Testing the contextual Interaction theory in a UHC pilot district in South Africa

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dc.contributor.authorMichel, Janet
dc.contributor.authorMohlakoana, Nthabiseng
dc.contributor.authorBärnighausen, Till
dc.contributor.authorTediosi, Fabrizio
dc.contributor.authorEvans, David
dc.contributor.authorMcIntyre, Di
dc.contributor.authorBressers, Hans T A
dc.contributor.authorTanner, Marcel
dc.date.accessioned2022-04-12T19:36:22Z
dc.date.available2022-04-12T19:36:22Z
dc.date.issued2022-03-15
dc.date.updated2022-03-20T04:14:14Z
dc.description.abstractBackground World-wide, there is growing universal health coverage (UHC) enthusiasm. The South African government began piloting policies aimed at achieving UHC in 2012. These UHC policies have been and are being rolled out in the ten selected pilot districts. Our study explored policy implementation experiences of 71 actors involved in UHC policy implementation, in one South African pilot district using the Contextual Interaction Theory (CIT) lens. Method Our study applied a two-actor deductive theory of implementation, Contextual Interaction Theory (CIT) to analyse 71 key informant interviews from one National Health Insurance (NHI) pilot district in South Africa. The theory uses motivation, information, power, resources and the interaction of these to explain implementation experiences and outcomes. The research question centred on the utility of CIT tenets in explaining the observed implementation experiences of actors and outcomes particularly policy- practice gaps. Results All CIT central tenets (information, motivation, power, resources and interactions) were alluded to by actors in their policy implementation experiences, a lack or presence of these tenets were explained as either a facilitator or barrier to policy implementation. This theory was found as very useful in explaining policy implementation experiences of both policy makers and facilitators. Conclusion A central tenet that was present in this context but not fully captured by CIT was leadership. Leadership interactions were revealed as critical for policy implementation, hence we propose the inclusion of leadership interactions to the current CIT central tenets, to become motivation, information, power, resources, leadership and interactions of all these.en_US
dc.identifier.apacitationMichel, J., Mohlakoana, N., Bärnighausen, T., Tediosi, F., Evans, D., McIntyre, D., ... Tanner, M. (2022). Testing the contextual Interaction theory in a UHC pilot district in South Africa. <i>BMC Health Services Research</i>, 22(1), 343. http://hdl.handle.net/11427/36349en_ZA
dc.identifier.chicagocitationMichel, Janet, Nthabiseng Mohlakoana, Till Bärnighausen, Fabrizio Tediosi, David Evans, Di McIntyre, Hans T A Bressers, and Marcel Tanner "Testing the contextual Interaction theory in a UHC pilot district in South Africa." <i>BMC Health Services Research</i> 22, 1. (2022): 343. http://hdl.handle.net/11427/36349en_ZA
dc.identifier.citationMichel, J., Mohlakoana, N., Bärnighausen, T., Tediosi, F., Evans, D., McIntyre, D., Bressers, H.T.A. & Tanner, M. et al. 2022. Testing the contextual Interaction theory in a UHC pilot district in South Africa. <i>BMC Health Services Research.</i> 22(1):343. http://hdl.handle.net/11427/36349en_ZA
dc.identifier.ris TY - Journal Article AU - Michel, Janet AU - Mohlakoana, Nthabiseng AU - Bärnighausen, Till AU - Tediosi, Fabrizio AU - Evans, David AU - McIntyre, Di AU - Bressers, Hans T A AU - Tanner, Marcel AB - Background World-wide, there is growing universal health coverage (UHC) enthusiasm. The South African government began piloting policies aimed at achieving UHC in 2012. These UHC policies have been and are being rolled out in the ten selected pilot districts. Our study explored policy implementation experiences of 71 actors involved in UHC policy implementation, in one South African pilot district using the Contextual Interaction Theory (CIT) lens. Method Our study applied a two-actor deductive theory of implementation, Contextual Interaction Theory (CIT) to analyse 71 key informant interviews from one National Health Insurance (NHI) pilot district in South Africa. The theory uses motivation, information, power, resources and the interaction of these to explain implementation experiences and outcomes. The research question centred on the utility of CIT tenets in explaining the observed implementation experiences of actors and outcomes particularly policy- practice gaps. Results All CIT central tenets (information, motivation, power, resources and interactions) were alluded to by actors in their policy implementation experiences, a lack or presence of these tenets were explained as either a facilitator or barrier to policy implementation. This theory was found as very useful in explaining policy implementation experiences of both policy makers and facilitators. Conclusion A central tenet that was present in this context but not fully captured by CIT was leadership. Leadership interactions were revealed as critical for policy implementation, hence we propose the inclusion of leadership interactions to the current CIT central tenets, to become motivation, information, power, resources, leadership and interactions of all these. DA - 2022-03-15 DB - OpenUCT DP - University of Cape Town IS - 1 J1 - BMC Health Services Research KW - Contextual interaction theory KW - Leadership KW - Motivation KW - Information KW - Resources KW - Context KW - Interactions KW - Implementation KW - Policy-practice gaps LK - https://open.uct.ac.za PY - 2022 T1 - Testing the contextual Interaction theory in a UHC pilot district in South Africa TI - Testing the contextual Interaction theory in a UHC pilot district in South Africa UR - http://hdl.handle.net/11427/36349 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s12913-022-07705-z
dc.identifier.urihttp://hdl.handle.net/11427/36349
dc.identifier.vancouvercitationMichel J, Mohlakoana N, Bärnighausen T, Tediosi F, Evans D, McIntyre D, et al. Testing the contextual Interaction theory in a UHC pilot district in South Africa. BMC Health Services Research. 2022;22(1):343. http://hdl.handle.net/11427/36349.en_ZA
dc.language.isoenen_US
dc.language.rfc3066en
dc.publisher.departmentHealth Economics Uniten_US
dc.publisher.facultyFaculty of Health Sciencesen_US
dc.rights.holderThe Author(s)
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.sourceBMC Health Services Researchen_US
dc.source.journalissue1en_US
dc.source.journalvolume22en_US
dc.source.pagination343en_US
dc.source.urihttps://bmchealthservres.biomedcentral.com/
dc.subjectContextual interaction theoryen_US
dc.subjectLeadershipen_US
dc.subjectMotivationen_US
dc.subjectInformationen_US
dc.subjectResourcesen_US
dc.subjectContexten_US
dc.subjectInteractionsen_US
dc.subjectImplementationen_US
dc.subjectPolicy-practice gapsen_US
dc.titleTesting the contextual Interaction theory in a UHC pilot district in South Africaen_US
dc.typeJournal Articleen_US
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