oa South African Health Review - District health systems and local government developments : framework for transformation
The provinces have, in the absence of strong national leadership, national legislation and clear strategic direction over the past eight years, attempted to fill the vacuum with the introduction of their own legislative frameworks and policies. These generally differ from each other and from the policy direction given by the national Department of Health (NDoH) in February 2001. This chapter reviews the variations in current provincial legislation and strategic planning resulting from these uncoordinated processes. <br>Expected changes in the next draft National Health Bill suggest that, with the exception of environmental health, which will become a local government responsibility, the remainder of PHC will be a provincial responsibility. Although provinces will remain responsible for the funding and planning of these PHC services, it is expected that over time they will be delegated to Metro (type A) and District (type C) Councils for implementation. In turn it is envisaged that District Councils will be able to delegate the rendering of services to Local Municipalities (type B).
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