Implementation of National Health Insurance in South Africa: views of healthcare managers in a private healthcare institution
- Authors: Grewar, David Alan
- Date: 2017
- Subjects: National health insurance -- South Africa , Health care reform -- South Africa , Medical personnel -- South Africa
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10948/7503 , vital:21789
- Description: South Africa is in the process of reforming its healthcare system by implementing universal health coverage for its citizens. Universal health coverage is defined as the access of all people to comprehensive health services at an affordable cost with protection against catastrophic health expenditures leading to financial hardship. The system being implemented in South Africa is known as National Health Insurance (NHI) and is seen by the South African government as the key to addressing the shortcomings and disparities in the current public and private healthcare sectors. Healthcare managers have a crucial role to play in health reform yet are often overlooked in debate over health reform. The primary aim of this study was to better understand the views of healthcare managers, working in a private healthcare institution in South Africa, towards the implementation of the NHI. The purpose of this was to make recommendations that would assist the private healthcare institution under investigation to optimise the implementation of the NHI. A quantitative research design was used to explore and describe the views of healthcare managers. Firstly, a literature review was conducted to gain international as well as local perspectives of healthcare practitioners on universal health coverage. Secondly, a census survey in the form of an online questionnaire was developed and distributed to 193 healthcare managers representing different managerial and medical disciplines in a private healthcare institution with facilities nation-wide. A total of 63 questionnaires were returned for analysis. Quantitative data were analysed using Microsoft Excel, Statistica and SPSS Statistics. Qualitative data in the form of written comments by the participants were analysed using interpretive analysis that involved sequential steps of familiarisation and immersion, development of themes, coding, elaboration and interpretation and checking. The qualitative element of the study was limited in nature and was used merely to enrich the quantitative findings. The study found that there was a lack of knowledge amongst private healthcare managers concerning the NHI, poor communication from the government regarding the proposed NHI and high levels of negativity towards the ability of the government to successfully implement the NHI. However it was found that despite concerns regarding the NHI, the private healthcare managers surveyed showed a willingness to actively participate in its implementation. Recommendations regarding policy and practise were made for private healthcare institutions as well as for the South African government in order to assist with the implementation of the NHI.
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- Date Issued: 2017
Consumer decision-making processes for scholar transportation in South African cities: the case of Johannesburg and Pretoria
- Authors: Letsholonyane, Nelly
- Date: 2016
- Subjects: Consumer behavior -- South Africa -- Johannesburg Consumer behavior -- South Africa -- Pretoria
- Language: English
- Type: Thesis , Masters , MBA
- Identifier: http://hdl.handle.net/10948/13283 , vital:27171
- Description: Scholar transport in South Africa remains an area that needs to be addressed in the interest of all communities, rich and poor alike. The National Development Plan 2030, provides a clarion call for nation building to develop highly knowledgeable South African citizens for building innovative capacity for the nation as a whole(NDP, 2014).
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- Date Issued: 2016
Investigating the effectiveness of environmental sustainability initiatives at General Motors South Africa
- Authors: Walsh, Lauren Arlene
- Date: 2013
- Subjects: General Motors Corporation , Sustainable development , Economic development -- Environmental aspects , Industrial management -- Environmental aspects
- Language: English
- Type: Thesis , Masters , MBA
- Identifier: vital:8903 , http://hdl.handle.net/10948/d1020996
- Description: There is a consensus globally that climate change is one of the biggest challenges facing operations. Immediate actions are required to reduce the carbon footprint in order for the environment to endure future logistics processes and activities (The National Treasury department of South Africa, 2010). Greenhouse gases (GHGs) are emissions generated from manufacturing processes, distribution networks and treatments processes (Verfaillie and Bidwell, 2000). Companies globally are expected to monitor pollution and focus on reducing the discharge of pollutants. Logistics Managers are therefore pressured to reduce the carbon footprint as it affects the environment and our health. Companies are becoming more concerned with the impact of various activities and processes on the environment. Traditional logistics models, primarily focuses on minimising cost with little focus on the environmental impact and sustaining operations for the future (Sbihi and Eglese, 2009) General Motors (GM) is a multi-national vehicle manufacturer with operations in various countries. GM filed for bankruptcy in 2009 resulting in the formation of the new GM; one of the focus areas was to ensure sustainability which resulted in the introduction of the ‘Sustainability in motion’ program in 2009 (New York Times, 2009). General Motors South Africa (GMSAf) is a vehicle assembler with manufacturing facilities and head offices located in Port Elizabeth. The company is a wholly owned subsidiary of the multinational General Motors Company. The aim of the research is to determine whether a culture that promotes environmentally conscious behaviour exists within employees and their relationships within a team, with management, stakeholders and suppliers. The study will assist in highlighting areas which need improvement to enable the creation of environmentally sustainable initiatives and implementation thereof. The empirical study revealed that the following management commitment, education and training, performance management and participation and involvement were important factors in the effective implementation of an environmental sustainability program.
