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The paper's aim is to determine the role of non‐profit organizations (NPOs) in filling possible gaps in primary health care (PHC) service provision.

District (n=10) and sub‐district needs (n=14) analyses were conducted in five South African provinces. In each case, the district/sub‐district manager was interviewed using a semi‐structured interview guide.

The service gaps identified were understaffing/lack of capacity, difficulty in retaining and recruiting staff, service disparities, inaccessibility of services/low‐service utilisation and limited funding. It was believed that NPOs could fill these gaps. About 83 per cent perceived the relationship between government and NPOs as good. Contract monitoring, quality of service, communication and quality control were said to be unsatisfactory. The majority of sub‐districts (11) indicated that they provided supplies to NPOs; 50 per cent perceived the relationship between the sub‐districts and NPOs as good or very good. NPOs have critical role to play in PHC service delivery.

The study provides critical information required to make informed effective strategic decisions that support district/sub‐district performance and sustainability in a decentralized health system.

Public Health; Leadership; Organisational Development; Organisational Behaviour; Public Administration Management.

Postgraduate level for honours or masters programmes in courses on public health; executive leadership and management programmes; MBA level.

The case unpacks decentralisation as a means to promote and improve local decision-making and accountability through community participation and engagements. Ayanda Nkele was a programme manager in a health district in South Africa. He was faced with many challenges when trying to implement his programme, most of which were related to local authority, responsibilities and decision-making abilities at his level. This case describes briefly the South African health system. and how it functions. It describes the proposed changes to the health system and its transformation towards Universal Health Coverage. The decision space analysis as discussed in the case illustrates the types of decentralisation in the country and how this also applies to Nkele’s level.

Understanding the concepts and principles of decentralisation within the context of strengthening district health services, the re-engineering of primary health care (PHC) and rolling out a National Health Insurance in South Africa. Applying the “decision space” approach to analyse the extent of decentralisation. Grasping the requirement of leaders to be “contextually intelligent” and identify the important contextual variables to take into account when analysing public health care.

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CSS 7: Management Science.

The Regulation of the Minister of Justice and Human Rights of the Republic of Indonesia No 34, 2016 was issued to regulate the criteria of districts/municipalities care about human rights. Anak-Dalam Tribe (Suku Anak Dalam – SAD), a remote indigenous community in Batanghari, Jambi Province, faces its own challenges in health services. This study aims to assess the readiness of Batanghari as the District of Human Rights Care to fulfill the health care of SAD.

Using qualitative approach, this study explored the viewpoints of relevant stakeholders equipped with secondary data, literature review and analysis of relevant news in mass media as a form of triangulation.

Generally, Batanghari District Government has fulfilled the criteria of preparedness of the District of Human Rights Care about the distribution of health services. Nevertheless, there are still obstacles, such as difficulties in registering the SAD community – the Residence Registration Number and the strong customs in SAD's beliefs and traditions. Local government tries to overcome these problems with affirmative policies that facilitate member of the SAD community.

This study was supported by the Directorate of Research and Community Service of Universitas Indonesia. The authors have no conflicts of interest with the material presented in this manuscript. The authors declare that no ethical issues may arise after the publication of this manuscript.

Despite enormous progress in health globally, primary healthcare services in many developing countries are facing different challenges. Many studies have documented that decentralisation could be useful in supporting and developing health services closer to citizens. The purpose of this paper is to assess the effect of decentralisation on health services, and to draw general lessons which might help to develop appropriate strategies to improve health services in Nepal.

A mixed method was used, consisting of reviews of current literatures relevant to decentralisation and health performance, engaging with health service inputs‐outputs data between 2001 and 2007, and assessing the range of choices (management, finance and governance) available to local authorities using Bossert's “decision‐space approach”.

Decentralisation in many countries, including Nepal, suggests a new form of service delivery.

Review of the selected studies in triangulation with health services data has revealed that decentralisation in many cases has improved access to, utilisation of, and management of health services. The effects on other performance dimensions such as policy, equity, quality and service effectiveness are poorly investigated topics in the literature. The findings suggest that the successful implementation of decentralisation requires a broader context of institutional capacity building and resource management, and underlines the need for their consideration during implementation processes, and further investigation.

Over the past two decades, Community-Based Health Planning and Services (CHPS) has been a pragmatic strategy towards universal Primary Health Care (PHC) in Ghana. However, the ability and capacity of these facilities to deliver quality primary health care remain an illusion as they are still crumbling in myriad challenges. These challenges are translated to the poor-quality services provision and low community utilization of CHPS facilities. The study presents a comparative analysis of three communities in the Kassena-Nankana East Municipality, Ghana.

Using a mixed-method research design, the study gathered and analysed data from 110 households, three community health officers (CHOs) and three community leaders using semi-structured questionnaires and interview guides.

The findings indicated that the facilities do not have the requisite inputs such as drugs and supplies, logistics, appropriate health personnel, good infrastructure, funding support necessary to deliver quality and appropriate healthcare services that meet the health needs of the communities. For the CHPS to realize their full potentials as PHC facilities, it is required that the needed inputs such as logistics, drugs and appropriate staff are in place to facilitate the activities of CHOs.

Due to the limited number of participants and selection of the study communities, the results may generalization. Also, the researchers acknowledged the inability to interview the district level health officials and the Kassena-Nankana Municipal Assembly during the field visits. This could have provided in-depth knowledge on the findings of this research as well as the validation of the results from the communities' perspective. Several attempts were made to contact and interview district-level authorities which proven futile due to the unavailability of targeted respondents. This resulted in limiting the studies at the community level. However, this limitation does not disprove the findings of this study.

