Browsing by Author "Mathews, Verona"

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    Constraints to implementing an equity-promoting staff allocation policy: understanding key actors perspectives affecting implementation in South Africa
    (Oxford University Press, 2012) Scott, Vera; Mathews, Verona; Gilson, Lucy
    Much of current research on issues of equity in low- and middle-income countries focuses on uncovering and describing the extent of inequities in health status and health service provision. In terms of policy responses to inequity, there is a growing body of work on resource reallocation strategies. However, little published work exists on the challenges of implementing new policies intended to improve equity in health status or health service delivery. While the appropriateness of the technical content of policies clearly influences whether or not they promote equity, policy analysis theory suggests that it is important to consider how the processes of policy development and implementation influence policy achievements. Drawing on actor analysis and implementation theory, we seek to understand some of the dynamics surrounding the proposed implementation of one set of South African staff allocation strategies responding to broader equity-oriented policy mandates. These proposals were developed by a team of researchers and mid-level managers in 2003 and called for the reallocation of staff between better- and lesser-resourced districts in the Cape Town Metropolitan region to reduce broader resource allocation inequities. This was felt necessary because up to 70% of public health expenditure was on staff, and new financing for health care was unavailable. We focus on the views and reactions of the two sets of implementing actors most directly influenced by the proposed staff reallocation strategies: district health managers and clinic nurses. One strength of this analysis is that it gives voice to the experience of the district level—the key but much neglected implementation arena in a decentralized health system. The paper’s findings unpack differences in these actors’ positions on the proposed strategies, and explore the factors influencing their positions. Ultimately, we show how a lack of trust in the relationships between mid-level managers and nurse service providers influenced the potential to implement a specific set of equity-oriented strategies
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    Human resource management in a district health system in the public health sector
    (AOSIS, 2025) Mathews, Verona
    Orientation: There is a misalignment between the strategic goals of the public health sector, which include strengthening health systems to produce desired health outcomes, and the human resource management of the human resources for health. Research purpose: This study aimed to describe the extent and identify the factors influencing the human resource management in achieving the strategic objectives of the public health sector. Motivation for the study: Managers in the public health sector can develop interventions and effective procedures to improve alignment in the human resource management of the human resources for health to improve health outcomes. Research approach/design and method: A qualitative descriptive study design with an interpretivist approach was utlised to conduct the study. A document review and sixteen face-to-face interviews were conducted, eight human resource (HR) practitioners and eight line managers purposively selected from an urban and rural district. Main findings: The public health sector provides a unique context that requires different considerations for human resource management. Human resource managers and line managers do not only have different backgrounds and orientations but they also function in different contexts (administrative vs. clinical) in the public health sector. The factors influencing effective human resource management are as follows: the lack of capacity to implement key HR strategies in the public health sector, competing priorities and the absence of clear roles in performing human resource practices. Practical/managerial implications: There is a need to foster a partnership approach between the HR manager and line manager to provide effective human resources management as it is complex and fractured, particularly during change and decentralisation. Contribution/value-add: This article addresses the research gap on human resource management in the public health sector shifting focus from individual practices to a systems thinking approach in strengthening human resource management. It also makes a theoretical contribution by adding context to human resource management as a key requirement for implementation decision making.
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    Information for human resource management
    (Health Systems Trust, 2005) Mathews, Verona
    This chapter emphasises the need for a routine information system for Human Resources Management (HRM). It provides an assessment of the current information system for HRM using a case study approach. It also outlines a suggested approach for the development of a Routine Information System with an Essential Data Set for HRM. Finally, it provides an overview of proposed indicators to produce information for the management and monitoring of Human Resources for the health sector.
