Affect Service Delivery Research Articles

Epidemiology of hepatitis C from 2015 to 2022 in a central Italian region: the OPT-HepaC project

Abstract Background Chronic hepatitis C virus (HCV) infection is a major global public health problem. This study investigated the evolving landscape of HCV in Tuscany (Italy) from 2015 to 2022, considering demographic shifts, clinical profiles, treatment regimens, and outcomes. Methods The study was conducted in order to characterize HCV-positive patients who started treatment between 2015 and 2022 in Tuscan prescribing centers. The study was part of OPT-HepaC, a project funded by Regional Health Service. Data on demographics, clinical history and outcomes were collected. Three different temporal eras were analysed: the period before andfter the universal availability of direct-acting antivirals (DAA) and the COVID-19 era. Treatment’s effectiveness was evaluated by the Sustained Virological Response (SVR12), assessed 12 weeks after the end of treatment. Outcomes included SVR12, non-SVR12 and lost to follow-up (LTFU). ANOVA, Kruskal-Wallis test and multinomial logistic regression were used for statistical analysis. Results 6882 HCV patients (age: 58.88±14.21) were treated by the centres participating at the study. Males (56.4%) and Italian (91.8%) were predominant. Sociodemographic and variable characteristics vary across the time. While the overall SVR12 remained stable over time (χ2(2)=0.357, p = 0.837), the LTFU rate significantly increased during the COVID-19 era. Facilitating factors for the non-SVR12 and LTFU outcomes were male gender (Odds Ratio (OR)=2.134, p = 0.006)/cirrhosis (OR = 1.713, p = 0.040)/HIV co-infection (OR = 3.251, p = 0.005) and DAA treatment of third generation (OR = 4.187, p = 0.006), respectively. Conclusions The study provides a comprehensive view of the HCV landscape, highlighting demographic changes, treatment regimens and outcomes. The COVID-19 pandemic affected service delivery, delaying HCV diagnosis/treatment and influencing the LTFU rate. Despite challenges, the region maintained high SVR12 rates, emphasizing the importance of sustained efforts in HCV care. Key messages • The study highlights the dynamic nature of HCV management in Tuscany. • The study emphasises the need for continuous adaptation to public health challenges, providing insights for future public health strategies.

Factors influencing vaccination up-take among nomadic population in four regions of Ghana: a qualitative study

BackgroundVaccination has contributed to the reduction in vaccine preventable diseases. Despite, improved global coverage, vaccination among nomadic populations is still low especially in Africa. This study explored factors influencing vaccination uptake among pastoralist nomads in Ghana.MethodsWe conducted key informant interviews (KII) in 11 districts across four regions of Ghana, using grounded theory qualitative research approach. One hundred and eighty-two KII were conducted among pastoralist nomads, community opinion leaders, community health volunteers, security services personnel, local government personnel and health workers. Guided by the WHO health systems building blocks, data was coded using Nvivo 12 and analysed thematically. Results were presented as narratives with excerpts to support the findings.ResultsCommunity leaders support vaccination among pastoralist nomads as part of their leadership and governance responsibilities. Language barrier between health workers and pastoralist nomads affects service delivery. Also, healthcare providers fear being attacked by pastoralist nomads hence are hesitant to visit their settlements for vaccination. With regards to health workforce, healthcare providers’ perceived use of derogatory words and discrimination against pastoralist nomads influence their vaccination uptake. On medical product, the lack of knowledge about diseases, severity and perceived negative effects about vaccines influence vaccination uptake. Inadequate funds and logistics at the district health directorates affects outreach to nomads during vaccinations. Leveraging existing partnership between the health services and community leaders, information centers, volunteers and butchers to send health information to pastoralist nomads influence vaccination uptake.ConclusionCommunity leaders support vaccination among pastoralist nomads. Nomadic pastoralist miss vaccination dues to language barrier, feel discriminated against, and lack information about diseases and vaccinations. Strengthening Ghana Health Service collaboration with leaders of pastoralist nomads could build trust, create awareness and overcome language barrier between healthcare providers and pastoralist nomads.

