Abstract
BackgroundThe use of the performance management (PM) system is highly contested by public servants in South Africa, although its value as essential to the appraisal and management of staff is undeniable.ObjectivesThe aim of this study was to explore nurses’ perceptions and experiences of the PM system at primary healthcare (PHC) facilities in relation to the current health system’s reforms.MethodAn exploratory, descriptive and qualitative design was utilised. Participants were selected through purposive sampling. A semi-structured interview tool was used to collect data from 18 nurses in four sub-districts of Dr. Kenneth Kaunda district in the North West province. Data were analysed through thematic analysis.ResultsThe findings of this study confirmed that PM is implemented to some extent. However, various loopholes in its implementation threaten the accuracy and transparency of the system and leave it vulnerable to perceived organisational injustice and unfairness, with the objectivity of the system questioned. The limitations of the current PM system revealed by this study include (1) the lack of alignment with current health system reforms towards comprehensive and integrated care that demands person-centred care; (2) the system’s usefulness for career progression, performance improvement and rewarding exceptional performance.ConclusionPerformance management is inadequately applied in PHC facilities at district level and needs to be realigned to include the appraisal of key attributes required for the current health system’s reforms towards comprehensive and integrated care, including the provision of person-centred care, which is central for responding adequately to South Africa’s changing disease profile towards multi-morbidity.
Highlights
Health systems reforms are underway in South Africa, notably the introduction of National Health Insurance (NHI) and the re-engineering of primary healthcare (PHC) to promote integrated clinical services management (ICSM) of acute and multi-morbid conditions
They understood that its main purpose was to meet up with and evaluative developmental objectives, and that the value of performance management and development system (PMDS) dwells in its potential to provide feedback that could be helpful in improving their job performance and the provision of quality care
Abualrub and Al-Zaru (2008), who conducted a study on job stress, recognition, job performance and intention to stay at work amongst Jordanian hospital nurses, found a direct and buffering effect of recognition of nurses’ performance on job stress and the level of intention to stay at work
Summary
Health systems reforms are underway in South Africa, notably the introduction of National Health Insurance (NHI) and the re-engineering of primary healthcare (PHC) to promote integrated clinical services management (ICSM) of acute and multi-morbid conditions. Poor human resource management (HRM) methods and practices in the healthcare system have been found to threaten the successful implementation of quality healthcare in South Africa (Republic of South Africa 2012a). These processes must be managed appropriately to encourage a shared vision, inspire health workers and build a culture of performance that drives the entire health system towards a common purpose. The use of the performance management (PM) system is highly contested by public servants in South Africa, its value as essential to the appraisal and management of staff is undeniable
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