ArticleHealth policy and planning2020
Decision space and participation of primary healthcare facility managers in the Ideal Clinic Realisation and Maintenance programme in two South African provinces.
Article in Health policy and planning, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Policy implementers' perspectives of the implementation of the national guidelines for patient safety incident reporting in selected South African public hospitals.BMC health services research · 2026Article
- Research gaps on universal health coverage in the South African context and other low and middle-income countries; putting things into perspective: a scoping review.BMC health services research · 2026Article
- Perceptions of healthcare practitioners about NHI implementation in the public sector in Sedibeng district, Gauteng province.BMC health services research · 2025Article
- Professional nurses' perspectives on the influence of Ideal Clinic status on patient care quality in eThekwini, South Africa.Health SA = SA Gesondheid · 2025Article
- Contested and nervous spaces: exploring the environment of healthcare provision for international migrants in the Gauteng province of South Africa.Global health action · 2024Article
- Nurse perceptions of practice environment, quality of care and patient safety across four hospital levels within the public health sector of South Africa.BMC nursing · 2024Article
- The Meso-Level in Quality Improvement: Perspectives From a Maternal-Neonatal Health Partnership in South Africa.International journal of health policy and management · 2024Article
- Ensuring leadership at the operational level of a health system in protracted crisis context: a cross-sectional qualitative study covering 8 health districts in Eastern Democratic Republic of Congo.BMC health services research · 2023Article
- Article
- Hospital managers' views on the state of patient safety culture across three regions in Ghana.BMC health services research · 2022Article
- Newborn and infant hearing screening at primary healthcare clinics in South Africa designated as National Health Insurance pilot sites: An exploratory study.The South African journal of communication disorders = Die Suid-Afrikaanse tydskrif vir Kommunikasieafwykings · 2022Article
- Leveraging HIV Care Infrastructures for Integrated Chronic Disease and Pandemic Management in Sub-Saharan Africa.International journal of environmental research and public health · 2021Article
- Implementing the Ideal Clinic Program at Selected Primary Healthcare Facilities in South Africa.International journal of environmental research and public health · 2021Article
- Providers' definitions of quality and barriers to providing quality care: a qualitative study in rural Mpumalanga Province, South Africa.Journal of global health science · 2021Article
- Article
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3 authors.
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No grant is acknowledged in the PubMed record.
Abstract
In South Africa, the introduction of a national health insurance (NHI) system is the most prominent health sector reform planned to achieve universal health coverage in the country. Primary health care (PHC) is the foundation of the proposed NHI system. This study draws on policy implementation theory and Bossert's notion of decision space to analyse PHC facility managers' decision space and their participation in the implementation of the Ideal Clinic Realisation and Maintenance (ICRM) programme. We conducted a cross-sectional survey among 127 PHC facility managers in two districts in Gauteng and Mpumalanga provinces. A self-administered questionnaire elicited socio-demographic information, the PHC managers' participation in the conceptualization and implementation of the ICRM programme, their decision space and an optional open-ended question for further comments. We obtained a 100% response rate. The study found that PHC facility managers reported lack of involvement in the conceptualization of the ICRM programme, high levels of participation in implementation [mean score 5.77 (SD ±0.90), and overall decision space mean score of 2.54 (SD ±0.34)]. However, 17 and 21% of participants reported narrow decision space on the critical areas of the availability of essential medicines and on basic resuscitation equipment respectively. The qualitative data revealed the unintended negative consequences of striving for 'ideal clinic status', namely that of creating an illusion of compliance with the ICRM standards. The study findings suggest the need for greater investment in the health workforce, special efforts to involve frontline managers and staff in health reforms, as well as provision of adequate resources, and an enabling practice environment.
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