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- Date Issued: 2013
Green business and environmental issues: family versus non-family business
- Authors: Grobler, Marthinus Petrus Johannes
- Date: 2012
- Subjects: Environmental impact analysis -- South Africa , Family-owned business enterprises
- Language: English
- Type: Thesis , Masters , MBA
- Identifier: vital:8636 , http://hdl.handle.net/10948/d1008058 , Environmental impact analysis -- South Africa , Family-owned business enterprises
- Description: The aim of the study was to understand whether family businesses and non-family business differ from one another regarding green business and environmental issues. Green business issues are of global importance for the continued existence of business within the world. Businesses do not exist in isolation but within the context of the environment within which they function. Business has an impact on the environment and the environment has an impact on business. Furthermore, family businesses constitute a large part of the world economy and estimates range from 60-90 percent of GDP contributed by family businesses. In the South African context family businesses also form a significant part of the business environment. A literature study was conducted. The study identified five factors and considered each of these factors in the study. The five factors are: Green Business; Values; Stewardship; Succession; and, Stakeholders. In addition to a literature, primary research was conducted and data were collected by means of a questionnaire that collected data on the factors identified as well as some biographical information, including race, age and the sectors in which the respondents operated. The study’s findings correspond with the literature study, although no clear difference was found between family business and non-family business relating to green business and environmental issues. Family businesses do however believe that they are stewards of the environment and need to care for the environment.
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- Date Issued: 2012
The effects of goat browsing on ecosystem patterns and processes in succulent thicket, South Africa
- Authors: Lechmere-Oertel, Richard Geoffrey
- Date: 2003
- Subjects: Succulent plants -- South Africa -- Eastern Cape , Landscape ecology -- South Africa -- Eastern Cape , Goats -- Feeding and feeds
- Language: English
- Type: Thesis , Doctoral , PhD
- Identifier: vital:11074 , http://hdl.handle.net/10948/309 , Succulent plants -- South Africa -- Eastern Cape , Landscape ecology -- South Africa -- Eastern Cape , Goats -- Feeding and feeds
- Description: Transformation in the arid succulent thicket of the Eastern Cape of South Africa in response to unsustainable livestock production has been widespread, with less than 10 percent remaining intact. Transformation in succulent thicket has resulted in large areas of dense thicket (comprising a two-phase mosaic of perennial-vegetated patches separated by animal paths and bare patches) being replaced with a ‘pseudo-savanna’ of remnant canopy trees with a structurally simple field layer of ephemeral and short- lived perennial grasses and forbs. There is an extensive literature describing the transformation of succulent thicket, with many speculative statements about the underlying mechanisms of transformation. The central focus of this study was to improve our mechanistic understanding of transformation in succulent thicket using field experiments. Hopefully these results will set another foundation upon which future management of succulent thicket can be improved and large-scale restoration initiated. This study comprises four themes that are linked to the concept of landscape function. The central premise of landscape function is that functional landscapes have mechanisms that capture and retain scarce resources. Conversely, as landscapes become increasingly dysfunctional, so these mechanisms become disrupted. In succulent thicket, dysfunctio n appears to be linked to the reduced ability to harvest water, cycle carbon and a loss of organic carbon. In this thesis I examined some of the key processes that influence water and organic carbon fluxes: perennial vegetation cover, soil fertility, litter fall and decomposition, and runoff and soil erosion. The experimental design that was used for all this work was a factorial ANOVA based on replicated fenceline contrasts that reflect differences in long-term management history. The main objectives of this thesis were to: quantify the patterns of transformation in an arid form of succulent thicket, including changes in the biomass, cover and structure of the dominant vegetation guilds; test the stability of the transformed succulent thicket ecosystem to show whether it is a new stable state or an intermediate stage in a trajectory towards a highly desertified state where only the ephemeral grasses and forbs persist; describe and compare soil fertility across transformation contrasts, concentrating on changes in the spatial patterns of soil resources and the ability of the soil to harvest precipitation; to compare litter fall and decomposition of leaf material from the dominant plants in intact and transformed succulent thicket; to quantify and compare run-off and erosion from run-off plots in intact and transformed succulent thicket. Transformation and stability I quantified the changes in plant diversity, physiognomy and biomass that occur across transformation contrasts. Thicket transformation results in a significant loss of plant diversity and functional types. There is also a significant reduction in the biomass (c. 80 t.ha-1) and structural complexity of the vegetation, both vertically and horizontally. These results were interpreted