Differences in antiretroviral scale up in three South African provinces: the role of implementation management

Simple item page
dc.contributor.authorSchneider, Helenen_ZA
dc.contributor.authorCoetzee, Daviden_ZA
dc.contributor.authorVan Rensburg, Dingieen_ZA
dc.contributor.authorGilson, Lucyen_ZA
dc.date.accessioned2015-10-28T07:09:11Z
dc.date.available2015-10-28T07:09:11Z
dc.date.issued2010en_ZA
dc.description.abstractBACKGROUND:South Africa's antiretroviral programme is governed by defined national plans, establishing treatment targets and providing funding through ring-fenced conditional grants. However, in terms of the country's quasi-federal constitution, provincial governments bear the main responsibility for provision of health care, and have a certain amount of autonomy and therefore choice in the way their HIV/AIDS programmes are implemented. METHODS: The paper is a comparative case study of the early management of ART scale up in three South African provincial governments - Western Cape, Gauteng and Free State - focusing on both operational and strategic dimensions. Drawing on surveys of models of ART care and analyses of the policy process conducted in the three provinces between 2005 and 2007, as well as a considerable body of grey and indexed literature on ART scale up in South Africa, it draws links between implementation processes and variations in provincial ART coverage (low, medium and high) achieved in the three provinces. RESULTS: While they adopted similar chronic disease care approaches, the provinces differed with respect to political and managerial leadership of the programme, programme design, the balance between central standardisation and local flexibility, the effectiveness of monitoring and evaluation systems, and the nature and extent of external support and programme partnerships. CONCLUSIONS: This case study points to the importance of sub-national programme processes and the influence of factors other than financing or human resource capacity, in understanding intervention scale up.en_ZA
dc.identifier.apacitationSchneider, H., Coetzee, D., Van Rensburg, D., & Gilson, L. (2010). Differences in antiretroviral scale up in three South African provinces: the role of implementation management. <i>BMC Health Services Research</i>, http://hdl.handle.net/11427/14481en_ZA
dc.identifier.chicagocitationSchneider, Helen, David Coetzee, Dingie Van Rensburg, and Lucy Gilson "Differences in antiretroviral scale up in three South African provinces: the role of implementation management." <i>BMC Health Services Research</i> (2010) http://hdl.handle.net/11427/14481en_ZA
dc.identifier.citationSchneider, H., Coetzee, D., Van Rensburg, D., & Gilson, L. (2010). Differences in antiretroviral scale up in three South African provinces: the role of implementation management. BMC Health Services Research, 10(Suppl 1), S4.en_ZA
dc.identifier.ris TY - Journal Article AU - Schneider, Helen AU - Coetzee, David AU - Van Rensburg, Dingie AU - Gilson, Lucy AB - BACKGROUND:South Africa's antiretroviral programme is governed by defined national plans, establishing treatment targets and providing funding through ring-fenced conditional grants. However, in terms of the country's quasi-federal constitution, provincial governments bear the main responsibility for provision of health care, and have a certain amount of autonomy and therefore choice in the way their HIV/AIDS programmes are implemented. METHODS: The paper is a comparative case study of the early management of ART scale up in three South African provincial governments - Western Cape, Gauteng and Free State - focusing on both operational and strategic dimensions. Drawing on surveys of models of ART care and analyses of the policy process conducted in the three provinces between 2005 and 2007, as well as a considerable body of grey and indexed literature on ART scale up in South Africa, it draws links between implementation processes and variations in provincial ART coverage (low, medium and high) achieved in the three provinces. RESULTS: While they adopted similar chronic disease care approaches, the provinces differed with respect to political and managerial leadership of the programme, programme design, the balance between central standardisation and local flexibility, the effectiveness of monitoring and evaluation systems, and the nature and extent of external support and programme partnerships. CONCLUSIONS: This case study points to the importance of sub-national programme processes and the influence of factors other than financing or human resource capacity, in understanding intervention scale up. DA - 2010 DB - OpenUCT DO - 10.1186/1472-6963-10-S1-S4 DP - University of Cape Town J1 - BMC Health Services Research LK - https://open.uct.ac.za PB - University of Cape Town PY - 2010 T1 - Differences in antiretroviral scale up in three South African provinces: the role of implementation management TI - Differences in antiretroviral scale up in three South African provinces: the role of implementation management UR - http://hdl.handle.net/11427/14481 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/14481
dc.identifier.urihttp://dx.doi.org/10.1186/1472-6963-10-S1-S4
dc.identifier.vancouvercitationSchneider H, Coetzee D, Van Rensburg D, Gilson L. Differences in antiretroviral scale up in three South African provinces: the role of implementation management. BMC Health Services Research. 2010; http://hdl.handle.net/11427/14481.en_ZA
dc.language.isoengen_ZA
dc.publisherBioMed Central Ltden_ZA
dc.publisher.departmentDepartment of Public Health and Family Medicineen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution Licenseen_ZA
dc.rights.holder2010 Schneider et al; licensee BioMed Central Ltd.en_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/2.0en_ZA
dc.sourceBMC Health Services Researchen_ZA
dc.source.urihttp://www.biomedcentral.com/bmchealthservres/en_ZA
dc.subject.otherAnti-Retroviral Agentsen_ZA
dc.subject.otherHealth Plan Implementationen_ZA
dc.titleDifferences in antiretroviral scale up in three South African provinces: the role of implementation managementen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Schneider_Differences_antiretroviral_scale_2010.pdf
Size:
521.87 KB
Format:
Adobe Portable Document Format
Description:
Download
Collections
Journal Articles