Small business education and training in Transkei
In: Development Southern Africa, Band 8, Heft 3, S. 313-328
ISSN: 1470-3637
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In: Development Southern Africa, Band 8, Heft 3, S. 313-328
ISSN: 1470-3637
Since the publication of the Government-Wide Monitoring and Evaluation Policy Framework (GWM&EPF) by the Presidency in South Africa (SA), several policy documents giving direction, clarifying context, purpose, vision, and strategies of M&E were developed. In many instances broad guidelines stipulate how M&E should be implemented at the institutional level, and linked with managerial systems such as planning, budgeting, project management and reporting. This research was undertaken to examine how the 'institutionalisation' of M&E supports meaningful project implementation within the public sector in South Africa (SA), with specific reference to the Department of Rural Development and Land Reform (DRD&LR). This paper provides a theoretical and analytical framework on how M&E should be "institutionalised", by emphasising that the IM&E is essential in the public sector, to both improve service delivery and ensure good governance. It is also argued that the M&E has the potential to support meaningful implementation, promote organisational development, enhance organisational learning and support service delivery.
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Since the publication of the Government-Wide Monitoring and Evaluation Policy Framework (GWM&EPF) by the Presidency in South Africa (SA), several policy documents giving direction, clarifying context, purpose, vision, and strategies of M&E were developed. In many instances broad guidelines stipulate how M&E should be implemented at the institutional level, and linked with managerial systems such as planning, budgeting, project management and reporting. This research was undertaken to examine how the 'institutionalisation' of M&E supports meaningful project implementation within the public sector in South Africa (SA), with specific reference to the Department of Rural Development and Land Reform (DRD&LR). This paper provides a theoretical and analytical framework on how M&E should be "institutionalised", by emphasising that the IM&E is essential in the public sector, to both improve service delivery and ensure good governance. It is also argued that the M&E has the potential to support meaningful implementation, promote organisational development, enhance organisational learning and support service delivery.
BASE
Background. The proposed National Health Insurance (NHI) system aims to re-engineer primary healthcare (PHC) provision in South Africa, with strategic purchasing of services from both private and public sector providers by the NHI Fund. Currently, while access to the private sector is primarily restricted to high-income insured earners, an important proportion of the low-income segment is choosing to utilise private PHC providers over public sector clinics. In recent years, a number of private providers in SA have established innovative models of PHC delivery that aim to expand access beyond the insured population and provide affordable access to good-quality PHC services.Objectives. To describe the current landscape of private PHC clinic models targeting low-income, uninsured earners and the role they might play during the transition to NHI.Methods. Key informant interviews were conducted with representatives of a sample of private PHC provider organisations providing services to low-income, uninsured earners with clinics – beyond the traditional private sector general practitioner model. Organisations were asked to describe their service delivery model, the population it serves, the PHC services offered and the financing model. Written responses were captured in Excel and coded manually, and the results were thematically analysed.Results. Of the eight organisations identified, most have actively engaged strategies to ensure the provision of affordable quality care. Within these strategies, scale is an important pivot in spreading fixed costs across more paying patients as well as task shifting to lower cadres of healthcare workers. Access to government medicines and laboratory tests is an important factor in achieving lower costs per patient. Together, these strategies support the sustainability of these models.Conclusions. We have provided an exploratory analysis of private PHC service delivery models serving the low-income, uninsured patient population, establishing factors that increase the efficiency of such service delivery, and delineating combinations of strategies that could make these models successful both during the transition to NHI and during full-scale NHI implementation. A clear regulatory framework would act as a catalyst for further innovation and facilitate contracting. These existing models can enhance and complement government provision and could be scaled up to meet the needs of expanding PHC under NHI. Understanding these models and the space and parameters in which they operate is important.
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Adolescents are the only age group with growing AIDS-related morbidity and mortality in Eastern and Southern Africa, making HIV prevention research among this population an urgent priority. Structural deprivations are key drivers of adolescent HIV infection in this region. Biomedical interventions must be combined with behavioural and social interventions to alleviate the socio-structural determinants of HIV infection. There is growing evidence that social protection has the potential to reduce the risk of HIV infection among children and adolescents. This research combined expert consultations with a rigorous review of academic and policy literature on the effectiveness of social protection for HIV prevention among children and adolescents, including prevention for those already HIV-positive. The study had three goals: (i) assess the evidence on the effectiveness of social protection for HIV prevention, (ii) consider key challenges to implementing social protection programmes that promote HIV prevention, and (iii) identify critical research gaps in social protection and HIV prevention, in Eastern and Southern Africa. Causal pathways of inequality, poverty, gender and HIV risk require flexible and responsive social protection mechanisms. Results confirmed that HIV-inclusive child-and adolescent-sensitive social protection has the potential to interrupt risk pathways to HIV infection and foster resilience. In particular, empirical evidence (literature and expert feedback) detailed the effectiveness of combination social protection particularly cash/in-kind components combined with "care" and "capability" among children and adolescents. Social protection programmes should be dynamic and flexible, and consider age, gender, HIV-related stigma, and context, including cultural norms, which offer opportunities to improve programmatic coverage, reach and uptake. Effective HIV prevention also requires integrated social protection policies, developed through strong national government ownership and leadership. Future ...
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Background: The COVID-19 pandemic has disrupted routine hospital services globally. This study estimated the total number of adult elective operations that would be cancelled worldwide during the 12 weeks of peak disruption due to COVID-19. Methods: A global expert response study was conducted to elicit projections for the proportion of elective surgery that would be cancelled or postponed during the 12 weeks of peak disruption. A Bayesian β-regression model was used to estimate 12-week cancellation rates for 190 countries. Elective surgical case-mix data, stratified by specialty and indication (surgery for cancer versus benign disease), were determined. This case mix was applied to country-level surgical volumes. The 12-week cancellation rates were then applied to these figures to calculate the total number of cancelled operations. Results: The best estimate was that 28 404 603 operations would be cancelled or postponed during the peak 12 weeks of disruption due to COVID-19 (2 367 050 operations per week). Most would be operations for benign disease (90·2 per cent, 25 638 922 of 28 404 603). The overall 12-week cancellation rate would be 72·3 per cent. Globally, 81·7 per cent of operations for benign conditions (25 638 922 of 31 378 062), 37·7 per cent of cancer operations (2 324 070 of 6 162 311) and 25·4 per cent of elective caesarean sections (441 611 of 1 735 483) would be cancelled or postponed. If countries increased their normal surgical volume by 20 per cent after the pandemic, it would take a median of 45 weeks to clear the backlog of operations resulting from COVID-19 disruption. Conclusion: A very large number of operations will be cancelled or postponed owing to disruption caused by COVID-19. Governments should mitigate against this major burden on patients by developing recovery plans and implementing strategies to restore surgical activity safely.
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