Intergovernmental relations and cooperative governance: a case study of the KwaZulu-Natal Department of Health.

Abstract

This study explored and evaluated the effectiveness of intergovernmental relations and cooperative governance in enhancing service delivery using the KwaZulu-Natal Department of Health. The research used selected concepts from theories of intergovernmental relations and cooperative governance to construct a conceptual framework. The information derived from the literature review and case study was then analysed according to the concepts in the analytical framework. The research found that the KZN Department of Health has adopted measures to tackle resource constraints, such as establishing alliances with communities, NGOs, and sectoral collaborations. "Operation Sukuma Sakhe" is implemented to facilitate the coordination of service delivery among stakeholders. The revival of district health councils is underway, with the provincial department actively involving municipalities through COGTA. The primary objective of extra-IGR is to enhance societal well-being and foster optimal health. Nevertheless, inadequate synchronisation of policy implementation throughout government spheres results in substandard care and restricted devolution of authority. The 1996 Constitution advocates for equitable involvement, but the National Health Department frequently regards itself as the dominant authority, leading to fragmented planning, budgeting, implementation, and subpar performance. The IGR Framework Act 13 of 2005 delineates each government level's specific functions and obligations; however, resource constraints may hinder adherence. Inadequate collaboration among governmental entities can result in substandard service provision and the breakdown of social order. The purpose of a consultation is to synchronise efforts and prevent avoidable conflicts and unproductive expenses. The findings indicate that the existing procedures for intergovernmental relations are ineffective. The areas that require attention include the distribution of responsibilities between districts and provinces, the appropriate delegation of authority between these two spheres, and the assurance of proper allocation of resources.