Determining the Potential of Health Executive Leaders to Disrupt the South Africa Health System
A Systems Evaluation of the Albertina Sisulu Executive Leadership Programme in Health (ASELPH)
How might we determine the leverage points within the South Africa Health System where ASELPH could play a significant role in generating positive change?
Assessing this challenge, the SPACES team provided a quantitative and qualitative systems analysis. Pulling from GKI’s repertoire of systems tools and methods and previous work analyzing healthcare systems, GKI conducted the qualitative portion of the evaluation. The goal of this evaluation was to determine the extent to which the ASELPH Programme could positively impact the South Africa Health System.
GKI began by employing a modified version of the World Health Organization’s (WHO) building blocks for health systems as a framework for analyzing distinct health system functions. The functions analyzed included Human Resources, Supply Chain Management, Service Delivery, Policy, Finance, and Monitoring & Evaluation. These functions guided the direction of background research and the design of the interview protocol. The team conducted 47 interviews with key stakeholders in South Africa across 4 provinces: Gauteng, Eastern Cape, Mpumalanga, and Limpopo. The insights gleaned from the interviews helped inform the creation of a causal loop diagram, a type of system map focused on critical feedback loops. This diagram underscored the skills which require additional emphasis in the South Africa Health System, systemic enablers and barriers, and possible recommendations for how the ASELPH team might play a role in alleviating those barriers. The results presented are intended to serve as a precursory step to an impact evaluation by way of highlighting which areas in the South Africa Health System ASELPH might have the greatest potential for impact.
Results / Outcomes
- Continued to introduce and apply systems monitoring and evaluation approaches across USAID Missions and Bureaus through the innovative mechanism designed to bring advanced Monitoring, Evaluation, Research and Learning (MERL) methods known as the Strategic Program for Analyzing Complexity and Evaluating Systems (SPACES).
- Gained key insights through conducting 47 interviews with health system stakeholders, including ASELPH fellows, ASELPH faculty, and non-ASELPH members working across 4 provinces in South Africa.
- Created a causal loop diagram, based on the insights gathered from the interviews and qualitative coding that identified common themes across health system functions that prevent critical skills from reaching scale among health professionals.
- Identified 13 groups of recommendations where the ASELPH Programme could play a significant role in generating change within the South Africa Health System.