Monitoring and evaluation policy as a tool for performance enhancement in the public service: the case of the Eastern Cape Department of Health

Abstract

The study sought to interrogate the practice of Monitoring and Evaluation (M&E) as a useful performance enhancement tool for the Eastern Cape Department of Health (ECDoH). In so doing, the study proposes an M&E model for enhancing performance in the ECDoH. As a pro-efficiency practice, public entities can take advantage of M&E to ensure a timeously rendering of services. In the context of this study, public healthcare services are enshrined in Section 27 of the Constitution of the Republic of South Africa (1996) making it a fundamental legal right of all citizens. The ECDoH has to ensure that the delivery of public healthcare services is improved in terms of both access and swiftness of how citizens get access to this critical service. Furthermore, the study is premised on the problem explained as follows. Above all, the problem of less efficient processes and activities used to ensure a progressive realisation of public healthcare rights by the healthcare users in the Eastern Cape Province of South Africa. The haphazard manner in which the ECDoH presently delivers its public healthcare services has left consumers of public healthcare services living in rural enclaves which are remote and somewhat secluded from receiving quality healthcare. In addition, the continued use and reliance on the Performance Management and Development System (PMDS) to manage the Department's performance stalls progress. This is mainly due to the fact that the PMDS is obsessed with individual employee performance at the expense of overall organisational progress. A triangulated approach was used to gather data included both a literature study and empirical evidence collection. A literature review was done where a dominant golden thread emerged showing M&E as a catalytic tool for public entities such as government departments specifically the ECDoH due to its ability to enable tracing and tracking of performance thereby allowing room for remediation to ensure goals remain attainable. Data was collected through semi-structured interviews, from a sample of 50 respondents who included members of the senior management as well as the PMDS unit in the ECDoH. The respondents were spread across the ECDoH in Bisho, King Williams Town, and East London. The analysis of data was done qualitatively using the Grounded Theory approach to enable the objective thematic coding and holistic analysis. The findings of the study included an evident existence of poor public healthcare service delivery due to the absence of an M&E framework. Other impediments affecting the efficient delivery of healthcare by the ECDoH were established comprising the massive infrastructural shortfalls. A nine-phase model was further proposed to markedly mitigate the negative effects of the identified challenges and keep the ECDoH on track with the sustainable achievement of its mandate; and above all, delivery of this vital healthcare service to its constituencies.