A critical performance evaluation of the South African Health Facilities Infrastructure Management Programme of 2011/12

Abstract

The Health Facilities Infrastructure Management Programme in South Africa aims to ensure an appropriate and sustainable platform for the delivery of health services. Since 1994, the average number of hospital beds has decreased from 4.4 beds per 1 000 people to 2.4 beds per 1 000 people. During the same period, there was no significant reduction in the 1 372 clinic backlog. The evaluation of the performance of the Health Facilities Infrastructure Management Programme was based on a systems approach. This performance evaluation was conducted across four dimensions, with 12 assessment instruments and within 134 assessment parameters. Several of these instruments were developed as part of this study. Actual performance, per assessment parameter, was expressed in terms of a four level project management maturity scale. About one third of the parameters indicated a low level of project management maturity, one third indicating a medium-low level of maturity, with less than 10% judged to have reached maturity. It was found that the Infrastructure Unit in the National Department of Health is solely responsible for addressing more than half of the performance areas described by the assessment parameters. The proposed prioritisation model indicated that 50% of the performance areas needed to be addressed as a matter of urgency. The study concludes with 10 system transformation recommendations aimed at maturity growth in the Infrastructure Unit in the National Department of Health, as well as maturity growth in the Health Facilities Infrastructure Management Programme as a whole. The following key terms are relevant: • Health Facilities Infrastructure Management Programme • Performance evaluation • Infrastructure Unit • National Department of Health of South Africa • Project management maturity • Assessment instruments • Assessment parameters • Prioritisation model