ABSTRACT
Healthcare reform is a difficult policy issue that involves complex trade-offs between
policy goals, such as ensuring access to high-quality healthcare and keeping public
spending at fiscally affordable levels. Namibia, like most emerging economies faces
challenges in expanding public healthcare coverage without undermining its fiscal
sustainability. Yet, in the wake of the 2008 global financial crisis, developed countries
had to undertake fiscal consolidation, which has seen a decline in the flow of donor funds
to healthcare in developing countries. With dwindling donor funding and increased public
outcry on the deterioration of healthcare delivery systems in Namibia, the Ministry of
Health and Social Services had for the first time since independence, to introduce the
Health Sector Strategic Plan 2009 – 2013. With this in mind, the aim of this study was to
develop a deterministic framework for the successful measurement of healthcare service
quality in public healthcare organisations, focusing on the staff members’ satisfaction
levels with the 2009 - 2013 strategic decisions implementation in three Namibian State
hospitals based in Windhoek (Katutura), Rundu and Oshakati. A quantitative interpretive
structural modelling (ISM) approach was used within an action implementation
framework (AIF). The AIF is an implementation science approach that played the dual
role of providing a hands-on approach to implement strategy and identifying determinants
for its evaluation. As such, this study employed three models that complied with the action
implementation framework’s dual roles. The EIS model provided the hands on support to
the implementing strategy role by retrospectively focusing on the 2009-2013 MoHSS
Strategic plan implementation. While, the Enablers, also referred to as the Implementation
Success Factors (ISF) model and the Inhibitors, also referred to as the Implementation
Failure Factors (IFF) models were used to identify the determinants for its evaluation. The
study used primary data from a cross-sectional field survey of 290 staff from the three
intermediate state hospitals. The study found 13 effective factors related to four
dimensions, which are content of the strategy, contextual, structural, and operational
factors. As such, the study concludes that content and context factors are interdependent
such that the content of the strategy depends on the strategic context. At the same time,
effective implementation depends on the operational factors, which are also influenced by
structural factors during the strategy formulation stage. Consequently, the study
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formulated a research model for the successful measurement of healthcare service quality
in public healthcare organisations based on the perceptions of the healthcare staff. The
study recommends that the intermediate hospitals should have their own financial
management strategies that guide the implementation of national strategies and policies.
SHOPATI, A (2021). Towards The Successful Implementation Of Intervention Strategies In Three Namibian State Hospitals: A Deterministic Framework. Afribary. Retrieved from https://afribary.com/works/towards-the-successful-implementation-of-intervention-strategies-in-three-namibian-state-hospitals-a-deterministic-framework
SHOPATI, ABNER "Towards The Successful Implementation Of Intervention Strategies In Three Namibian State Hospitals: A Deterministic Framework" Afribary. Afribary, 28 Apr. 2021, https://afribary.com/works/towards-the-successful-implementation-of-intervention-strategies-in-three-namibian-state-hospitals-a-deterministic-framework. Accessed 10 Nov. 2024.
SHOPATI, ABNER . "Towards The Successful Implementation Of Intervention Strategies In Three Namibian State Hospitals: A Deterministic Framework". Afribary, Afribary, 28 Apr. 2021. Web. 10 Nov. 2024. < https://afribary.com/works/towards-the-successful-implementation-of-intervention-strategies-in-three-namibian-state-hospitals-a-deterministic-framework >.
SHOPATI, ABNER . "Towards The Successful Implementation Of Intervention Strategies In Three Namibian State Hospitals: A Deterministic Framework" Afribary (2021). Accessed November 10, 2024. https://afribary.com/works/towards-the-successful-implementation-of-intervention-strategies-in-three-namibian-state-hospitals-a-deterministic-framework