Mapping the multiple intersectoral spaces for civil society participation and responsiveness strengthening in the South African health system – focusing on the Western Cape

dc.contributor.advisorOlivier, Jill
dc.contributor.authorWhiting, Amy
dc.date.accessioned2022-03-30T10:11:49Z
dc.date.available2022-03-30T10:11:49Z
dc.date.issued2021
dc.date.updated2022-03-22T13:57:31Z
dc.description.abstractSince the Alma Ata Declaration of 1978, community participation in health policy development and health system functioning has called for a collaborative intersectoral approach, engaging civil society as a pivotal agent for improving policy-makers' responsiveness in the public health system. Intersectoral approaches are widely accepted and research has shown the value in engaging communities in the improvement of their health. However, astonishingly little is known about the overall configuration, nature, and focus of the ‘spaces' where civil society are participating in health system-relevant engagement, or their contribution towards improved system responsiveness. This study describes a local provincial health system, the Western Cape province in South Africa, mapping the intersectoral spaces where civil society participates in the health system, provides feedback to the system (towards responsiveness), and contributes to health system improvement decisions. A mixed method case study was conducted, integrating desk-based review of multiple forms of openly available data, with verification from experts in the field. Sixteen intersectoral spaces in the Western Cape health system were mapped and compared, with analysis focussing on current governance practices in these spaces, evidence of accountability measures and civil society participation within the broader goal of improving health system responsiveness. Multiple spaces exist for intersectoral engagement in the Western Cape of South Africa, but there is a lack of any ‘system-wide' integrative approach – which creates overlap, a focus on vertical programming, and parts of civil society remain ‘disconnected' from the system. Feedback from civil society back into national or provincial policy-making processes is sporadic due to fragmented tiered governance. New efforts towards ‘whole-system' intersectoral collaboration need to be initiated and actively protected, if they are to succeed. This study demonstrates that while ‘intersectoral action for responsiveness strengthening' is broadly encouraged in this health system, it needs to be more fully assessed and operationalised in terms of multilevel governance, accountability and civil society empowerment. In doing so avenues can be identified for improving civil society's feedback into the public health system, and ensuring adequate system's response to this feedback, in health policy and practice.
dc.identifier.apacitationWhiting, A. (2021). <i>Mapping the multiple intersectoral spaces for civil society participation and responsiveness strengthening in the South African health system – focusing on the Western Cape</i>. (). ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. Retrieved from http://hdl.handle.net/11427/36238en_ZA
dc.identifier.chicagocitationWhiting, Amy. <i>"Mapping the multiple intersectoral spaces for civil society participation and responsiveness strengthening in the South African health system – focusing on the Western Cape."</i> ., ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2021. http://hdl.handle.net/11427/36238en_ZA
dc.identifier.citationWhiting, A. 2021. Mapping the multiple intersectoral spaces for civil society participation and responsiveness strengthening in the South African health system – focusing on the Western Cape. . ,Faculty of Health Sciences ,Department of Public Health and Family Medicine. http://hdl.handle.net/11427/36238en_ZA
dc.identifier.ris TY - Master Thesis AU - Whiting, Amy AB - Since the Alma Ata Declaration of 1978, community participation in health policy development and health system functioning has called for a collaborative intersectoral approach, engaging civil society as a pivotal agent for improving policy-makers' responsiveness in the public health system. Intersectoral approaches are widely accepted and research has shown the value in engaging communities in the improvement of their health. However, astonishingly little is known about the overall configuration, nature, and focus of the ‘spaces' where civil society are participating in health system-relevant engagement, or their contribution towards improved system responsiveness. This study describes a local provincial health system, the Western Cape province in South Africa, mapping the intersectoral spaces where civil society participates in the health system, provides feedback to the system (towards responsiveness), and contributes to health system improvement decisions. A mixed method case study was conducted, integrating desk-based review of multiple forms of openly available data, with verification from experts in the field. Sixteen intersectoral spaces in the Western Cape health system were mapped and compared, with analysis focussing on current governance practices in these spaces, evidence of accountability measures and civil society participation within the broader goal of improving health system responsiveness. Multiple spaces exist for intersectoral engagement in the Western Cape of South Africa, but there is a lack of any ‘system-wide' integrative approach – which creates overlap, a focus on vertical programming, and parts of civil society remain ‘disconnected' from the system. Feedback from civil society back into national or provincial policy-making processes is sporadic due to fragmented tiered governance. New efforts towards ‘whole-system' intersectoral collaboration need to be initiated and actively protected, if they are to succeed. This study demonstrates that while ‘intersectoral action for responsiveness strengthening' is broadly encouraged in this health system, it needs to be more fully assessed and operationalised in terms of multilevel governance, accountability and civil society empowerment. In doing so avenues can be identified for improving civil society's feedback into the public health system, and ensuring adequate system's response to this feedback, in health policy and practice. DA - 2021_ DB - OpenUCT DP - University of Cape Town KW - Health Systems LK - https://open.uct.ac.za PY - 2021 T1 - Mapping the multiple intersectoral spaces for civil society participation and responsiveness strengthening in the South African health system – focusing on the Western Cape TI - Mapping the multiple intersectoral spaces for civil society participation and responsiveness strengthening in the South African health system – focusing on the Western Cape UR - http://hdl.handle.net/11427/36238 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/36238
dc.identifier.vancouvercitationWhiting A. Mapping the multiple intersectoral spaces for civil society participation and responsiveness strengthening in the South African health system – focusing on the Western Cape. []. ,Faculty of Health Sciences ,Department of Public Health and Family Medicine, 2021 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/36238en_ZA
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Public Health and Family Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.subjectHealth Systems
dc.titleMapping the multiple intersectoral spaces for civil society participation and responsiveness strengthening in the South African health system – focusing on the Western Cape
dc.typeMaster Thesis
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMPH
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