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Providers' responses to the patients' rights charter in South Africa: a case study in policy implementation

Thesis (M.P.H.), Faculty of Health Sciences, University of the Witwatersrand, 2009 / Abstract
The Patient Rights’ Charter is one of several progressive health policies in South Africa with
disappointing implementation in practice. Barriers to implementation have already been
described. Policy analysis theory and empirical studies suggest that power and resistance may
contribute to implementors’ responses to policies. This secondary analysis of existing semistructured
interviews with health providers in Limpopo explicitly examined the influence of
power and resistance on their implementation of the Patients’ Rights Charter.
Open coding yielded themes of implementation experience, to which a deductive analysis
applied a heuristic framework, derived from the literature, to examine power and resistance.
The critical importance of implementors in translating policy into practice, and of discursive
manifestations of power, were reiterated. Resonances in the data of the functionalist ‘sick role’
brought together surveillance, expert knowledge and the loss of health workers’ influential
voice, in a way not previously discussed. Implications for future management strategies are
Date28 January 2010
CreatorsRaphaely, Nika Thandiwe
Source SetsSouth African National ETD Portal
Detected LanguageEnglish

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