects of the decisions. While such findings are useful to facilitate the industry’s focus on addressing the failure in achieving client satisfaction, and point to the route for improvement, they are arbitrary and do not provide a systematic basis for investigating the real impact on client satisfaction. The nature of strategic decisions and the significance of its impact on client satisfaction have not been clearly identified and client satisfaction has remained an elusive issue for a majority of construction professionals. This research was hence undertaken to seek empirical evidence of an interrelationship between strategic decisions and client satisfaction. Defining strategic decisions, often associated with project stages, as ones that are complex and made under uncertainty and have a long-term impact on project success, a quantitative research methodology combined with qualitative approaches, was adopted in investigating the interrelationship between strategic decisions and client satisfaction. Findings of a detailed literature review revealed that client satisfaction at any stage depends as much on the service quality attributes of service providers including overall service delivery, people of service providers and communications with clients as on the influence of strategic decisions and the client itself. These performance attributes and the groups of strategic decisions, referred as strategic decision cluster (SDC), were further assessed and the relationships between these measures and strategic decisions were examined using factor analysis and multiple regression modelling techniques. Analyses revealed SDCs including Design Approach, Procurement and Implementation predict better the outcomes of service quality and hence higher levels of client satisfaction. Service delivery and communications with clients have a positively significant correlation with the levels of client satisfaction. Of these two attributes, communications with clients makes the largest unique contribution to the variance and is considered the better predictor for client satisfaction. The developed models is validated via external and internal validation and the findings support the thesis that strategic decisions have a impact on client satisfaction by strongly influencing the performance of service quality although causality cannot be assumed. It is recommended that service providers including contractors and consultants devote more efforts to improve their performance on the attributes of service quality identified as having significant association with client satisfaction, particularly service delivery and communications with clients. Further research efforts focusing on providing a practical tool or expert system so as to address the practical issues for a wider range of clients and service providers are also recommended.

Paper 1 - Consultation is a widely used model of practice amongst Educational Psychology Services (EPS) in the United Kingdom (UK) as evidenced in the amount of research carried out on this practice (Leadbetter, 2006, p. 246). This paper attempts to supplement the limited evidence on how and why consultation is used. This paper provides an account of Educational Psychologists (EPs) perceptions of using consultation in a Welsh Educational Psychology Service (EPS). The study uses a thematic analysis of interviews with EPs and 3 accounts of the practice of consultation are provided as examples of how consultation is used. Data analysis revealed that EPs’ practice is dominated by the influence of Wagner’s model of consultation, which is a result of both university, and service based training and not because they feel it is necessarily the best way of working and were vague about their reasons for using this approach. Evidence emerged to suggest EPs were only aware of one model of consultation, which is the Wagner model. Evidence also emerged to suggest that EPs confused service delivery models with models of consultation and that EPs are unclear about their unique skills and role when using consultation and feel that schools do not understand the work they are trying to achieve when working in this way. EPs also considered that schools want more time with them, but burdensome bureaucracy hinders this. These findings are discussed in more detail at the end of Paper 2 where the overall findings suggest there is a systemic problem in Pantysgawn EPS, where the dominance of the EP role to provide statutory assessments prevents EPs from working in a truly consultative way. The paper ends by discussing the key element of the EP’s role, whether a consistent and rigid adherence to one practice model is practicable or desirable, and the various ways that EP services can monitor outcomes to alleviate some of the bureaucratic processes. Paper 2 - Paper 1 of this study looked at EPs’ perceptions of using consultation. Very few studies have looked at service users experiences in consultation based EP services. Paper 2 therefore looks at schools’ perceptions of the EP service and considers the benefits and barriers to effective service delivery using a thematic analysis of interviews with staff from 5 primary and 3 secondary schools. Findings suggest that schools continue to regard the expertise of the EP as being a provider of individual assessments, but they also revealed an awareness of the wider systemic role that EPs can provide. This traditional view of the role of the EP is discussed in terms of a wider systemic pressure for schools to seek this kind of EP intervention due to the Local Authority’s (LA) focus on statutory assessments. Schools appreciated a greater continuity of EPS staff as this helped them to develop more productive working relationships and they wanted more time with the EP. The findings suggest that the level of bureaucracy and the statutory assessment requirements to gain access to targeted resources were a barrier to working more effectively with schools. The paper ends by integrating these findings with the paper 1 findings and discussing the key element of the EP’s role, whether a consistent and rigid adherence to one practice model is practicable or desirable, and the various ways that EP services can monitor outcomes to alleviate some of the bureaucratic processes.

Masters in Public Administration - MPA / The focus of the study is on the implementation of public policies through provision of basic services such as water and sanitation in the City of Cape Town. The case study of the research is the informal settlements of Khayelitsha area which falls under the jurisdiction of the City of Cape Town. The study identified and analysed the socioeconomic conditions of the people living in the informal settlements of Khayelitsha and the impact of such conditions to their lives. The study emphasizes the role of all spheres of government in the implementation of public policies.The study identified various challenges faced by government in the implementation of public policies, particularly at local government level. Among the challenges is the lack of communication, lack of public participation and lack of capacity. The study emphasizes the importance of intergovernmental relations and cooperate governance in order to achieve the objectives of good governance and effective and efficient service delivery. The study reveals that civil society plays an important role in the implementation of public policies and also holds the government accountable to the people. It is important to indicate that government cannot achieve the goals and objectives of providing clean water and adequate sanitation facilities if communities do not form part of the structures that implement projects and programmes of development in their respective areas.Hence, the study emphasizes the importance of communication and consultation of communities on issues that directly affect them. The study emphasizes the fact that communities need to take control of the resources and infrastructure provided to them in order to avoid unnecessary expenditure of replacing and repairing resources damaged and destroyed by the very same community.

