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A model for the integration of provincial and local authority nurses rendering primary health care services in a district

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dc.contributor.advisor King, Letitia Jacoba, 1945- en
dc.contributor.advisor Human, Susara Petronella, 1952- en
dc.contributor.author Mashazi, Maboikanyo Imogen en
dc.date.accessioned 2009-08-25T10:46:57Z
dc.date.available 2009-08-25T10:46:57Z
dc.date.issued 2002-02
dc.date.submitted 2009-08-25 en
dc.identifier.uri http://hdl.handle.net/10500/814
dc.description.abstract Prior to 1994, the South African Health Department was characterised by a fragmented health care system, which was largely curative and hospital based, with services planned and managed without community involvement and participation. The government, through the establishment of a district health system, integrated the health services with the aim of overcoming the fragmentation, and providing integrated comprehensive health care services that are equitable, accessible, efficient and effective. The integration of health services in Gauteng, meant the devolution of primary health care services from the provincial health department to the local authority health department, because the local authority services are nearer and accountable to the community. The process of integration of health services also meant the closing down of provincial clinics and transferring of provincial authority nurses to the local authority clinics. The transfer process impacted negatively on staff morale and on the resources available for health care delivery to the communities. It is against this background that the researcher decided to investigate the integration process. The researcher then conducted focus group interviews with the local authority nurses, provincial authority nurses and the district management team as these nurses's immediate supervisors. The results revealed that the local and provincial authority nurses were integrated without proper consultation and as a result integration was rejected. The following themes emerged from the results as negative perceptions and obstacles towards integration: lack of consultation, disparities in conditions of service and resistance to change. Positive perceptions also emerged from the results as strategies to improve the integration, and these strategies were used to develop guidelines to operationalise the model. It is envisaged that the proposed model will serve as a theoretical framework for nurse managers from both spheres of government, local and provincial to improve the integration of nurses through proper consultation, and involvement of nurses in the process affecting them. It is further envisaged that the model will serve as guideline to introduce changes within the district health system with more understanding and acceptance by nurses affected. Health care managers will find the model useful to overcome disparities in conditions of service among nurses and, in turn this may boost the moral of nurses and lead to successful integration of provincial and local authority nurses. en
dc.format.extent 1 online resource (viii, 186 leaves) en
dc.language.iso en en
dc.subject Primary health care en
dc.subject Disparities in conditions of service en
dc.subject Management of resistance to change en
dc.subject Proper consultation en
dc.subject Acceptance en
dc.subject Uniform conditions of service en
dc.subject Resistance to change en
dc.subject.ddc 362.173068
dc.subject.lcsh Nursing services -- Administration en
dc.subject.lcsh Primary nursing en
dc.title A model for the integration of provincial and local authority nurses rendering primary health care services in a district en
dc.type Thesis en
dc.description.department Health Studies en
dc.description.degree D.Litt. et Phil (Health Studies) en


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