Essay Example: Poor Performance and Productivity in the South African Public Health Sector: Managerial Duties, Impact and Challenges

Poor Performance and Productivity in the South African Public Health Sector: Managerial Duties, Impact and Challenges

1. Introduction

1.1 Context of Public Sector Performance Culture

Performance improvement initiatives in government have long emphasised goal setting and evidence-based decision making, yet systemic underperformance persists. Culture plays a central role: even robust performance frameworks falter when workplace culture undermines strategic objectives (Risher, 2024). In South Africa’s public health sector, entrenched poor performance and low productivity reflect a culture where managers often lack the skills and experience necessary to drive institutional performance (Chirwa, 2025).

1.2 Thesis Statement and Paper Structure

This paper examines the diverse duties of managers in the South African National Department of Health, evaluates how these duties affect performance and productivity, and assesses the challenges managers face in achieving strategic objectives. Section 2 outlines managerial duties; Section 3 analyses their impact; Section 4 explores key challenges; and Section 5 summarises findings.

2. Diverse Duties of Managers in a Selected Government Department

2.1 Planning and Strategic Alignment in the Department of Public Health

Effective planning aligns institutional goals with national health priorities. The National Department of Health’s Strategic Plan 2020/21–2024/25 sets measurable targets—such as increasing life expectancy to 66.6 years by 2024—and guides programme design across six strategic focus areas (Mkhize, 2020). Managers translate these high-level objectives into operational plans, ensuring district health systems, infrastructure development, and universal health coverage initiatives conform to national guidelines.

2.2 Organising Resources and Teams

Managers coordinate personnel, budgets and logistics to match resources with service demand. In the Department of Health, this entails staffing primary healthcare teams, allocating medical products equitably, and leveraging inter-sectoral partnerships for multisectoral collaboration (Mkhize, 2020). Building functional teams requires clarity of roles, decentralised management, and alignment with Batho Pele values of access and transparency.

2.3 Leading and Motivating Employees

Leadership style critically shapes employee engagement. Transformational leadership—characterised by vision casting and empowerment—positively influences motivation in resource-constrained health NGOs (Chirwa, 2025). Conversely, transactional approaches, reliant on rewards and penalties, may yield short-term compliance but undermine intrinsic motivation over time. Managers in the Department of Health must foster a supportive culture that values employee input and strengthens commitment to patient-centred care (Risher, 2024).

2.4 Controlling Performance and Accountability

Monitoring performance through data-driven reviews, audits and feedback loops ensures accountability. The department’s institutional programme performance information system measures progress against key outcome statements (Mkhize, 2020). Managers enforce service standards, identify deviations, and implement corrective actions. Regular performance reviews reinforce strategic alignment and drive continuous improvement (Risher, 2024).

3. Impact of Managerial Duties on Performance and Productivity

3.1 Effect of Strategic Planning on Service Delivery Outcomes

Strategic planning underpins service delivery improvements. By setting clear targets for maternal and child health outcomes, managers have helped increase antenatal first-visit coverage to over 68% and reduce neonatal mortality rates in several provinces (Mkhize, 2020). Effective planning drives resource mobilisation and guides district-level interventions.

3.2 Role of Resource Allocation in Operational Efficiency

Efficient resource allocation minimises waste. The department’s focus on evidence-based procurement and supply chain optimisation has improved access to essential medicines. Managers who align procurement with demand forecasts reduce stock-outs and streamline workflows, enhancing throughput without additional funding (Mkhize, 2020).

3.3 Influence of Leadership Style on Employee Engagement

Leadership style mediates employee engagement. In Zambian health NGOs, transformational leadership increased motivation more than transactional or autocratic styles, with organisational culture playing a mediating role (Chirwa, 2025). South African health managers adopting this approach report higher staff satisfaction and lower absenteeism (Risher, 2024).

3.4 Importance of Performance Monitoring and Feedback

Regular feedback sustains productivity. Data-driven performance reviews reinforce accountability and energise staff by recognising achievements. A culture of open feedback fosters innovation and strengthens trust, which is essential in environments where performance deficits have become entrenched (Risher, 2024).

4. Challenges Managers Face in Achieving Strategic Objectives

4.1 Skill and Knowledge Gaps

Many managers lack formal training in modern public sector management practices. This skills gap hampers strategic planning, performance management and change leadership.

Note: This section includes information based on general knowledge, as specific supporting data was not available.

4.2 Bureaucratic Constraints and Policy Limitations

Red tape and complex approval processes delay reforms. Government transformation projects often stall due to protracted authorisation cycles and short leadership tenures, which erode continuity and momentum (Daly, 2025).

4.3 Resource Scarcity and Budgetary Pressures

Competing priorities and limited budgets constrain project scope. Change management is frequently under-resourced, forcing managers to juggle reform initiatives alongside operational duties, undermining focus and implementation quality (Daly, 2025).

4.4 Resistance to Change and Cultural Barriers

Institutional culture can resist strategic shifts. Entrenched routines and scepticism among employees and communities impede adoption of new practices. Overcoming this resistance requires deliberate culture-change efforts that engage stakeholders and build trust (Risher, 2024; Daly, 2025).

5. Conclusion

5.1 Summary of Key Findings

Managers in the South African Department of Health perform planning, organising, leading and controlling duties that directly influence service delivery outcomes and operational efficiency. While strategic planning and transformational leadership boost productivity and engagement, skill gaps, bureaucratic inertia, resource constraints and cultural resistance pose significant challenges. Strengthening managerial capacity, streamlining processes and fostering a supportive culture are essential to transform performance and productivity in the public health sector.

References

Chirwa, L. (2025) ‘Impact of leadership styles on employee motivation as mediated by organizational culture: A case of healthcare NGO in Zambia’, International Journal of Academe and Industry Research, 6(1), pp. 84–107. doi:10.53378/ijair.353165.

Daly, C. (2025) ‘6 Reasons Change Management in Government is Challenging’, ThoughtExchange, 10 June.

Mkhize, Z.L. (2020) Strategic Plan 2020/21 – 2024/25, National Department of Health.

Risher, H. (2024) The Forgotten Key to Improving Performance: Culture Change, Careers in Government.