measuring organisational readiness for health system change in south africa using the european foundation for quality management excellence model
1
Registrar, Health Professions Council of South Africa, TSHWANE, South Africa
2
Public health medicine, University of Kwazulu Natal, Durban, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
ABSTRACT:
Measuring organisational readiness for health system change in south africa using the european foundation for quality management excellence model Authors: magome masike1,2, ozayr mahomed1
BACKGROUND:
successful health system transformation depends on organisational readiness, yet few african studies have applied structured excellence frameworks to assess change capacity. This study evaluated the readiness of two district health systems in the north west province of south africa using the european foundation for quality management excellence model.
METHODS:
a descriptive cross-sectional survey was conducted using a standardised efqm-based self-administered questionnaire. The tool was distributed to 200 senior and middle-level health managers, chief executive officers, and clinical leaders across bojanala platinum and ngaka modiri molema districts. Quantitative efqm domain scores were calculated and compared between districts.
RESULTS:
a total of 193 responses were received (96.5%), with complete efqm process data from 112 participants. The overall mean efqm score was 65.5% (sd: 15.8), with a median of 66.95% (iqr: 55.3–77.1), indicating moderate organisational readiness. Bojanala platinum demonstrated a significantly higher median readiness score (75.2%; iqr: 62.1–78.8) than ngaka modiri molema (62.4%; iqr: 53.4–73.6) (p < 0.05). Leadership (76.9%) and policy and strategy (72.8%) were the strongest-performing efqm domains, falling within the strengthening range (>70%). In contrast, people (51.8%) and partnerships and resources (45.5%) scored below the readiness threshold, identifying critical vulnerabilities in human resource engagement and resource coordination. No significant associations were observed between readiness scores and socio-demographic characteristics.
CONCLUSIONS:
health system readiness in the north west province is supported by strong leadership and policy alignment; however, weaknesses in workforce empowerment and partnership management present substantial risks to sustainable reform. Targeted strengthening of these low-performing domains is essential to translate strategic intent into resilient, people-centred health system change.
Measuring organisational readiness for health system change in south africa using the european foundation for quality management excellence model Authors: magome masike1,2, ozayr mahomed1
BACKGROUND:
successful health system transformation depends on organisational readiness, yet few african studies have applied structured excellence frameworks to assess change capacity. This study evaluated the readiness of two district health systems in the north west province of south africa using the european foundation for quality management excellence model.
METHODS:
a descriptive cross-sectional survey was conducted using a standardised efqm-based self-administered questionnaire. The tool was distributed to 200 senior and middle-level health managers, chief executive officers, and clinical leaders across bojanala platinum and ngaka modiri molema districts. Quantitative efqm domain scores were calculated and compared between districts.
RESULTS:
a total of 193 responses were received (96.5%), with complete efqm process data from 112 participants. The overall mean efqm score was 65.5% (sd: 15.8), with a median of 66.95% (iqr: 55.3–77.1), indicating moderate organisational readiness. Bojanala platinum demonstrated a significantly higher median readiness score (75.2%; iqr: 62.1–78.8) than ngaka modiri molema (62.4%; iqr: 53.4–73.6) (p < 0.05). Leadership (76.9%) and policy and strategy (72.8%) were the strongest-performing efqm domains, falling within the strengthening range (>70%). In contrast, people (51.8%) and partnerships and resources (45.5%) scored below the readiness threshold, identifying critical vulnerabilities in human resource engagement and resource coordination. No significant associations were observed between readiness scores and socio-demographic characteristics.
CONCLUSIONS:
health system readiness in the north west province is supported by strong leadership and policy alignment; however, weaknesses in workforce empowerment and partnership management present substantial risks to sustainable reform. Targeted strengthening of these low-performing domains is essential to translate strategic intent into resilient, people-centred health system change.
| eISSN: | 2654-1459 |
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