Private Sector In South Africa Research Articles

Fostering organisational commitment: a resilience framework for private-sector organisations in South Africa.

Organisations worldwide encounter three significant and challenging issues related to talent management: intense competition for skilled employees, elevated rates of employee attrition, and the ongoing struggle to attract top-tier talent. This research focused on investigating the interconnected dynamics among factors associated with employee retention, including organisational commitment, job embeddedness, and hardiness, in conjunction with resilience-related behaviours such as resilience and career adaptability. A cross-sectional survey design was used to gather quantitative data from a convenience sample of employees within the private sector in South Africa (N = 293). The self-assessments of the participants were assessed using a range of well-established and validated instruments. Correlation and regression analyses, followed by structural equation modelling, were utilised to construct a resilience framework designed specifically for private sector organisations in South Africa. The results reveal significant associations between organisational commitment, job embeddedness, and hardiness (as retention-related attributes) and resilience and career adaptability (as resilience-related behavioural capacities). These relationships served as the basis for the development of a resilience framework for employees in South African private organisations. In South African private-sector organisations, talent retention is crucial due to a talent shortage. The study found that employees have a strong emotional attachment to their organisations, are highly aligned with their jobs and communities, and display resilience. Organisational commitment, job embeddedness, and hardiness are key factors in reducing turnover, forming an effective retention strategy. This research contributes to the development of a resilience framework for South African private sector organisations.

The Challenges of Small, Medium and Micro Enterprises in Engineering: South Africa

Abstract The small, medium and micro enterprise sector is an economic engine for many countries. Realizing the potential of small, medium, and micro enterprises, the government of the Republic of South Africa has put a burden on itself to create 90% of jobs through small, medium, and micro enterprises through the implementation of the 2030 National Development Plan. Despite these initiatives, the failure rate of these enterprises in South Africa is still high and continues to increase. This research aims to investigate the challenges of small, medium and micro enterprises that operate in the formal economy, with the focus narrowed down to small, medium and micro enterprises that provide engineering services to engineering-intensive firms in the public and private sectors in South Africa. The target is a sample of member companies of Consulting Engineers South Africa, as well as random engineering service firms that render similar services. In general, engineering services’ small, medium and micro enterprises mainly depend on owners’ limited capital, which limits growth initiatives. Moreover, the absence of adequate resources, business facilities and specialised equipment puts small, medium and micro enterprises at a competitive disadvantage and, therefore, causes stagnation. Government’s initiatives are not well publicised and, therefore, small, medium and micro enterprises are not well informed to capitalise on such initiatives.

A national retrospective descriptiveanalysis ofcriticalcaretransfers in the private sector in South Africa.

Critical care transfers (CCTs) are necessitated by the growing prevalence of high-acuity patients who require upgrade of care to multidisciplinary teams from less-equipped referring facilities. Owing to the high acuity of the critical care patient, specialised teams with advanced training and equipment are called upon to undertake these transfers. The inherent understanding of the potential effects, and therefore the needs of the critical care patient during transfer, are affected owing to the paucity of international, but more specifically, local data relating to CCTs. To describe a cohort of patients who underwent CCT by dedicated critical care retrieval services (CCRS) in the private sector in South Africa (SA). This retrospective, descriptive study sampled all paediatric and adult CCTs completed over a 1-year period (1 January 2017 - 31 December 2017) from the dedicated CCRS of two national emergency medical services in SA. All neonatal patients were excluded. Data were extracted from patient report forms by trained data extractors and subjected to descriptive analysis. A total of 1 839 patients were transferred between the two services. A total of 3 143 diagnoses were recorded, yielding an average of ~2 diagnoses per patient. The most prevalent primary diagnosis was cardiovascular disease (n=457, 25%), followed by infection (n=180, 10%) and head injury (n=133, 7%). Patients had an average of ~3 attachments, with the most prevalent being patient monitoring (n=2 856, 155%), peripheral intravenous access (n=794, 43%) and mechanical ventilation (n=445, 24%). A total of 2 152 instances of medication infusion or administration were required during transport, yielding an average of ~1 medication or infusion per patient transported. The most common medications recorded were central nervous system depressants (n=588, 32%), followed by analgesics (n=482, 26%) and inotropic or vasoactive agents (n=320, 17%). This study provides insight into the demographics, most prevalent diagnoses and interfacility transfer monitoring needs of patients being transported in SA by two private dedicated CCRS. The results of this study may be used to inform future specialised critical care transport courses and qualifications, equipment procurement and scopes of practice for providers undertaking critical care transfers.

