sahr2001 - Health Systems Trust

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Sources of motivation and job satisfaction Most DMs mentioned two factors that sustain them in their jobs, and give them motivation and job satisfaction. First, the job itself is a challenge, and provides the opportunity to get experience, develop skills and to ‘see myself moving up the ladder’ and secondly, the team spirit among the District Management Teams (DMTs) they are heading keeps them going. In a similar vein some feel that they get support from other managers, work with staff who are very willing and get great reward from their contact with communities. Other motivational factors include: ◆ The vision of bringing about transformation and seeing improvement, getting results ◆ Receiving recognition from politicians in the District Council. Sources of support When asked to indicate where/who they received a lot of support from, the district managers cited the regional director, junior officers, ‘My Boss’, assistant director for community health services, and colleagues. Recommendations for improving the working conditions of the DM Recommendations for improving working conditions, fall under four categories: Organograms and Staffing Issues Material Resources Support from higher levels ◆ There is a need to review the structure of the district office in line with the health programmes that exist at the provincial office ◆ Service plans should be developed ◆ An organogram for each programme and facility should be developed and the necessary posts created and approved ◆ Staff should be appointed on an official basis, not on an acting basis. ◆ The district budget should not be cut and more resources should be provided. ◆ Consistent support is required from the province. “Don’t leave district managers to swim alone yet when there are problems you expect them to explain.” 240
13 • Voices of District Managers Gender Imbalances Men remain in the majority in top positions, and gender imbalance seems to be particularly problematic in some municipalities, to the point that there is concern about whether woman will be taken on at all. Thus, attention needs to be paid to this issue and women’s needs catered for. Five most important policies of government When asked to name five important policies of government, one district manager named the following: ◆ PHC package ◆ Basic conditions of employment ◆ Batho Pele and patients’ rights ◆ Recruitment policies ◆ Occupational health and safety. Other district managers mentioned up to three policies each, which were a combination of: ◆ The District <strong>Health</strong> System and the white paper on the transformation of health ◆ Separation of clinics from hospitals ◆ Pharmaceuticals ◆ Batho Pele ◆ Policies around maternal and child health and HIV/AIDS ◆ All health programmes ◆ Clinic supervision ◆ PHC package ◆ Public finance management ◆ HR policies including the basic conditions of employment and various recruitment policies ◆ Occupational health and safety. Discussion 1-5 The fact that all of the district managers interviewed were nurses might be said to reflect sampling bias. However it is widely known that most district managers were nurses by profession. Prior to the advent of the District <strong>Health</strong> System, a triumvirate, consisting of the medical and nursing professions and the administrators, managed the health services in South Africa. Opportunities are emerging for other health professionals such as environmental health 241
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NORTHERN PROVINCE GAUTENG MPUMALANG
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Foreword Among significant events t
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14 Voices of National and Provincia
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Preface Listening to ‘Voices’
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an urgent need to improve the curre
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Transformation “Things happen so
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Introduction Health legislation is
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grounds. This was driven by the nee
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statutory powers in terms of the FA
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ecommend that the Minister make reg
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the expansion of their programme to
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Health Services are provided for in
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of a circumcision operation and the
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References 1 Report by the Joint Mo
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Introduction The District Health Sy
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(viz. environmental health services
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district’. This arrangement of su
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To illustrate the progress made tow
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References 1 Department of Health.
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Eastern Cape Category A and C Munic
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Gauteng Category A and C Municipali
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Mpumalanga Category A and C Municip
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Northern Province Category A and C
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Western Cape Category A and C Munic
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2 • The District Health System Ap
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Financing Local Government Health S
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3 • Financing Local Government He
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Private Sector Financing 4 Jane Gou
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4 • Private Sector Financing Fina
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4 • Private Sector Financing Tabl
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4 • Private Sector Financing cons
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4 • Private Sector Financing priv
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Public-Private Partnerships 5 Julia
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5 • Public-Private Partnerships t
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5 • Public-Private Partnerships B
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5 • Public-Private Partnerships P
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5 • Public-Private Partnerships a
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5 • Public-Private Partnerships S
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5 • Public-Private Partnerships E
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5 • Public-Private Partnerships e
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5 • Public-Private Partnerships s
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Using Information for Health 6 Loui
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6 • Using Information for Health
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Annual Reports and the Public Finan
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7 • Annual Reports and the Public
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HIV/AIDS Financing 8 Paul Whelan In
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8 • HIV/AIDS Financing discussed
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8 • HIV/AIDS Financing Provincial
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8 • HIV/AIDS Financing Funds to p
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8 • HIV/AIDS Financing have short
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8 • HIV/AIDS Financing plans requ
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8 • HIV/AIDS Financing district H
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8 • HIV/AIDS Financing The fundin
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8 • HIV/AIDS Financing Gauteng: G
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8 • HIV/AIDS Financing condoms, a
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8 • HIV/AIDS Financing Conditiona
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8 • HIV/AIDS Financing Financial
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Mainstreaming HIV/AIDS Progress and
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9 • Mainstreaming HIV/AIDS magnit
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9 • Mainstreaming HIV/AIDS Figure
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9 • Mainstreaming HIV/AIDS from t
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9 • Mainstreaming HIV/AIDS The sy
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9 • Mainstreaming HIV/AIDS Preven
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9 • Mainstreaming HIV/AIDS Anothe
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9 • Mainstreaming HIV/AIDS Notwit
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9 • Mainstreaming HIV/AIDS the im
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9 • Mainstreaming HIV/AIDS Rememb
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9 • Mainstreaming HIV/AIDS 8 Kiro
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9 • Mainstreaming HIV/AIDS 47 Ken
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Voices of Service Users 10 Precious
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Page 215 and 216: Voices of Health Policy Makers and
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Page 219 and 220: Voices of Facility Managers 11 Nata
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Page 243 and 244: Voices of District Managers 13 Thul
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17 • Health and Related Indicator
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Glossary AIDS Acquired Immune Defic
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• Glossary MEC MINMEC MOU Member
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Index A Abortion (see Termination o
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• Index Condoms .................
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sahr2001 - Health Systems Trust

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