Strategic Planning and Service Delivery at Kenya Power Headquarters in Kenya

Purpose: The major objective was to establish how strategic planning affected service delivery in KenyaPower. The study was based on the theory of contingency. Methodology: The study employed descriptive design. The target population consisted of 247 managers at various levels (low-level, mid-level and senior-level) from 11 departments at headquarters of Kenya Power. This study employed stratified random sampling techniques to select sample size of 114 staff. The study used primary data collection utilizing both open and closed-ended questionnaire. The questionnaires were distributed and collected using a drop-off and pick-up later method. The quantitative analysis used descriptive techniques such as frequency, percentage, standard deviations and means. The research also employed linear regression to examine the effect of strategic planning on service delivery. Findings: The research established that strategic planning (β=0.787; p=0.000) had substantial effects on service delivery at KenyaPower. Research concluded that strategic plannings have significant effects on delivery of services in Kenya Power. Unique Contribution to Theory, Policy and Practice: The study recommended that Kenya Power's executives should implement training programs for its workers. This would provide employees with the essential skills and abilities needed to improve the quality of service delivered to clients. Kenya Power should also make sure that its goals and objectives are clear and understandable to employees at every level by use of efficient communications.

Contribution of Responsive Governance to Personal Security of Crime Victims in Kenya

This study explored the critical role of responsive governance in enhancing the efficacy of victim assistance programs, with a particular focus on Kenya’s criminal justice system. By examining Kenya's low ranking on the World Justice Project's Rule of Law Index and comparing it with other nations such as the U.S., U.K., Germany, and Nigeria, the study highlights significant gaps in the protection of crime victims' rights. Employing a mixed-methods approach, this study investigated how governance impacts victim support by analyzing data from surveys and interviews with victims, government officials, law enforcement, and advocacy groups in Nairobi. The research identified the key principles for successful victim support, including inclusivity, transparency, accountability, and flexibility. It underscores the need for victim-centered approaches that prioritize accessibility, empathy, respect, confidentiality, and empowerment. The findings reveal both successes and challenges in current programs, with issues such as inadequate funding and limited collaboration affecting service delivery. The study advocates for the establishment of a Victim Support Agency (VSA) in Kenya to centralize victim support, enhance transparency, and foster effective stakeholder collaboration. The study recommends a holistic, coordinated, and well-funded approach that includes continuous improvement of victim support programs to address the existing gaps and advance justice and support for crime victims.

Information Communication Technology Adoption and Service Delivery by Microfinance Institutions in Nandi County: A Case Study of Juhudi Kilimo Limited

The Study Aimed To Investigate The Factors Affecting The Adoption Of Information Communication Technology In Service Delivery By Microfinance Institutions In Nandi County With Juhudi Kilimo Limited As The Main Point Of Focus. The Investigation Aimed To: Examine Whether Ict Illiteracy Affects Service Delivery By Microfinance Institutions In Nandi County, Find Out How Technological Infrastructure Has An Effect On Service Delivery By Microfinance Institutions In Nandi County, Ascertain How The Cost Of Adoption Has An Effect On Service Delivery By Microfinance Institutions In Nandi County, And Examine How Perceived Usefulness Has An Effect On Service Delivery By Microfinance Institutions In Nandi County. The Research Considered A Population Of 200 Employees And Clients Of Juhudi Kilimo In Nandi County. The Study Employed A Simple Random Sampling Technique. The Technology Acceptance Theory Constituted The Foundations Of The Research. The Research Employs A Descriptive Design To Examine The Characteristics Of The Target Population, Consisting Of It Officers, Finance Officers, Operations Officers, Research And Development Officers, Internal Auditors, And Clients Of Juhudi Kilimo. A Representative Sample Of 60 Respondents Was Selected Randomly. Data Collection Involved Questionnaires, Validated Through A Pilot Study And Expert Evaluation. The Research Also Provided A Robust Framework For The Study, Ensuring Methodological Rigor And Ethical Adherence In Investigating Ict Adoption's Impact On Mfi Service Delivery. The Study Revealed Strong Positive Correlations Between Ict Illiteracy And Adoption Costs (0.983), Technological Infrastructure (0.310), And Perceived Usefulness (0.459). Technological Infrastructure Demonstrated A Strong Positive Correlation With Perceived Usefulness (0.751) And A Moderate Positive Correlation With Adoption Costs (0.652). Adoption Costs Exhibited Strong Positive Correlations With Both Ict Illiteracy (0.983) And Technological Infrastructure (0.995). Perceived Usefulness Showed A Moderate Positive Correlation With Ict Illiteracy (0.459) And Strong Positive Correlations With Both Technological Infrastructure (0.978) And Adoption Costs (0.959).

