Not so long ago, in mid 2017, I was part of a team evaluating a system-wide initiative in Nelson Mandela Bay Metropolitan (NMBM) health district to improve the quality and accountability of its primary health care services and district hospitals. Our independent assessment was overwhelmingly positive. We documented an integrated system of problem analysis and response in frontline health services, engaging providers and their immediate supervisors in a manner that was both generative and meaningful to them.
These successes occurred under the stewardship of an experienced health district manager in the metro, whose achievements included the successful amalgamation of previously separate local and provincial primary health care services. This required complex transfers of assets and staff across the two spheres of government, a task yet to be achieved in other metros.
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