Systems analysis of Municipal Health Services in South Africa

Abstract

Municipal health services is a component of environmental health services and consequently ‘health services’, which is firmly founded in the Constitution of South Africa and an array of supporting legislation. Environmental health is multi-sectoral in nature and are dependent on the performance of others e.g. sector departments, institutions and individuals, who causes the environmental health risks to also remedy it. The sectoral relationships together with multi-level governance of structures involved render the control of social and environmental determinants of health, among others, very complex. Various sector legislation and regulating authorities are also impacting on MHS, and when not appropriately aligned causing overlaps, confusion, authority clashes and resultant ineffective service delivery with negative environmental health impacts which contribute to the burden of disease. The mandate for MHS provides for the prevention of ill health at source (local government level) through identifying, quantifying and mitigating environmental health risks which originates from among others, social and environmental determinants of health. MHS mandate is not appropriately aligned in sector legislation and programs to ensure the prevention of social and environmental determinants of health. MHS is poorly implemented and supported by government and supporting institution which resulted in a lack of appropriate preventative health outcomes. Therefore this assignment to identify gaps in order to rectify it.