Influence of occupational wellness programs on service delivery in faith-based hospitals in Nairobi metropolitan area

This study sought to evaluate occupational wellness programmes on service delivery in faith-based hospitals in the Nairobi metropolitan area. Despite their essential role, faith-based hospitals continuously face challenges, including workforce-related issues such as poor working conditions including working for longer hours, seeing more patients in a day exceeding the 8 recommended by the World Health Organization (WHO), high rates of absenteeism, lack of critical services, depression and other mental illness as well as drug and substance abuse. These occurrences affect service delivery. The study adopted descriptive survey and correlational research designs and targeted employees in faith-based hospitals in the Nairobi metropolitan area. The study used stratified random sampling to select 297 respondents. Primary data was obtained using a questionnaire. Descriptive and inferential statistics were used to analyse data. Descriptive statistics included frequencies, mean, standard deviation and percentages. Results were presented in tables. The study established that there was agreement among the respondents on the adoption of employees’ occupational wellness programmes in the Nairobi metropolitan area. The study thus concluded that employees’ occupational wellness programmes had a significant influence on service delivery in faith-based hospitals in the Nairobi metropolitan area.

An assessment on the influence of planning strategy on service delivery in Meru High Court

Despite numerous reforms, the Judiciary of Kenya has seen a rise in complaints about its service delivery. Common issues include slow service, missing files, corruption, delayed rulings, and delayed orders. This increase in complaints is surprising given the efforts to improve the judiciary's service delivery. Consequently, it is important to examine the planning strategies within the Judiciary and how they impact service delivery. This area has rarely been studied, leading to a lack of understanding in the existing literature about the effects of planning on service delivery in Kenya's Judiciary. This study aimed to fill that gap by focusing on the Meru High Court. The study aimed to examine the impact of planning strategy on service delivery at the Meru High Court, with a target population of 86 respondents. The research was guided by Kotter’s Eight Step Change Model. A descriptive survey design was employed. Before collecting the main data, a pilot test with 9 respondents was conducted at the Chuka Law Courts to assess the questionnaire's reliability and validity. Data analysis involved descriptive statistics such as frequency distribution, percentages, mean, and SD, along with regression and correlation analyses. The findings showed that a plan is created prior to implementing any changes. Respondents confirmed that the information provided by the Judiciary regarding changes is both reliable and pertinent. The research is significant as it helps the Judiciary understand how planning strategies affect service delivery.

Organisational and technological factors affecting efficient service delivery in trustworthy digital repositories: A qualitative approach

This study was undertaken to identify the organisational and technological factors that affect the efficiency of service delivery in trustworthy digital repositories of university libraries, where digital repositories have become increasingly common. The interpretive research paradigm, which relies on qualitative research, was adopted for the study. Data was collected through semi-structured interviews with nine participants from selected universities in the South West region of Nigeria. The data was analysed thematically to explore the factors affecting service delivery in trustworthy digital repositories. The findings show that both organisational factors (such as standardised organisation policies, stakeholders’ participation and financial sustainability) and technological factors (digital repository certification, technological standards, etc.) have a significant effect on service delivery in a university-based trustworthy digital repository. It is concluded that by adopting these factors, institutions can establish digital repositories that are not merely data storage facilities, but also trusted and valuable sources of scholarly information and knowledge.

