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The Social Determinants of Health and the Role of the Health Care System: A Case Study of the Significance of Good governance in Public Hospitals in South Africa

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Health 2016年第12期8卷 1288-1306页

作者： Adam Fusheini John Eyles Jane Goudge Centre for Health Policy/MRC Health Policy Research Group School of Public Health Faculty of Health Sciences University of the Witwa-tersrand Johannesburg South Africa Department of Health Policy Planning and Management School of Public Health University of Health and Allied Sciences Ho Ghana School of Geography and Earth Sciences McMaster University Hamilton Canada

Increasingly international and national policies are being directed at actions for the social determinants of health and for an integrated approach to health care provision, not only in terms of institutional cooperation but also stakeholder involvement. A key component of both these policies is the development of good governance principles in all health care agencies and organizations. A neglected dimension in these debates has been the role of the public hospital which remains a vital and expensive dimension of service provision. In a case study of a public hospital in South Africa, this paper charts the readiness of its management principles and activities to provide quality health care linked to population health and to contribute to the non-medical determinant of health. Using Taylor’s principles of good governance, we conclude that there is a mixture of good and not so good governance activity. The paper concludes by examining the external constraints on the public hospital and by providing suggestions for future activities.

关键词： Social Determinants of Health Healthcare System Public Hospitals governance and governance principles South Africa

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