An evaluation of the implementation and capacity of hospital boards at district hospitals in KwaZulu-Natal in 2008.
Introduction Hospital boards are vital structures that represent the needs and aspirations, of the community that hospitals serve. Aim This study aims to determine whether district-level hospital boards in KwaZulu-Natal (KZN) are equipped to support hospital management in the effective and efficient delivery of hospital services. Methods A quantitative, descriptive and cross-sectional health systems research study has been used. Thirty-two (32) of the thirty five (35) district hospitals in KZN participated in the study. Nineteen (19) chairpersons of hospital boards (CHB) and twenty-four (24) chief executive officers (CEO’s) were telephonically interviewed using a structured but open-ended questionnaire. Ordinary board members at eleven district hospitals were interviewed over a period of four (4) months using an interview schedule. Minutes of fifty-eight (58) board meetings were scrutinised to establish what items were discussed at board meetings and how matters were dealt with. Hospitals were excluded from the study after five (5) failed attempts to involve them in the study. Results Hospital boards in KwaZulu-Natal (KZN) are interim structures. The role and responsibilities of hospital board members are unclear and their supervision is inadequate. Their commitment and ability to function is limited and they are not representative of the community that they serve. There is a lack of clarity as to the real purpose of hospital boards. Training, orientation and induction of new members are weak. There was little evidence about how boards provide feedback to the community and health users. Conclusion Hospital boards will function adequately once legislative regulations have been passed, clear policies finalised and appointed board members are adequately trained and capacitated. Recommendation The KZN Department of Health should promulgate legislation that will govern hospital boards, appoint permanent hospital boards, develop policies and training manuals and capacitate board members on an on-going basis.