Managing oral health in the Oral Health Service of the South African Medical Service :A Systems Approach

[摘要] Problems concerning the planning and practicing of health care currently exist.Countries are spending more funds on medical care without making a discernible dent in the health status of their citizens. This lack of success in obtaining health is obviously a problem for everyone experiencing ill health or the effects thereof It also creates apersonal problem for all health workers, because a halt is being called to profligatespending on health that will affect all. The problems underlying tl:e health care crisis arerising costs, unequal distribution, low productivity, poor heali..ii status, and a lack insensitivity towards the communities it serves. The multi-disciplinary, complex nature ofthese problems in health care, their magnitude and their inter-relatedness indicate thattraditional approaches to health care planning and management have been inadequate or have failed. An alternative approach to solve these problems is to adopt a holistic view, i.e., to see all parts (components) which contribute to the problem as parts of the whole. By viewing the problem as a whole, more enduring solutions may be formulated.The aim of this study was to employ and evaluate the adoption of a systems approach tosolve real life problems. The Soft Systems Methodology of Peter Checkland was utilized to assess the situation within the Oral Health Service of the SAMS and toidentify relevant systems to improve the situation. The need for a Preventive System anda Performance Measurement System was established. These two systems were planned,developed and implemented using and obeying systems rules and techniques. Both these systems were evaluated and found to be highly efficient, effective, cost-effective and made a positive net contribution to the Oral Health Service of the SAMS.It is finally concluded that the adoption of a systems approach to identify and solve reallife problems was effective and efficient. It is therefore recommended that a systemsapproach to the management of oral health, and probably health too, should be embraced by the encumbered health industry.

[发布机构] University of Pretoria