Impact of the COVID-19 pandemic on audiology services in South Africa: A preliminary study.

Hygiene-, work practices, travel, personal interactions and access to healthcare services changed for the majority of the world during the pandemic. This study aimed to discover the knowledge, impact and attitudes towards COVID-19 on the professional practices of public and private sector audiologists in South Africa. The study included 76 audiologists registered with the Health Professions Council of South Africa (HPCSA) and employed in the public, educational, tertiary or private practice and private sector in South Africa. A cross-sectional self-administered electronic survey study design was implemented. Audiologists had appropriate knowledge regarding COVID-19. During hard lockdown, 69% of respondents saw less than 40% of their usual patient load, only 31% saw 60% - 100% of their usual patient load. During lower lockdown levels, majority of respondents (73.7%) saw 60% - 100% of their patient load while 26.3% still saw less than 40% of their usual patient load. Only hearing aid reprogramming, hearing aid trouble shooting, cochlear implant pre-counselling and adult hearing screening could be offered via tele-audiology. The main challenges faced were fear of infection, infection control measures in the workplace, accessibility and limited services provided during the various lockdown levels. The pandemic and lockdown levels had a definite impact on audiological service provision and many adaptations regarding service delivery and infection control in the workplace were required. The relevance of this work for health services is the identification of the challenges experienced by audiologists during the pandemic and the opportunities to prepare for the future.

Justice in the provision of healthcare services – A stifled right in the private sector

Private medical aids are essentially non-profit organisations that aim to deliver speedy treatment and should prevent members from unexpected, out of pocket expenses for medical care. However, although the latest statistics show that 16.2% of individuals in South Africa were members of medical aid schemes, making the promise of private healthcare accessible to a small percentage of the population, they are not without their own unique set of challenges. The restrictions that exist within the private sector have a direct bearing on the types of healthcare services patients can access, which in turn impacts on the fundamental right to access healthcare. Using a recent High Court Case decision, this article seeks to explore whether there is justice in the provision of healthcare services, specifically within the private sector in South Africa.

Patient perceptions of surgical training in the private sector in South Africa - a single centre survey

As the worldwide demand for specialist surgeons increases, and to complement surgical training provided through governmental institutions, private hospitals are increasingly hosting trainees. Wits Donald Gordon Medical Centre (WDGMC) is a private academic hospital in Johannesburg with a Colorectal Unit (CRU) that hosts several trainees. While published studies demonstrate that the involvement of trainees in surgery does not adversely impact outcomes, private patients' perceptions of the role of trainees in their care have not been as widely researched.This was a prospective, cross-sectional study using a self-administered questionnaire hosted on a REDCap database. Statistical analysis was performed using SPSS version 26.One hundred and seventy-four patients participated in the study, and 74.1% of respondents felt that training of doctors should occur in private hospitals in South Africa. Of the sample, 83.3% would allow a supervised trainee to perform a part of their operation, provided they had been made aware of trainee participation in advance (78%). Sixty per cent of patients felt that interaction with a trainee enhanced their care, and 52.3% of patients suggested that seeing more than one doctor a day improved their experience.Our results suggest that privately funded patients support the surgical training of medical doctors in private academic training hospitals, and they are willing to be participants in the training process. Moreover, training programmes in this setting appear to enhance the patient experience. We are optimistic that these findings could be used to advocate for expanded training opportunities across the private sector in South Africa.

Surgical training in the private sector in South Africa

Surgical training in the private sector in South Africa

Managed healthcare: Treatment protocols and fiduciary duties of funders

Managed healthcare has become the cornerstone of health service delivery in the private sector in South Africa and the world over. As a result, managed care organizations and medical aid schemes have had to draw up recommended treatment protocols in accordance with the rules and regulations of the Council for Medical Schemes (CMS). T he protocols are rigid, do not always consider each case on its own merit and do not always benefit the members of the respective schemes . The purpose of the protocols is to determine which treatment options constitute essential medical care, costeffective treatment and which ones do not. The article examines the fiduciary duties of the medical aids and the existing relationship between the managed healthcare company and the members in a trustee-beneficiary duty of loyalty.

