RHD Prelude Chapter - Health Systems Trust

Health District Management
The organogramme below (Figure 2.6) shows the generic structure of the health district
management team. Each district varies according to local need and staffing numbers. In Ganyesa,
the rural health district, some area managers have responsibility for a particular health programme
as well; in Klerksdorp, the urban health district, the municipal employed health manager and
facility managers are part of the management team, although they report to the municipal
structures as their line managers. There is no single person appointed in any health district to
be in charge of reproductive health. As at national and provincial levels, the responsibility is
shared among a number of officials, all of whom report to the Assistant Director- Community
Health Services (ADCHS).
Figure 2.6: North West Province - Health District Generic Organogramme
Regional Director
Health District Level
Health District Manager
AD Administration
AD Community
Health Services
49
Finances
Programme Manager
MCWH, Com Dis
Human Resources
Health Area Managers
Other support
services
CHC, Clinics, Mobiles
Source: NW PDoH, 2003
Health services in districts are delivered through Health Areas, each managed by an appointed
Health Area Manager who is in charge of the community health centres, clinics, mobiles and
other services in their areas. Facility managers take responsibility for the services within their
facility, including contributing to the budgeting process. Facility managers report to the area
managers who assists them in solving problems. Patients requiring higher level of care are
referred, by ambulance or private transport, to the district hospital. The district hospital is under
a separate management structure. In some health districts there is no district hospital. These
services are then supplied by a regional or provincial hospital that is located within the health
district.
Services are rendered as a comprehensive, integrated service, often referred to as a ‘supermarket’,
one-stop approach. This means that all services are available at all times that the clinic is open.
The opening times of clinics vary. As far as possible there is a community health centre (CHC)
within each health area that provides 24 hour service, including maternity care. Problem cases
are referred from the CHC to a hospital.