A trait-based approach to quantify ecosystem services delivery potentials in the Sundarbans mangrove forest of Bangladesh

An ecosystem’s potential to deliver goods and services, primarily determined by the functional traits of the species, is crucial for assessing its health and conservation value. This study uses a trait-based approach to evaluate the spatial and temporal variation in the ecosystem services delivery potentials (ESDPs) of the Sundarbans mangrove. We analyzed abundance data from 81 permanent sample plots (PSPs), spread over different saline zones, collected between 1986 and 2014, paired with species-specific plant functional traits. Seventeen traits were examined, with species-level data sourced from secondary literature, linking traits to ecosystem services. Study revealed that plant height, specific leaf area, and root length are key traits for assessing ESDPs. The Sundarbans’ ESDPs varied spatially across different saline zones but remained stable over time. Notably, ESDPs were significantly higher in low saline zones compared to ESDPs in high saline zones. This spatial variation is partly explained by differences in plant species composition among saline zones and the relatively stable species composition over time. Results from mixed effect models showed that PSP as a random factor for all four models is attributed to the nested effect. The study highlights the value of functional traits in ecosystem service assessments, providing a robust method to predict how changes in biodiversity and environmental conditions affect service delivery. The observed trend of decreasing ESDPs with increasing salinity offers insights into the potential impacts of sea-level rise on mangrove forest functions. These findings are essential for developing conservation strategies and policies to preserve the Sundarbans’ ecological integrity and support local livelihoods. This research advocates for a trait-based framework as a critical tool for the sustainable management of mangrove ecosystems globally.

Appraisal of Students Admission on Service Delivery in the Directorate of Undergraduate Studies (DUS) Federal College of Education (FCE), Yola

Establishment of relationship between policy issues and service delivery in tertiary institution of learning requires to encourage policy implementations to relate to policy formulation that would address rather than dismal service delivery in tertiary educational institutions across the country. Precisely the research intends to establish if policy issues on students’ admission affect service delivery in DUS FCE, Yola. The main instruments used for data collection were the Questionnaires, Focus Group Discussion (FGD), observation check list and Semi Structured Interview (SSI) formats. This paper proposes Analysis of Variance (ANOVA) test statistic as a measurement tool for the study. The findings show that consideration of only first choice for JAMB Admission affect students intake in DUS and cut off marks for admission into DUS poses a threat to intake in some programmes. Post JAMB screening of applicants ensures selection of better candidates. Also, clearly stated memorandum of understanding (MoU) with portal managers and memorandum of understanding (MoU) with ICT facility managers would enhance service delivery in DUS. The study recommends that admission guidelines/policies of regulatory bodies like JAMB and affiliate institution need to be carefully studied and regularly incorporated in the students’ guide book.

Service Delivery of Non-Governmental Organizations in Somaliland: The Role of Strategy Implementation Drivers

This paper examines the relationship between strategy implementation and service delivery among Non-Governmental Organizations (NGOs) in Somaliland. This study is motivated by the increasing need for sustainable NGOs capable of effectively fulfilling their mandates and the lack of empirical evidence on strategy implementation in Somaliland. The research focuses on key drivers of strategy implementation: financial resources, organizational leadership, organizational structure, and organizational culture. The theoretical framework of this paper is anchored in the resource-based view theory and institutional theory. Utilizing a descriptive research design, the study surveyed 86 respondents from Save the Children, a leading NGO in Somaliland. Using a sampling formula, these respondents were selected from a target population of 110 employees. Data collection was conducted using a structured questionnaire. Descriptive and inferential analyses were performed using SPSS version 27. The findings indicate that organizational structure significantly influences service delivery among NGOs. Additionally, organizational leadership plays a crucial role in determining the effectiveness of service delivery. Financial resources also have a substantial impact on influencing service delivery. Lastly, organizational culture is identified as a critical driver of strategy implementation, significantly affecting service delivery. The study concludes that strategy implementation is a vital determinant of how well NGOs deliver their mandates, with its success heavily reliant on the supporting drivers of implementation.