Understanding the decision making process of selection of medicines in the private sector in South Africa \u2013 lessons for low-middle income countries

BackgroundThe affordability of essential medicines is a challenge in achieving Universal Health Coverage (UHC). One of The Lancet Commission’s recommendations on financing of essential medicines is to ensure governments and national health systems include essential medicines in the benefit packages provided by public and private healthcare sectors. Currently in South Africa (SA), there is a dearth of information on the processes for medicines selection for private sector medical scheme formularies. This study aimed to improve the understanding of how formulary managers of selected medical schemes made decisions for the selection of medicines for their formularies. This paper described their opinions obtained from in-depth interviews.MethodsQualitative in-depth interviews were conducted with 10 individuals from 7 private sector medical schemes and administrators in SA. All participants interviewed were involved in formulary development and management. Interviews were conducted from June 2013 – January 2015. Interviews were guided by a discussion guide and audio recorded. Recorded interviews were transcribed verbatim. Transcripts were coded by the first author, corroborated by the second author, reconciled, and imported into NVIVO for data analysis.ResultsSchemes and administrators had similar formulary decision making and management committees in place (viz. Clinical and Therapeutics committees). The process of and criteria for medicines selection and evidence based review of formularies were also similar. Selection of medicines was inherent in the formulary review process. Medicine price was important in the decision taken to list medicines. Most schemes expressed a difficulty with lack of information to support pharmacoeconomic evaluations of medicines for inclusion on the formulary. This together with the basic monitoring of use of medicines by patients for most schemes left room for improvement in the decision making process for those schemes.ConclusionsThis is one of the first studies in SA describing interviews with private sector medical scheme Formulary managers. It contributes to an increased understanding of how decisions are taken to include/exclude medicines on private sector medical scheme formularies. It provides insight into the medicine selection and review processes, including processes on monitoring and evaluation of medicines use by the private sector which serve as lessons for Low-Middle income countries moving towards UHC.

The state of kidney transplantation in South Africa.

Kidney transplantation has been performed in South Africa (SA) since 1966. Transplants were initially limited to public hospitals, and the entry of the private sector heralded a new era in organ transplantation. To document kidney transplantation in SA and compare numbers, rates, trends and sources of kidneys transplanted in the public and private sectors in SA over 25 years. National kidney transplant data collected between 1991 and 2015 by the Organ Donor Foundation of South Africa were analysed. The total number of kidneys transplanted in the country was counted and rates were calculated. The numbers and rates in the private and public sectors were compared. The source of donor kidneys and sites where transplants were performed were documented. Over the 25-year period under review, 7 191 kidney transplants were performed in SA. The overall kidney transplant rate was 6.4 per million population (pmp), averaging 4.8 pmp in the public sector and 15.2 pmp in the private sector; 58.3% of the donor kidneys were derived from deceased donors. Cape Town and Johannesburg hospitals performed 75% of the country's kidney transplants. The overall transplant rate in SA is declining, especially in the public sector. Most kidney transplants in the country were performed in the public sector, and deceased-donor transplants predominated. Discrepancies exist in the allocation of kidneys. Recommendations are made on how the situation may be improved.

Appendicectomy in private practice in KwaZulu-Natal Province, South Africa.

The treatment of appendicitis is regarded as a bellwether procedure that can be used to describe the delivery of essential surgical care. Little has been published on clinical outcomes in the private sector in South Africa (SA), and this study attempts to address this deficiency. To extend our understanding of the outcomes of acute appendicitis in the public and private sectors in SA. Data on patients covered by a leading medical aid who underwent appendicectomy in 26 private hospitals in Durban and Pietermaritzburg, KwaZulu-Natal Province, during the period 2010 - 2015 were obtained and compared with existing data from a recent study of patients with appendicitis treated in the Pietermaritzburg academic complex. Between January 2010 and December 2015, 397 patients covered by the medical aid underwent appendicectomy in private hospitals. Their mean age was 29.7 years (range 3.7 - 87.6), the mean length of stay 4.6 days (range 1 - 41) and the mean operation time 70.6 minutes (range 24.0 - 335.0). Of the procedures 66.5% were laparoscopic. A total of 33 patients (8.3%) required intensive care unit (ICU) admission, and 38 (9.6%) were readmitted. While there was no information on the reasons for readmission, this is a proxy marker for possible complications. The mean total event cost per patient was ZAR38 934. A total of 134 open operations were performed (33.8%). In the state sector, a total of 1 004 patients were documented. The mean patient age was 20.2 years (difference not statistically significant), mean length of stay was significantly longer at 7.3 days (p=0.02, one-tailed t-test), and 10% of patients required ICU admission. In the state hospitals only 3% of the operations were laparoscopic. None of the private sector patients but 40% of the state patients required further surgery. Medical aid data provide useful information on disease profiles and outcomes in private practice. The outcome of acute appendicitis in the private sector appears to be significantly better than in the state sector. Further work is required to fully elucidate the reasons for this, although late presentation in the state patients almost certainly contributes to their poor outcome. In terms of cost, SA private practice appears to be highly efficient and is relatively inexpensive in comparison with international equivalents.

