Browsing by Author "van Belle, Sara B."

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    COVID-19 and informal settlements: An urgent call to rethink urban governance
    (Springer Nature, 2020) Tabana, Hanani; van Belle, Sara B.; Affun-Adegbulu, Clara
    While some countries are nearing or reaching their peak of coronavirus infections, others are only at what seems to be the early stages of the infection curve. Some of these countries, particularly in the Global South, contain some of the world’s largest informal and/or urban settlements and are low resource settings. Given that the last few months have shown us how quickly COVID-19 can push health systems to the brink or overwhelm them, even in high-income countries, it is worrying to think what would happen if the outbreak becomes severe in such contexts.
  • Thumbnail Image
    Item
    The crowded space of local accountability for maternal, newborn and child health: A case study of the South African health system
    (Oxford University Press, 2020) Mukinda, Fidele Kanyimbu; van Belle, Sara B.; George, Asha S.
    Global and national accountability for maternal, newborn and child health (MNCH) is increasingly invoked as central to addressing preventable mortality and morbidity. Strategies of accountability for MNCH include policy and budget tracking, maternal and perinatal death surveillance, performance targets and various forms of social accountability. However, little is known about how the growing number of accountability strategies for MNCH is received by frontline actors, and how they are integrated into the overall functioning of local health systems. We conducted a case study of mechanisms of local accountability for MNCH in South Africa, involving a document review of national policies, programme reports, and other literature directly or indirectly related to MNCH, and in-depth research in one district. The latter included observations of accountability practices (e.g. through routine meetings) and in-depth interviews with 37 purposely selected health managers and frontline health workers involved in MNCH. Data collection and analysis were guided by a framework that defined accountability as answerability and action (both individual and collective), addressing performance, financial and public accountability, and involving both formal and informal processes. Nineteen individual accountability mechanisms were identified, 10 directly and 9 indirectly related to MNCH, most of which addressed performance accountability.
  • Thumbnail Image
    Item
    Perceptions and experiences of frontline health managers and providers on accountability in a South African health district
    (Springer Nature, 2020) Mukinda, Fidele Kanyimbu; van Belle, Sara B.; Schneider, Helen
    Public primary health care and district health systems play important roles in expanding healthcare access and promoting equity. This study explored and described accountability for this mandate as perceived and experienced by frontline health managers and providers involved in delivering maternal, newborn and child health (MNCH) services in a rural South African health district. Methods: This was a qualitative study involving in-depth interviews with a purposive sample of 58 frontline public sector health managers and providers in the district office and two sub-districts, examining the meanings of accountability and related lived experiences. A thematic analysis approach grounded in descriptive phenomenology was used to identify the main themes and organise the findings. Results: Accountability was described by respondents as both an organisational mechanism of answerability and responsibility and an intrinsic professional virtue. Accountability relationships were understood to be multidirectional - upwards and downwards in hierarchies, outwards to patients and communities, and inwards to the 'self'.