Longitudinal trends in service utilisation of Alcohol and Other Drugs Services (AODS) during COVID-19: A Scoping Review

Background: COVID-19 has affected service delivery and utilization of AODS worldwide with a potential negative impact on service users and staff. Objectives: To understand the trends of service utilization of AODS, identify knowledge gaps, and provide directions for future research and planning. Methods: Medline, Embase, CINAHL, PubMed and PsycINFO were searched for original articles published in English since 2019, with quantitative analysis of service utilization of AODS. Of the 1546 initial search results, 938 were screened after de-duplication and 43 underwent full-text review. Data extracted from 30 studies informed this review. Results: Of the studies, 29 were from high-income countries and 15 focused on medication for opioid use disorders (MOUD). An initial reduction of service utilization followed by gradual improvement was seen in most treatment types, with most disruptions in residential programs, outreach services, home visits, group therapy and needle syringe programs and fewer disruptions in individual counselling and MOUD. Treatment initiations decreased, while treatment adherence improved during COVID-19. The use of telehealth and treatment-related policy changes were associated with improved service utilization. Telehealth was associated with catchment expansion and broadening of service-user profiles. An increased tendency to use the opioid long-acting injection was reported in Australia. Conclusions: The impact of COVID-19 on AODS changed over time and according to, the drug/treatment type and geographical remoteness. Main contributors to minimizing disruptions in service utilization included treatment-related policy changes, telehealth, and newer treatment modalities. Longitudinal studies beyond 2021 and studies on regional/rural AODS and AOD workforce are recommended.

Systemic barriers hinder person-centered home and community based services (HCBS): Perspectives of service users and professionals

BackgroundIn response to the 2014 Final Settings Rule issued by the Centers for Medicaid and Medicare Services, home-and-community based services (HCBS) provider organizations strengthened person-centered (PC) planning for HCBS to improve participants' choice and control over their services. Despite the call for widespread adoption of PC services, systemic barriers influence service users’ and professionals' experiences in receiving and delivering PC services. ObjectiveThis study describes the perspectives of HCBS professionals and users on systemic barriers that affect PC HCBS delivery. MethodsSemi-structured interviews with 20 HCBS users and 22 HCBS professionals explored perspectives on providing and receiving PC HCBS as well as higher level systems challenges to providing PC services. Qualitative analysis focused on participants’ perspectives of system-level issues. ResultsQualitative analysis generated three themes: (1) Workforce considerations; (2) Resources and service access; and (3) Infrastructure for feedback. High direct service provider turnover rates, service-eligibility determination procedures, and waitlists affected service delivery. Participants highlighted a need for increased direct service provider compensation, access to higher-quality training, improved financial resources, and effective feedback infrastructures. Waiver flexibility due to the Covid-19 public health emergency allowed expanded service access and improved quality. ConclusionOrganizational and system-level issues hinder delivery of PC services. Increased flexibility and resource allocation for service provision, as demonstrated in the Covid-19 public health emergency response, should be sustained. HCBS users’ suggestions for service-delivery improvements are consistent with recent state and organizational initiatives. HCBS improvements benefit from user-identified solutions in program development and implementation.

Prevalence of work-related burnout and associated factors among police officers in central Gondar zone, Northwest Ethiopia, 2023.

