Week 10 - Introduction to Leadership and Governance

Session 1 – What is Health Systems Science?

  1. Spark Questions
  2. Session summary and reflection
  3. Learning Outcome
  4. Concluding Questions: Introduction to Leadership and Governance

Spark Questions

Do you know which level of Government is responsible for the delivery of health care services in South Africa?

In South Africa, the provincial government is primarily responsible for the delivery of healthcare services. The national government sets policies, provides funding, and ensures overall health standards, while the provincial government implements and manages healthcare services within its regions. Local governments may also play a role in certain public health functions, such as environmental health and community-based services.

Session summary and reflection

In South Africa, governance is structured across three levels—national, provincial, and local—each with distinct but interconnected roles.

    • National Government: Responsible for overarching policy, legislation, and coordination across sectors, led by the President and Cabinet. National departments develop policies, initiate laws, and oversee strategic goals.
    • Provincial Government: Manages healthcare, education, and other services within each province. Each province has its own legislature, headed by a Premier and a cabinet, to implement policies aligned with national standards.
    • Local Government: Focuses on municipal services, including sanitation, water, and waste management, operating through elected councils in districts, sub-districts, and wards.

Learning outcome - What is Health Systems Science?

  • Define what a government is.
    • A government is an organization or system that makes and enforces laws, policies, and decisions for a society or country.
  • Define and discuss the concept of health governance.
    • Health governance refers to the structures, processes, and policies that guide decision-making in health systems to improve health outcomes, ensure accountability, and manage resources effectively.
  • Describe the roles of each level of government.
    • National: Sets policies, allocates funding, and creates health legislation.
    • Provincial: Implements policies, manages healthcare facilities, and oversees regional health services.
    • District: Coordinates health services at the district level, allocates resources to local facilities, and monitors district health programs.
    • Local: Provides direct services, manages local health programs, and ensures community health needs are met.
  • Discuss how health districts are managed.
    • Health districts are managed by district health offices, which coordinate healthcare services, allocate resources, monitor health programs, and ensure alignment with provincial and national health policies. 

Conclusion questions: Introduction to Leadership and Governance

Core Content: Health Governance 

  • How is the Government structured in South Africa? 
    • The South African government is structured into three levels: national, provincial, District, and local (municipal),  each with specific powers and responsibilities, operating within a constitutional framework.
  • Who is responsible for delivering healthcare services in South Africa? 
    • Healthcare services are primarily delivered by the provincial governments, with support and oversight from the national government, while local municipalities assist in delivering certain health services at the community level.
  • What roles should each level of government play?
    • National: Sets policies, allocates funding, and creates health legislation.
    • Provincial: Implements policies, manages healthcare facilities, and oversees regional health services.
    • District: Coordinates health services at the district level, allocates resources to local facilities, and monitors district health programs.
    • Local: Provides direct services, manages local health programs, and ensures community health needs are met.

Complementary Content: Health Law

  • What types of law do we have in South Africa? 
    • South Africa’s health system is governed by various laws, including the National Health Act, the Mental Health Care Act, the Medical Schemes Act, and the Medicines and Related Substances Act. These laws regulate healthcare services, patient rights, healthcare funding, and the safety of medicines.
  • What are the different sources of the law that can be drawn upon when making a legal case? 
    • The main sources of law in South Africa are the Constitution, legislation (statutes passed by Parliament), common law (judge-made law), case law (judicial decisions), and customary law.
  • What is the relationship between the law, bioethics and human rights? 
    • The law, bioethics, and human rights are interconnected, as the law upholds bioethical principles like autonomy, beneficence, and justice in healthcare. Human rights ensure individuals’ rights to health, dignity, and equality, while bioethics provides a framework for making morally sound decisions within legal boundaries.