The study has been made in association with a facility management company where the service delivery to a specific customer has been studied. The purpose of the study is to map the main factors that makes both the customer, and the employees that work in the delivery process, satisfied in order to get the rating for customer and employee satisfaction up. The purpose of the study is also to map which improvements that can be made to get the rating for customer and employee satisfaction up. The data for the study has been collected through semi- structured interviews with both customers and employees. The results of the study shows that the customer is not satisfied with the current delivery in spite of an increase in satisfaction over the past six month. The employees is currently shown to be satisfied but talks about an increase in satisfaction over time. The results shows that the customers and employees is aware of possible improvements in the delivery process. The report includes theory of customer and employee satisfaction and change- and quality management. Conclusions show that customers seems to be affected by seven different factors in case of their satisfaction where reliability is the most important one. The employees seems to be affected by five different factors in case of their satisfaction, for example fundamental rights and communication. The conclusions also show that there is a gap between the customer's expectations and the offer received and that improvements made by the customers and employees can be of value to the company. / Studien har genomförts på ett Facility Management företag med fokus på affärsenheten för  fastighet. Facility Management, förkortat FM, innebär att företaget bistår med den strategiska ledningen av resurser och tjänster som krävs för att en byggnad eller fastighet ska fungera effektivt. Studien berör servicekvaliteten i en serviceleverans till en specifik kund som äger och förvaltar fastigheter för bland annat utbildning och vård. Anledningen till att studien genomförts är då ett missnöje har konstaterats hos såväl kund som medarbetare i den studerade leveransen utifrån företagets kund- och medarbetarundersökning år 2018. Undersökningen visade störst behov av förbättring inom området Servicekvalité för att öka kund- och medarbetarnöjdheten i leveransen. Syftet med studien blev därför att undersöka vilka huvudsakliga faktorer som ligger till grund för kunders och medarbetares nöjdhet i en serviceleverans samt vilka förändringar som kan göras för att förbättra kund- och medarbetarnöjdheten. Rapporten är en fallstudie som består av kvalitativ primär data. Data samlas in med hjälp av semistrukturerade intervjuer hos det undersökta företaget samt hos företagets kund. Studiens resultat visar att kunden inte är helt nöjd med leveransen, trots en ökad nöjdhet de senaste sex månaderna. Företagets medarbetare visar också ökad nöjdhet över tid och anger att de anser sig själva nöjda med arbetssituationen i nuläget. Resultatet visar att både kund och medarbetare har förslag på hur leveransen kan förbättras för att öka nöjdheten både både för kund och medarbetare utöver de förbättringar som hittills har gjorts i leveransen. Kunden ger förslag både på vad företaget kan erbjuda men även vad de själva kan göra för att uppnå nöjdhet. Medarbetarna ger förslag på åtgärder som skulle förbättra deras vardags samt förbättringar som de anger skulle hjälpa dem att leverera en högre servicekvalitet. Studiens resultat har stöttats av teorier samt tidigare forskning om kund- och medarbetarnöjdhet samt förbättringsarbete, däribland Grönroos modell för tjänstekvalitet, Kano- kundmodell samt Gap-modellen. Studiens slutsatser är att kunders nöjdhet påverkas av sju olika faktorer där kunden värdesätter tillförlitlighet och pålitlighet högst av faktorerna medan faktorn omgivning är den minst viktiga för kunden för att känna nöjdhet. Studien visar även att medarbetares nöjdhet påverkas av fem olika faktorer vilka är: grundläggande rättigheter, kommunikation, uppskattning, sammanhållning samt utveckling. Studiens slutsats är även att servickvaliteten har gap mellan kundens förväntningar och det erhållna erbjudandet där kundens och medarbetarnas konkreta förslag till förbättring kan hjälpa företaget att förbättra både kund- och medarbetarnöjdhet.

BACKGROUND: Quality improvement (QI) efforts in which providers from various health facilities, with support from coaches, work together to implement innovations for improving health care are rapidly spreading from high-income settings to resource-poor settings. However, limited research exists regarding the factors which drive teams to succeed or fail, spread, and sustain best practices. The purpose of this study was to understand the factors facilitating or inhibiting the performance of QI teams of maternal and child health (MCH) service delivery in resource-poor settings. METHODS: A qualitative multi-site case study was conducted in northern Ghana to determine the views and beliefs of QI teams, coaches, and beneficiaries of Project Fives Alive (PFA) about the application of QI to MCH service delivery. Using key informant interviews, document review, and group interviews, the study elicited information about: 1) the factors that affect QI team success and failure when implementing QI methods designed to improve MCH service delivery; 2) the interplay of factors that facilitate or inhibit the spread of best practices among QI teams in northern Ghana; and 3) steps being taken by stakeholders to sustain these best practices. Grounded theory processes were used to identify themes from the data. RESULTS: Testing of changes using Plan-Do-Study-Act (PDSA) cycles and adoption of a client-centered model to the delivery of services has helped teams to identify the felt needs of clients, resulting in perceived increased uptake of MCH services. Key contributory factors to successes were: availability and accessibility of midwives, training of QI teams, incentive packages for providers and clients, community support groups, and PFA partners. Key challenges inhibiting success were: staff turnover, inadequate supervision, cultural practices, and inadequate infrastructure. Some of the key factors that shaped successes have dissipated, threatening sustainability of QI efforts two years after PFA ended. CONCLUSION: The presence of a midwife, providing leadership for organizing team members and implementing PDSA cycles, can facilitate success. Project staff support is important, but teams and coaches need space and time to drive the QI process independently and practice QI methods in ways that foster continuity beyond donor support.

No description available.