Work-related burnout is a state of physical and psychological fatigue and exhaustion resulting from chronic workplace stress related to work. The police workforce is vulnerable to this psychosocial hazard, which affects service delivery by police workers. However, there is little evidence about the prevalence of work-related burnout and associated factors among police officers in Ethiopia. Therefore, this research investigated the prevalence and predictor variables of work-related burnout among police officers in central Gondar zone, Northwest Ethiopia, 2023. An institution-based cross-sectional study was carried out from April 12 to May 12, 2023. A sample of 633 police officers was recruited through multistage random sampling techniques. To measure work-related burnout, a standardized, self-administered Copenhagen Burnout Inventory was used. To enter the collected data, EpiData V 4.6 and to analyze SPSS V 26 were used. To examine the association between work-related burnout and its predictor variables, both bivariable (p < 0.2) and multivariable (<0.05) logistic regression analyses were performed, and statistical significance was established via multivariable logistic regression. The response rate in this study was 96.05% (n = 608). The majority, 452 (74.3%) of the police officers, were male; the median (IQR) age of participants was 28. In the past six months, 45.7% of the police officers had experienced work-related burnout (n = 278). Being female, having a high job demand, having a high level of organizational police stress, having a moderate level of operational police stress, having a high level of operational police stress, experiencing job dissatisfaction, and sleeping troubles were risk factors significantly related to the occurrence of work-related burnout among police officers. According to this study, a significant number of police officers suffer from burnout due to their work. Police officers' work-related burnout was found to be influenced by factors such as sex, job demands, job satisfaction, workplace stress, organizational police stress, and sleeping troubles. To address this problem, improving the handling of work pressure, developing a stress management program, finding joy at work by improving interpersonal relationships and working conditions, offering support and inspiration to female police officers, and ensuring sufficient and restful sleep are advised.

Why Down-managing Backlog Forensic DNA Case Entries Matters

Forensic laboratories face a backlog of case files, affecting service delivery, causing delays. Forensic laboratories face a backlog of case ϐiles, affecting service delivery and causing delays. The backlog points to underfunding, poor planning, and inadequate support, hindering deoxyribonucleic acid (DNA) analysis. Resolving casework backlogs may initially seem like a straightforward and attainable measure to improve the arrest of offenders and promote justice. Longer turnaround times impede investigative leads, emphasising the need for efficient strategies and a comprehensive approach to address and prevent backlogs in forensic laboratories. No study has been published on the forensic DNA backlogs in South Africa. The article explicitly addresses one aspect of a Doctor of Philosophy study and aims to ascertain the impact of backlogs of forensic DNA case entries. The study article’s research questions included the following: “What cases are considered as backlog?”; “What is the current backlog in forensic DNA case entries in South Africa?” and “What are the main reasons for the backlog of cases involving forensic DNA?” The prompt processing of DNA evidence is vital not only for safeguarding individuals falsely accused of crimes based on circumstantial evidence but also for adding prosecutors and providing justice for crime victims.

A qualitative study examining the health system's response to COVID-19 in Sierra Leone.

The paper examines the health system's response to COVID-19 in Sierra Leone. It aims to explore how the pandemic affected service delivery, health workers, patient access to services, leadership, and governance. It also examines to what extent the legacy of the 2013-16 Ebola outbreak influenced the COVID-19 response and public perception. Using the WHO Health System Building Blocks Framework, we conducted a qualitative study in Sierra Leone where semi-structured interviews were conducted with health workers, policymakers, and patients between Oct-Dec 2020. We applied thematic analysis using both deductive and inductive approaches. Twelve themes emerged from the analysis: nine on the WHO building blocks, two on patients' experiences, and one on Ebola. We found that routine services were impacted by enhanced infection prevention control measures. Health workers faced additional responsibilities and training needs. Communication and decision-making within facilities were reported to be coordinated and effective, although updates cascading from the national level to facilities were lacking. In contrast with previous health emergencies which were heavily influenced by international organisations, we found that the COVID-19 response was led by the national leadership. Experiences of Ebola resulted in less fear of COVID-19 and a greater understanding of public health measures. However, these measures also negatively affected patients' livelihoods and their willingness to visit facilities. We conclude, it is important to address existing challenges in the health system such as resources that affect the capacity of health systems to respond to emergencies. Prioritising the well-being of health workers and the continued provision of essential routine health services is important. The socio-economic impact of public health measures on the population needs to be considered before measures are implemented.