The article implications for planning primary health care strategies include a keen assessment of community health needs and institutional management of primary health care facilities, equip PHC facilities with adequate resources such as drugs and appropriate staffing to provide the health needs of the communities.

The paper fulfils the gap in the literature by providing empirical data on how the challenges of primary health care facilities affected the provision of high quality service and how this can affect community’s use of the facilities.

The terms are not synonymous; their differences are mainly of function and areas of administration. Community Health is used in national health service law; environmental health to describe the residuum of health functions remaining with local authorities after the first NHS/Local Government reorganization of 1974. Previously, they were all embraced in the term public health, known for a century or more, with little attention to divisions and in the field of administration, all local authority between county and district councils. In the dichotomy created by the reorganization, the personal health services, including the ambulance service, may have dove‐tailed into the national health service, but for the remaining functions, there was a situation of unreality, which has persisted. It is difficult to know where community health and environmental health begin and end. From the outside, the unreality may be more apparent than real. The Royal Commission on the NHS in their Report of last year state that leaving environmental health services with local authorities “does not seem to have caused any problems”—and this, despite the disparity in status of the area health authority and the bottom tier, local councils.

Gweru District, Zimbabwe faces a major challenge of noncommunicable diseases (NCDs). Globally, health systems have not responded successfully to problems in prevention and management of NCDs. Despite numerous initiatives, reorienting health services has been slow in many countries. Gweru District has similar challenges. The purpose of this paper is to explore what the health systems in Zimbabwe have done, and are doing to respond to increasing numbers of NCD cases in adults in the nation, especially in the district of Gweru

The study employed a descriptive narrative review of the academic and grey literature, supplemented by semi-structured key informant interviews with 14 health care staff and 30 adults living with a disease or caring for an adult with a disease in Gweru District.

Respondents identified many limitations to the response in Gweru. Respondents said that screening and diagnosis cease to be helpful when it is difficult securing medications. Nearly all community respondents reported not understanding why they are not freed of the diseases, showing poor understanding of NCDs. The escalating costs and scarcity of medications have led people to lose trust in services. Government and NGO activities include diagnosis and screening, provision of health education and some medication. Health personnel mentioned gaps in transport, medication shortages, poor equipment and poor community engagement. Suggestions include: training of nurses for a greater role in screening and management of NCDs, greater resourcing, outreach activities/satellite clinics and better integration of diverse NCD policies.

This research offers an understanding of NCD strategies and their limitations from the bottom-up, lived experience perspective of local health care workers and community members.

The public health sector in South Korea introduced district health information systems (DHIS) in health centres in the early 1990s. DHIS aimed to help health centres to provide comprehensive health care services and to achieve effective and efficient management of their works. District health information systems are still being implemented in health centres. Information generated and collected through the systems is to be used by local authorities to plan and manage health services in their areas, and further by the central government to make a health plan and health policy at the national level. However, the adoption and implementation of DHIS by health centres does not meet the initial anticipation. Moreover, reasons for that have not been explored yet. This paper presents the development of DHIS for health centres in Korea, evaluates the project focusing on impacts and problems found in implementing the systems, and provides lessons and recommendations for establishing a nationwide health information network.

Leadership and Health Care management and Organisational Development and Talent Management.

Postgraduate level for honours or master’s programs in courses on public health, executive leadership and management, organisational development and public administration leadership.

The case study offers an account of Ms Xolani Ngumi’s Chief Director, Enola District Health Services, South Africa, who was driving from her newly constructed modern district hospital to one of the municipal clinics that she was overseeing. It highlights the dilemma of the general practitioners (GP’s) that refused to be relocated, leading to many clinics being without clinical support.

Expected learning outcomes are as follows: Identification of stakeholders in a particular dilemma to aid leaders’ decision-making; developing the competence of balancing conflicting needs of stakeholders by juggling complex systems; and analysing staffing issues and offer recommendations to enhance talent management.

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CSS 7: Management Science.

The purpose of this paper is to describe progress in an across sectorial approach to primary health care at the district health service (DHS) level in Thailand in response to recent innovative national public policy directions which have been enshrined in constitutional doctrine and publicly endorsed by the Prime Minister. This paper describes one response to the Prime Minister’s challenge for Thailand to become the centre of learning in the sub-region in health management.

The authors utilised a descriptive case study approach utilising an analysis of the Naresuan University initiative of establishing the College of Health Systems Management (NUCHSM). Within that case study, there is a focus on challenges relevant to the socio-economic determinants of health (SOED) and an emphasis on utilising Sustainable Development Goals (SDGs) within the DHS structure.

The findings describe the establishment of the NUCHSM. A Master of Science (Health Systems Management) by research and a PhD degree have been created and supported by an international faculty. The Thailand International Cooperation Agency recognised NUCHSM by providing scholarships. International students are from Bangladesh, Bhutan, Kenya, Malawi and Timor Leste. Research consultancy projects include two in Lao People’s Democratic Republic; plus, a prototype DHS management system responsive to SDG attainment; and a project to establish a sustainable Ageing Society philosophy for a Thai municipality.

The case study on NUCHSM and its antecedents in its development have demonstrated originality in a long-standing international collaboration, and it has been recognised by the national government to provide scholarships to citizens of the countries in the sub-region to undertake postgraduate studies in health management. The concept of learning from each other and together, simultaneously as a group, through action research projects funded to enhance the evolution of DHSs is innovative.