Week 10 - Introduction to Leadership and Governance
Session 2 - Unpacking Levels of Governance in Health
- Spark Questions
- Session summary and reflection
- Learning Outcome
Session summary and reflection
Before 1994, healthcare was fragmented across 14 ethnically-based departments, leading to unequal access based on race, location, and income. Post-1994 reforms aimed to unify healthcare under one national system and focus on primary health as the foundation of public healthcare, guided by the principles of social and economic justice from the Freedom Charter and the Reconstruction and Development Programme (RDP).
Health services are organized into districts to improve access and streamline service delivery. Each district aligns with municipal boundaries and is managed by the provincial government, facilitating coordination between provincial and local health needs.
Districts are subdivided into sub-districts and wards, with each ward having a councilor and committee to address specific community needs, making healthcare accessible at the grassroots level.
The overarching vision is a “long and healthy life for all South Africans.” The focus areas include tackling the country’s quadruple burden of disease (HIV/AIDS, tuberculosis, maternal and child mortality, and non-communicable diseases), strengthening the primary health care system, and promoting health equity through universal health coverage.
The NDoH collaborates with other departments (such as Education and Social Development) to ensure a holistic approach to health, addressing social determinants like education, poverty, and infrastructure.
Learning Outcome - Defining Health
- Describe the levels of government and explain the role of each tier 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.
- Explain how each tier of government as they relate to health care delivery.
- National Level: Establishes health policies and standards, ensures funding for provincial health services, and oversees the national health system.
- Provincial Level: Operates provincial hospitals and clinics, adapts national health policies to meet local needs, and ensures the quality of healthcare within the province.
- District Level: Facilitates healthcare coordination across local municipalities, monitors district health program outcomes, and supports equitable resource distribution within the district.
- Local Level: Delivers primary healthcare services, manages community health programs (e.g., immunizations, health education), and addresses public health issues such as sanitation and water safety at the local level.