Discrete Event Simulation to Incorporate Infusion Wait-Time When Assessing Cost-Effectiveness of a Chimeric-Antigen Receptor T Cell Therapy

ObjectivesThe main objective was to use discrete event simulation to model the impact of wait-time, defined as the time between leukapheresis and chimeric antigen receptor (CAR-T) infusion, when assessing the cost-effectiveness of tisagenlecleucel in young patients with relapsed/refractory acute lymphoblastic leukemia. MethodsThe movement of patients through the model was determined by parametric time-to-event distributions, with the competing risk of an event determining the costs and quality-adjusted life-years (QALYs) assigned. Cost-effectiveness was expressed using the incremental cost-effectiveness ratio (ICER) for tisagenlecleucel compared with chemotherapy over the lifetime. ResultsThe base case generated a total of 5.79 QALYs and $622 872 for tisagenlecleucel and 1.19 QALYs and $181 219 for blinatumomab, resulting in an ICER of $96 074 per QALY. An increase in mean CAR-T wait-time to 6.20 months reduced the benefit and costs of tisagenlecleucel to 2.78 QALYs and $294 478 because of fewer patients proceeding to infusion, reducing the ICER to $71 112 per QALY. Alternatively, when the cost of tisagenlecleucel was assigned pre-infusion in sensitivity analysis, the ICER increased with increasing wait-time. ConclusionsUnder a payment arrangement where CAR-T cost is incurred post-infusion, the loss of benefit to patients is not reflected in the ICER. This may be misguiding to decision makers, where cost-effectiveness ratios are used to guide resource allocation. discrete event simulation is an important tool for economic modeling of CAR-T as it is amenable to capturing the impact of wait-time, facilitating better understanding of factors affecting service delivery and consequently informed decision making to deliver faster access to CAR-T for patients.

LEADERSHIP AND ETHICS IN THE SOUTH AFRICAN PUBLIC SECTOR: ETHICAL AND LEADERSHIP CHALLENGES

This paper analysis the leadership and ethical challenges facing South African public sector including municipalities. Generally, the South African public sector is grappling with service delivery challenges. On top of the public service crisis discourse there is a huge complain about the ethical challenges facing leadership in all the three spheres of government. The South African government sector has turned into a haven for bad management. This has resulted to unmet service delivery to residents of South Africa. This paper is conceptual in approach, and it contends that despite numerous factors affecting service delivery, one major cause that has been overlooked is the failure of the public sector officials to uphold moral principles when performing public duties in their offices. The paper conclude that the current South African sector requires ethically grounded leaders in order to achieve a stable service delivery system compatible with the South African citizenry and their satisfaction.

A Case of a South African Municipality's Audit Opinion, Audit Implementation Plan, and Service Delivery

Purpose: This study aimed to establish the perceptions of employees of a municipality in South Africa on how audit opinions are crafted into the audit implementation plan, and how such opinions affect service delivery.&#x0D; Design/Methodology/Approach: The study adopted a quantitative approach using a questionnaire as a data collection instrument. A case study approach was used, with the questionnaire administered to only one municipality that had had an audit opinion in the past three years. &#x0D; Findings: The study found that some staff were not aware of the existence of the Audit Implementation Plan in the municipality. However, the respondents acknowledged the implications of audit opinions for the municipality’s budget and service delivery. Furthermore, employees showed positive attitudes towards the effects of audit opinions on the municipality’s operations.&#x0D; Implications/Originality/Value: The findings have implications for public governance and monitoring of audit implementation plans by municipalities.&#x0D;

Literature review of the relationship between E-procurement and cost reduction

The purpose of this desktop study was to examine the efficacy of e-government technologies and the obstacles to their efficient use. The researchers assessed how well e-government affected service delivery, how it might result in cost savings and the advantages and difficulties of adopting and using it. The study also looked at the advantages of using e-government to investigate this. E-efficiency in providing services was demonstrated by greater citizen involvement and interaction with the local government, increased openness and accountability, and cost savings. The study revealed that the use of e-government improves traditional methods of conducting business and providing services while also enabling access to information and services online, reducing the need for rework, increasing transparency and accountability, and encouraging citizen participation. The ineffective use of e-government in local authorities was hampered by a lack of funding, inadequate enabling infrastructure, low ICT literacy levels, and the digital divide, among other factors. It was evidenced in this study, that e-procurement leads to cost savings, thus it affects cost reduction strategies positively. Thus, e-procurement reduces inventory costs.