Financial management building muscle in Mount Currie: KwaZulu-Natal

The DHS allows managers to take charge of the district services and available resources.

Only when health budgets are managed at the district level, will South Africa be able to say that it has a DHS. For this to happen, districts and provinces require a structured approach and integrated strategy to get resource-related decision making powers and capacity away from the centre. Decentralisation is therefore a key concern in district development.

Provincial offices are often concerned that districts are not yet ready for taking on new responsibilities, especially the management of financial resources. The districts on the other hand are often of the opinion that decentralisation is too slow and that they could do more if they could take charge of all services and finances. Yet, districts are also very aware of the capacity gaps they have. These gaps are usually the result of a lack of training,exposure and experience and a lack of skilled people in the district.

The Initiative for Sub-district Support (ISDS)plays a facilitating role and works with the interim district management team (IDMT)towards improved quality of care in Mount Currie Health District that falls within the ambits of the Port Shepstone Region.

Through this process the district identified financial management as a key area requiring intervention. This intervention started in October 1998.The strategy was to conduct a rapid situation analysis,identify key areas for support,establish a vision and then facilitate the move towards that vision.