The In-Betweeners: Racio-ethnic and Masculine Identity Work of Indian Male Managers in the South African Private Sector

This article examines the extent to which minority Indian male managers engage in identity work in their efforts to gain career ascendancy in the private sector in South Africa. Indian male managers occupying diverse management posts at middle management and senior management levels in various sectors were interviewed. Results indicate that Indian men worked and reworked their managerial and cultural identities to form coherent identities which they were comfortable enacting in corporate South Africa. Race hierarchy in some workplaces placed Indian males at a disadvantage related to promotional opportunities. There is no simple solution to the problem as race hierarchy still dominates corporate South Africa, and Western norms still prevail.

Vestibular assessment and management in adults: current practice by South African audiologists

Background: There is scarcity of research in vestibular assessment and management within the South African context.Methods: The current study explored the current practices of South African Audiologists in the assessment and management of vestibular disorders in adults. A survey research methodology with a cross-sectional research design was adopted. The current study made use of a 29 item web-based survey, and surveyed 32 audiologists from across the country on their practices around vestibular assessment and management in adults presenting with vestibular symptoms. Data were analyzed using descriptive statistics.Results: Current findings revealed that 53% of participants in the study were conducting vestibular assessments, even though 75% reported seeing patients presenting with vestibular symptoms in their practices. 34.4% of participants indicated using a core test battery adapted to the patient’s case history when assessing patients with vestibular disorders. The most common assessments performed were peripheral vestibular examinations and oculomotor tests. Furthermore, a majority (59.4%) of the participants do not have any high-tech equipment at their practice. Of the sample, 62.5% of the participants do not perform vestibular management. Of the individuals who do perform vestibular management, vestibular rehabilitation therapy and canalith repositioning maneuvers were the most common treatment procedures performed. The most commonly referred to professional is the Ear, Nose and Throat specialist, and 50% of participants make 0-5 referrals per week for patients with vestibular disorders. With regards to the facilitators and barriers to practice, 53% indicated that lack of vestibular equipment was the main barrier to practice, whereas 50% indicated that the main facilitator to practice was the fact that there were patients presenting with vestibular symptoms.Conclusion: Current findings raise implications about the provision of vestibular function services in both public and private sectors in South Africa. Implications for training and resource planning and allocation are highlighted.

Surgical resources in South Africa: an analysis of the inequalities between the public and private sector

The full extent of the global burden of surgical disease is largely unknown, however, the scope of the problem is thought to be large. Despite the substantial burden of surgical disease, surgical services are inaccessible to many of those who need them most. There are disparities between public and private sectors in South Africa, which compound inequitable access to surgical care. This study forms part of a series analysing surgical resources in South Africa. This study involved a descriptive analysis of surgical resources and included the total number of hospitals, of hospital beds, the number of surgical beds, the number of general surgeons (specialist and non-specialist), and the number of functional operating theatres in South Africa. A comparison was performed between the public and private sectors. Hospitals were contacted during the period from 1 October 2014 until 31 December 2014. Surgical resources were concentrated in metropolitan areas of urban provinces. There were striking differences between the public and private sectors, where private resources were comparable to those available in high income countries (HICs). Improving access to surgical services in lower middle income countries (LMICs) requires addressing gaps between the public and private sector regarding infrastructure, personnel, as well as equipment. These data identified disparities between geographic regions which may be contributing to ongoing inequity in South Africa, and by doing so allows for evidence-based planning towards improving surgical infrastructure and workforce.

The market dynamics of selective serotonin re-uptake inhibitors: a private sector study in South Africa.

The objective of this study was to analyse the market share of generic vs originator selective serotonin re-uptake inhibitors (SSRIs), and also compare market share of different SSRIs in the private health care sector in South Africa, over a period of 4 years. This was a retrospective, descriptive study that measured generic market volume as a percentage of the total private SSRI market volume. Retail private sector sales data for six SSRIs available in the private sector in South Africa was evaluated. Sales data were obtained from various stages in the pharmaceutical supply chain, June 2009 - May 2013. Generics constituted 86% and originators 14% of the private sector market volume of SSRIs. The share of the market volume of generic medicines increased by 29.93% over this 4-year period, while an overall increase of 27.86% in the ratio of generics to originators was observed. In line with policies, generic SSRIs hold a larger volume of the market in the private sector in South Africa.

