Managing records in South African public health care institutions : a critical analysis
Katuu, Shadrack Ayub
The historical evolution of South Africa’s health sector, dating back to the 17th century, is significantly
different from that of other African countries. Throughout the four centuries of development there have
been numerous advances in health policy, legislative instruments and health system progress. Against
this background this dissertation critically analysed the management of records in public health care
institutions in South Africa. The study did this by addressing three objectives: assess the legislative,
policy and regulatory contextual framework of South Africa’s health care system; assess the
effectiveness of records management within public health care institutions; and identify appropriate
interventions to address the challenges facing records management in the health care system. The
study used purposive sampling to identify respondents with diverse expertise in three main sectors: the
public sector, the private sector as well as in academic and research institutions. Using interview
research technique the study solicited data that was analysed in order to provide a composite picture in
addressing the research objectives.
The analysis of data revealed three overarching themes. First, there is substantial legislative and
regulatory dissonance in the management of health records in the country. While there are extensive
legislative, regulatory and policy instruments that could be used to manage records, many lack
coherence with records management issues such as records retention. Second, understanding the
complex interplay of different legal and regulatory instruments is a critical first step, but it remains the
beginning of the process towards building a sophisticated implementation process. For this process to
be successful, study respondents argued that records compliance would have to be the backbone of all
other compliance processes. Third, while there were substantial areas of weakness in the management
of records in South Africa’s public health sector, there have been a number of pockets of excellence.
These include the efforts towards complying to access to information legislation by the Limpopo
Department of Health and Social Development as well as the successful introduction of Enterprise
Content Management systems in health care institutions by the Western Cape Department of Health
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