Analysis of Financial Management at a District Level in ... · Analysis of Financial Management at...
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Analysis of Financial Management at a District Level in the South African Health Sector
Choonara, S.1* Eyles, J. Goudge, J. Nxumalo, N. *PhD Research Intern, [email protected]/ +2711 717 3438
Background:
1. European Union. Informal Meeting of Health Ministers. Economic Crises and Healthcare Discussion Paper. 5/05/2014]; Available from: http://gr2014.eu/sites/default/files/Athens%20Informal%2028-29.4 %20-%20Session%20II%20-%20Economic%20crisis%20and%20healthcare.pdf. 2. Von Holdt, K.M., M, Public Hospitals in South Africa: Stressed Institutions. Disempowered Management. . Management in Public Hospitals in South Africa. , 2006. 3. https://www.google.com/search?hl=en&site=imghp&tbm=isch&source=hp&biw=1600&bih=809&q=sa+money&oq=sa+money&gs_l=img.3..0l10.3100.5423.0.5752.10.8.0.1.1.0.375.894.2-1j2.3.0....0...1ac.1.53 .img..7.3.522.IxJBoLUMt5c#facrc=_&imgdii=_&imgrc=gDvuoW4YECcRpM%253A%3Baz-AD0aPw1xv4M%3Bhttp%253A%252F%252Fplascontrends.co.za%252Fwp-content%252Fuploads%252F2012%252F11%252 FNew-Notes-Image-Source-techcentral.co_.za_.jpg%3Bhttp% 253A%252F%252Fplascontrends.co.za%252Fmadiba-rand-notes-money-money-money%252F%3B640%3B350. Accessed 09-09-2014.
• Effective financial management (FM) is required across developed and developing countries
which face the dilemma of curbing health expenditure yet ensuring the delivery of quality
health services [1].
• Presently, the South African (SA) health system is characterised by inadequate FM [2].
Aim (Phase 1-Ongoing): • To provide an-in-depth analysis of the district’s (local level) finance unit.
Employee Centred
Director
Level of Actor
External
Provincial
District
Sub-district
DD Finance
Controller
Capturer Chief Clerk
Controller (Vacancy)
Controller Controller Controller
AD Finance
Capturer Capturer Petty Cash
Clerk Clerk
Intern Intern
Facility Managers
NGOs Finance Specialist
Finance Analyst
Treasury DOH
AD HR
Figure 1: Actor Map (Organogram) District Finance Unit By: S Choonara
Key: Direct Relationship Indirect Relationship
Level
External
Provincial
District
Actor
NGOs
DD Finance
AD Finance
Controller
Controller
Petty Cash
Intern
Provincial Finance
Meetings
Area Manager
Provincialisation
ProcFin Budget
DHER
DHP
DMT
Local Authority
Mental Health NGO
Finance Forum/ Internal
APU DHCTC EXCO
Figure 2: Meetings Attended District Finance Unit By: S Choonara
References & Acknowledgement(s):
Tools & Analysis:
- In-depth Interviews -Thematic
Sampling: -Purposive & Snowballing
Sample: -7 of 35 key participants interviewed
thus far
Sites: -2 health
districts, in SA
Study Design:
-Qualitative
-Case study
Methodology
• Senior staff attend a high number of meetings and do not have the
time to attend to the workload/ FM tasks adequately.
• Junior staff attend few or no meetings & have no knowledge of the
content/ key points of meetings.
• There is a disjunction between the junior & senior staff indicating a
lack of teamwork which is possibly affecting the district’s FM.
• Health systems in SA currently operates in chaos this organogram is
useful for internal communication and staff understanding the structure
of the finance department.
-Presently staff members in the district’s finance unit operate in isolation, there is a lack of teamwork. -There is a lack of communication and the high number of meetings attended by senior staff is hampering functioning of the district’s FM.
-It is evident that minor changes are required to yield big improvements in FM at a district level.
Preliminary Results (1 District)