Adult attention-deficit hyperactivity disorder: A database analysis of South African private health insurance

<p><strong>Background:</strong> Adult attention-deficit hyperactivity disorder (ADHD) is a chronic, costly and debilitating disorder. In South Africa (SA), access to funding for care and treatment of ADHD is limited, and research is lacking.</p><p><strong>Aim:</strong> This study aimed to establish the current situation with regard to the psychiatric management of and funding for treatment of adult ADHD in the private sector in SA.</p><p><strong>Methods:</strong> A diagnostically refined retrospective claims database analysis was conducted. We examined the prevalence, costs and funding profile of claims over a 2-year period for adult beneficiaries with possible ADHD of a large medical administrator in SA.</p><p><strong>Results:</strong> The prevalence of adult ADHD was lower than published international rates. The presence of adult ADHD increased the prevalence of comorbidity and doubled the health care costs of beneficiaries. Contrary to public belief, comorbidities (including their medicine costs) rather than psychiatric services or medicines were the main cost drivers.</p><p><strong>Conclusion:</strong> The current private health insurance funding model for ADHD limits access to funding. This affects early diagnosis and optimal treatment, thereby escalating long-term costs. Improved outcomes are possible if patients suffering from ADHD receive timely and accurate diagnosis, and receive chronic and comprehensive care. Balanced regulation is proposed to minimise the risk to both medical schemes and patients. A collaborative approach between stakeholders is needed to develop an alternative cost-effective funding model to improve access to treatment and quality of life for adults with ADHD in SA.</p>

ISQUA16-2820NARROWING THE GAP: HOSPITAL ACCREDITATION AND INEQUALITY IN SOUTH AFRICA

To identify differentials in aspects of performance (as measured by the various accreditation components) and quality, as measured by health outcomes, between the public and private sectors in South Africa. The South African health system is characterised by high levels of inequality; both in the quality of care provided and in the ability for different subsets of the population to access this care. The most notable differential is between the public and private healthcare sectors in South Africa. Private healthcare in South Africa is generally perceived to offer higher and more consistent quality of care, albeit at a price. The sector accounts for half …

Out of control: profit-seeking behaviour, unnecessary medical procedures and rising costs of private medical care in South Africa

The World Health Assembly passed a resolution on the importance of engaging with the private health sector. However, the reality is that universal health coverage aspirations are particularly challenging when...

Integrative Public Leadership in the private sector in South Africa

ABSTRACTComplex social issues exist in many emerging democratic contexts. It has been argued that boundary-crossing leadership is needed to overcome these issues. Scholarship has developed around this, arguing that leadership in these shared power contexts is different to leadership in hierarchical organisations. This study focuses on a sample of senior private-sector leaders in South Africa who have reached across sector boundaries, in their individual capacity, to make a difference. This extends the existing scholarship which has focused on public-sector and non-profit integrative leadership. The intention is to understand the relational context of their boundary-crossing work and to extend the concept of ‘Integrative Public Leadership’. The leaders studied manage relationships with the government, their own company and multi-company partners within a historical context. The findings emphasise three understudied issues: own-company buy-in, historical context and ‘integrative’ conflict. A shared concept of integrative leadership, located in the African context, could further enhance practice.

Market barriers for voluntary climate change mitigation in the South African private sector

A key challenge in the twenty-first century is to enable economic growth and increase both environmentalquality and social inclusiveness, while mitigating and adapting to the impacts of climate change. The need for a transition to more sustainable consumption and production patterns is undeniable and sustainable economic growth must be placed at the heart of future development for all citizens. The South African private sector is under enormous pressure to remain globally competitive while balancing the interests of society, the environment and its shareholders. It has been suggested that there are discrepancies between what companies say and what they actually do, as they are challenged to move from policy to action. This paper evaluates the extent to which the private sector in South Africa adheres to voluntary climate change mitigation mechanisms and identifies potential market barriers impeding the large-scale uptake of such mechanisms. The research findings suggest that the private sector in South Africa has adopted a “take position, wait and see approach” which places them in a position to take advantage of and influence the opportunities and risks associated with climate change without having a negative impact on the bottom line. The primary barrier to voluntary climate change action is the vagueness of local and international policy frameworks. The different rules and resultant uncertainty around local and international frameworks appear to impede consistent and meaningful action. Although this uncertainty does not prevent the private sector from taking voluntary action, it does appear to negatively affect the overall scale and type of climate change mitigation efforts. While companies are continually improving the quality of sustainability reporting and public disclosure, the challenge still lies in translating these strategies into daily operations and sustainable practice that goes beyond ad hoc mitigation actions.