Investigating staff morale and Batho Pele compliance of public oral healthcare professionals

[摘要] Since the introduction of democracy in 1994, South Africa has made remarkable progress in transformational healthcare in an attempt to provide redress for those affected by the previous apartheid policies. A primary healthcare approach was adopted built on a framework of quality, accessible and affordable service delivery to all South Africans. Batho Pele principles were introduced to provide a framework against which service delivery in the public sector and in particular the public healthcare sector can be measured. Batho Pele means putting people first. However, irrespective of the progress made since 1994, the South African public healthcare system has performed poorly despite the country's quantum of spending on healthcare. Various elements have been highlighted as contributing factors, such as tolerance to the ineptitude and failure of leaders, management and governance in the public healthcare sector and the inability or failure to deal decisively with the crisis faced within the healthcare workforce. These factors have negative consequences for all parties involved - patients and healthcare professionals alike. The powerless patient is left to bear the brunt of sub-optimal care and negative experiences whilst the healthcare professional is faced with staff shortages, health system deficiencies and an unsupportive management environment. In situations such as the aforementioned, it is understandable that the public healthcare professional will find it difficult to provide quality patient oriented service whilst upholding their professional code of conduct and ethics. The literature review started with a broad investigation of the South African healthcare system, the proposed National Health Insurance and public healthcare expenditure. It was then narrowed down to the public healthcare professional in context and the factors affecting the professional's morale, efficacy, flourishing and coherence in the workplace. The role of the public healthcare professional in Batho Pele compliance was also discussed followed by a discussion on the role that management plays in the creation of a conductive work environment for employees. A non-random convenient sampling method was utilised during this research. Participants were limited to clinically oriented oral healthcare professionals employed at Medunsa Oral Health Centre. The purpose of this research was to investigate a specific closed group of individuals, eliminating the need for generalisation and external validity. A structured self-administered questionnaire based on Likert-style questions assisted the researcher in obtaining valuable quantitative data from the 68 participants which was then statistically analysed. The research was aimed at addressing two research objectives: 1) the identification of factors affecting staff morale among public oral healthcare professionals and 2) the influence those factors will have on the quality of service delivery in the public healthcare domain. The research revealed that the general morale among public oral healthcare professionals employed at Medunsa Oral Health Centre was poor. Females had a lower morale than males. Dental assistants felt the most negative among designated workforces and contemplated leaving the institution the most. Female line managers posed a problem as factors such as victimisation and preferential treatment were noted. Employees also voiced their dismay with management. One-sided decision-making processes and mismanagement were raised as concerns. The annual Customer Satisfaction Survey (CSS) conducted by the quality assurance team of Medunsa Oral Health Centre revealed that patients were in general satisfied with the quality and effectiveness of service delivery at Medunsa Oral Health Centre. Waiting time was the main concern for patients, however, this cannot be directly linked to the morale amongst oral healthcare professionals as various other external factors need to be taken into consideration in this regard. After an in-depth discussion of the results, the researcher made a conclusive statement which addressed the objectives of the study. The factors affecting staff morale were indeed identified, however, there was no negative effect on Batho Pele principle compliance. Recommendations were made to assist management in addressing the various factors of concern raised during the research. Recommendations included team building initiatives, involving personnel in decision-making processes and addressing factors such as victimisation and preferential treatment in the workplace. Outsourcing of an employee-assistance program was also recommended.

[发布机构] North-West University