ArticleHealth policy and planning2019
'Doing more with less': a qualitative investigation of perceptions of South African health service managers on implementation of health innovations.
Article in Health policy and planning, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 50 citations in OpenAlex.
- Revolutionising health and social care: innovative solutions for a brighter tomorrow - a systematic review of the literature.BMC health services research · 2024Pooled it
- Siyakhana: A hybrid type 2 effectiveness-implementation stepped-wedge trial to reduce stigma towards substance use and depression among community health workers in HIV/TB care in South Africa.Journal of substance use and addiction treatment · 2025Trial
- Positive attitudes toward adoption of a multi-component intervention strategy aimed at improving HIV outcomes among adolescents and young people in Nampula, Mozambique: perspectives of HIV care providers.BMC health services research · 2023Trial
- The Association of Recurrent and Multiple Types of Abuse with Adverse Mental Health, Substance Use, and Sexual Health Outcomes among Out-of-School Adolescent Girls and Young Women in Cape Town, South Africa.International journal of environmental research and public health · 2021Trial
- Task Sharing or Task Dumping: Counsellors Experiences of Delivering a Psychosocial Intervention for Mental Health Problems in South Africa.Community mental health journal · 2021Trial
- From delay to detection: Dysphagia patterns in tracheostomised ICU patients in South Africa.The South African journal of communication disorders = Die Suid-Afrikaanse tydskrif vir Kommunikasieafwykings · 2025Article
- A stakeholder-driven approach to designing a peer recovery coach role for implementation in community-oriented primary care teams in South Africa.Addiction science & clinical practice · 2025Article
- Digital health readiness - insights from healthcare leaders in operational management: a cross-sectional survey.BMC health services research · 2025Article
- Ideal Clinic Realisation and Maintenance programme implementation in rural KwaZulu-Natal.African journal of primary health care & family medicine · 2024Article
- Capturing sources of health system legitimacy in fragmented conflict zones under different governance models: a case study of northwest Syria.Globalization and health · 2024Article
- A stakeholder-driven approach to designing a peer recovery coach role for implementation in community-oriented primary care teams in South Africa.Research square · 2024Article
- Concept analysis of health system resilience.Health research policy and systems · 2024Review
- Adopting standardized cancer patient pathways as a policy at different organizational levels in the Swedish Health System.Health research policy and systems · 2023Article
- Weighing up the pros and cons of dysphagia triage in South Africa.The South African journal of communication disorders = Die Suid-Afrikaanse tydskrif vir Kommunikasieafwykings · 2023Article
- Strategies for supporting the implementation of a task-shared psychological intervention in South Africa's chronic disease services: qualitative insights from health managers' experiences of project MIND.Global health action · 2022Article
- A Systematic Approach in Developing Management Workforce Readiness for Digital Health Transformation in Healthcare.International journal of environmental research and public health · 2022Review
- Article
- Innovative approaches to strengthening health systems in low- and middle-income countries: Current models, developments, and challenges.Health policy and technology · 2021Article
- Integration of mental health counselling into chronic disease services at the primary health care level: Formative research on dedicated versus designated strategies in the Western Cape, South Africa.Journal of health services research & policy · 2021Article
- Implementation science outcomes of a gender-focused HIV and alcohol risk-reduction intervention in usual-care settings in South Africa.Drug and alcohol dependence · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
Building resilience in health systems is an imperative for low- and middle- income countries. Health service managers' ability to implement health innovations may be a key aspect of resilience in primary healthcare facilities, promoting adaptability and functionality. This study investigated health service managers' perceptions and experiences of adopting health innovations. We aimed to identify perceptions of constraints to adoption and emergent behaviours in response to these constraints. A convenience sample of 34 facility, clinical service and sub-district level managers was invited to participate. Six did not respond and were not contactable. In-depth individual interviews in a private space at participants' place of work were conducted with 28 participants. Interviews were audio recorded and transcribed verbatim. NVivo 11 was used to store data and facilitate framework analysis. Study participants described constraints to innovation adoption including: staff lack of understanding of potential benefits; staff personalities, attitudes and behaviours which lead to resistance to change; high workload related to resource constraints and frequent policy changes inducing resistance to change; and suboptimal communication through health system structures. Managers reported employing various strategies to mitigate these constraints. These comprised (1) technical skills including participatory management skills, communication skills, community engagement skills and programme monitoring and evaluation skills, and (2) non-technical skills including role modelling positive attitudes, understanding staff personalities, influencing perceptions of innovations, influencing organizational climate and building trusting relationships. Managers have a vital role in the embedding of service innovations into routine practice. We present a framework of technical and non-technical skills that managers need to facilitate the adoption of health innovations. Future efforts to build managers' capacity to implement health innovations should target these competencies.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.