1 hour

Aims | To help us to:

• Deepen our understanding of the politics underpinning health in South Africa 
• Critically reflect on the health system in our own local municipalities

Task 1
Individual reflective analysis: Your local municipality health systems

30 minutes

The first part of this activity involves individual reflection and analysis time You’ll be thinking about the municipality that you either live, work or are an activist within:  

Describe and critically analyse the health system in your local municipality, in terms of its condition or state and the health outcomes that are being achieved. You will have an opportunity to deepen this work between Module 1 and Module 2. Write down your analysis either as talking notes. Here are prompts for your analysis: 

• Public health versus Private health – describe the kinds of facilities that exist by way of size, age of buildings, renovations/refurbishment, proximity to transport hubs, layout in terms of accessibility for patients
• Facility resourcing – the condition of the facility by way of resources such as age of medical equipment, quality of waiting area seating, reception, treatment rooms, wards, cleanliness, etc. – the overall quality 
• Ambulance services – the availability from public and private sector
• Care quality – the quality of health care provided 
• Fees – who pays and in which facilities
• Staffing –  the range of staff routinely on duty in the facilities as well as the vacancies you are aware of – nurses, doctors, specialists, other medical staff, community health workers, support staff (porters, cleaners, drivers, etc.), administration staff
• Ratio – the patient to health worker ratio e.g. in the public clinic there is 1 doctor to 5000 residents in the catchment area, etc 
• Pharmaceutical Supplies – the availability of pharmaceutical supplies and the quality of products, including any problems of stock-outs 
• Satisfaction – the level of patient satisfaction and perceptions and source of this information
• Effects on marginalised – the extent to which any of the above affects women and girls more than men and boys, as well as other vulnerable and marginalised groups in communities including migrants, the disabled, elderly, etcetera. 

Task 2
Group sharing: What’s similar, what’s different and why?

(30 minutes)

In small groups as assigned, allow each Fellow to share their analysis of their local health system with each Fellow allocated a maximum of 5 minutes (elect a timekeeper) to give the key features that stand out from their reflective analysis and to then compare them across the group to draw out:  

1.  What is similar? What explains the similarities?
2.  What are the differences? What explains the differences?
3.  What picture do the similarities and differences paint of South Africa’s health system as a whole? 

Keep 10 minutes of your 30 minutes at the end, for a snap discussion to quickly distil or crystalise the following. Do take notes of this closing discussion:

A. What explains the similarities and differences in your group’s view? 

While there will not be a plenary sharing immediately hereafter, the plenary sharing of these reflections are integrated into the closing session of today (see the end of Activity 8).