in terms of their implications for ecosystem functioning and stability. To test the stability of the transformed succulent thicket I used aerial photographs and ground-truthing to track the survivorship of canopy trees over 60 years in pseudo-savanna landscapes. I also measured seedling establishment in different habitats. I show that the pseudo-savanna is not a stable state owing to ongoing adult mortality and no recruitment of canopy trees. Soil fertility and water status I hypothesised that the above-ground changes in ve getation would be accompanied by similar trends in the pattern and levels of soil nutrient resources and the ability of the landscape to harvest precipitation. I compared soil fertility (organic carbon, available nitrogen and phosphorus), texture, matric potential, and surface micro-topography in the two main micro- habitats on either side of the replicated fenceline contrasts. The results show that intact spekboom thicket has a distinct spatial pattern of soil fertility where nutrients and organic carbon are concentrated under the patches of perennial shrubs, compared to under canopy trees and open spaces. Transformation results in a significant homogenisation out of this pattern and an overall reduction in the fertility of the landscape. The proportion of the landscape surface that would promote infiltration of water decreases from 60 – 0.6 percent. Soil moisture retention (matric potential) also decreases with transformation. I interpreted these patterns in terms of the ability of the landscape to harvest and release water after rainfall events. Litter fall and decomposition Surface litter and soil organic matter are critical components to wooded ecosystems; contributing to several ecosystem functions. The rates of litter fall and decomposition are ratelimiting steps in nutrient cycling and incorporation of organic matter into the soil. The ecological mechanisms behind the collapse of succulent thicket in the face of domestic herbivory are not fully understood, but are believed to include the breakdown of several ecosystem processes, including litter fall and decomposition. I quantified the changes in litter fall and litter decomposition of four of the dominant perennial woody plants (Euclea undulata, Pappea capensis, Portulacaria afra and Rhus longispina) across the replicated fenceline. Litter fall was measured over 14 months using mesh traps. Decomposition was measured over 15 months using a combination of litterbags and unprotected leaf packs. I also quantified soil microclimate during the experimental period; hypothesising that transformation would lead to soil conditions less amenable for biotic activity. Litter fall in succulent thicket was very high for a semi-arid system, comparing more to temperate forests. The leaf-succulent P. afra contributed the largest single component of the total litter production at a landscape scale. The effect of transformation on litter fall was species specific. Deep-rooted or drought-adapted species showed no change in litter yield with transformation; shallow-rooted species showed a significant decrease. There were few significant differences in decomposition rates across the transformation gradient and between litter types. Portulacaria afra litter had the steepest rate of mass loss, and was most affected by transformation. The more recalcitrant (high C:N ratio) leaves of P. capensis remained largely unaffected by transformation. These results indicate the critical role of the perennial vegetation in incorporating organic carbon into the soil. Transformation of succulent thicket leads to a disruption of the flow of carbon into the soil, reinforcing the cycle of transformation through reduced fertility. Rehabilitation of this ecosystem will require the active establishment of species, such as P. afra, that will restart the flow of carbon into the soil. Run-off & Erosion The landscape function model predicts that functional semi-arid shrublands efficiently conserve limiting resources such as water and water-bourn sediments (soil and organic matter). As these rangelands become transformed through unsustainable livestock production, so their ability to conserve resources decreases. The primary determinant of landscape function and conservation of resources appears to be the proportional cover of perennial vegetation. I hypothesised that the switch from a two-phase mosaic dominated by perennial succulent and woody shrubs to a single phase system dominated by an ephemeral field layer would be accompanied by disruption of the mechanisms that conserve resources. Specifically, I tested the hypothesis that transformation of succulent thicket increases runoff volume, sediment concentration of runoff, soil erosion and loss of organic matter at a patch scale (c. 100 m2). Runoff and water-borne sediment were measured from runoff plots established across replicated fenceline contrasts. Data were collected from eight extreme weather events over two years. There were no significant differences between runoff and erosion across the transformation contrast, as each extreme weather event was unique in terms of its runoff response. The transformed runoff plots alone also gave inconsistent results, largely due to differences in the cover of ephemeral forbs and weakly perennial grasses. Runoff and erosion were not predictable from the data across the transformation gradient due to complex interactions between the nature of the above-ground vegetation, soil micro-topography and land use history. The results highlighted the need for longer-term catchment experiments to generate a predictive understanding of the effect of transformation on runoff and erosion in succulent thicket.
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- Date Issued: 2003