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    Research to action to address inequities: The experience of the Cape Town Equity Gauge
    (BioMed Central, 2008-01-04) Scott, Vera; Stern, Ruth; Sanders, David; Reagon, Gavin; Mathews, Verona
    BACKGROUND: While the importance of promoting equity to achieve health is now recognised, the health gap continues to increase globally between and within countries. The description that follows looks at how the Cape Town Equity Gauge initiative, part of the Global Equity Gauge Alliance (GEGA) is endeavouring to tackle this problem. We give an overview of the first phase of our research in which we did an initial assessment of health status and the socio-economic determinants of health across the subdistrict health structures of Cape Town. We then describe two projects from the second phase of our research in which we move from research to action. The first project, the Equity Tools for Managers Project, engages with health managers to develop two tools to address inequity: an Equity Measurement Tool which quantifies inequity in health service provision in financial terms, and a Equity Resource Allocation Tool which advocates for and guides action to rectify inequity in health service provision. The second project, the Water and Sanitation Project, engages with community structures and other sectors to address the problem of diarrhoea in one of the poorest areas in Cape Town through the establishment of a community forum and a pilot study into the acceptability of dry sanitation toilets. METHODS: A participatory approach was adopted. Both quantitative and qualitative methods were used. The first phase, the collection of measurements across the health subdistricts of Cape Town, used quantitative secondary data to demonstrate the inequities. In the Equity Tools for Managers Project further quantitative work was done, supplemented by qualitative policy analysis to study the constraints to implementing equity. The Water and Sanitation Project was primarily qualitative, using in-depth interviews and focus group discussions. These were used to gain an understanding of the impact of the inequities, in this instance, inadequate sanitation provision. RESULTS: The studies both demonstrate the value of adopting the GEGA approach of research to action, adopting three pillars of assessment and monitoring; advocacy; and community empowerment. In the Equity Tools for Managers Project study, the participation of managers meant that their support for implementation was increased, although the failure to include nurses and communities in the study was noted as a limitation. The development of a community Water and Sanitation Forum to support the Project had some notable successes, but also experienced some difficulties due to lack of capacity in both the community and the municipality. CONCLUSION: The two very different, but connected projects, demonstrate the value of adopting the GEGA approach, and the importance of involvement of all stakeholders at all stages. The studies also illustrate the potential of a research institution as informed 'outsiders', in influencing policy and practice.
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    Risk factors for incident HIV infection among antenatal mothers in rural Eastern Cape, South Africa
    (Taylor & Francis Open Access, 2016) Businge, Charles Bitamazire; Longo-Mbenza, Benjamin; Mathews, Verona
    The prevalence of HIV among antenatal clients in South Africa has remained at a very high rate of about 29% despite substantial decline in several sub-Saharan countries. There is a paucity of data on risk factors for incident HIV infection among antenatal mothers and women within the reproductive age bracket in local settings in the Eastern Cape, South Africa.To establish the risk factors for incident HIV infection among antenatal clients aged 1849 years attending public antenatal clinics in rural Eastern Cape, South Africa.
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    Skills and competencies in health data analytics for health professionals: a scoping review protocol
    (BMJ Publishing Group, 2023) Nkwanyana, Akhona; Mathews, Verona; Zachary, Iris; Bhayani, Vishwa
    Introduction Healthcare data analytics is a methodological approach to the systematic analysis of health data, and it provides opportunities for healthcare professionals to improve health system management, patient engagement, budgeting, planning and performing evidence-based decision-making. Literature suggests that certain skills and/or competencies for health professionals working with big data in health care would be required. A review of the skills and competencies in health data analytics required by health professionals is needed to support the development or re-engineering of curriculum for health professionals to ensure they develop the abilities to make evidence-based decisions that ultimately can lead to the effective and efficient functioning of a healthcare system. Methods Using Arksey and O'Malley's framework, this study will review literature published in English from January 2012 to December 2022. The database search includes Academic Search Complete, CINAHL, and MEDLINE via EBSCOhost, PubMed, Science Direct, Scopus, and Taylor and Francis. The reference lists of key studies will be searched to identify additional appropriate studies to include. The review will be conducted using an inclusion and exclusion criteria. Iterative processes will be involved at the various stages of search strategy piloting, screening and data extraction. Articles will be reviewed through a two-step process (title and abstract, and full-text review) by at least two reviewers.