Latest News Archive

Please select Category, Year, and then Month to display items
Previous Archive
28 May 2024 Photo Supplied
Dr Ina Gouws
Dr Ina Gouws is Senior Lecturer: Programme: Governance and Political Transformation, Department of Political Studies and Governance, University of the Free State.

Opinion article by Dr Ina Gouws, Senior Lecturer: Programme: Governance and Political Transformation, Department of Political Studies and Governance, University of the Free State.

Community-based governance refers to the systems and processes involved in the interface between community participation, community engagement, and public sector decision-making. This requires a partnership between civil society, business, and government. For this partnership to work, all partners must commit and invest in these processes for the sake of better services to communities. In recent years, communities have had to approach community-based governance with regional and local governments as mostly absent partners.

As South Africa approaches the national and provincial elections this week, voters need to reflect on the indispensable role civil society organisations have assumed in bridging the governance gap left by ineffective local and provincial governments. These organisations, driven by a profound commitment to community welfare, have extended their reach beyond their designated mandates, skillsets, and financial capacities to address pressing community needs. Their tireless efforts have underscored the significance of community-based governance and the urgent need for collaboration between civil society and government institutions.

Embracing community-based governance

In most provinces across South Africa, communities have found themselves grappling with the consequences of governance failures, ranging from inadequate service delivery to systemic corruption. Faced with these challenges, civil society organisations have emerged as beacons of hope, leveraging their grassroots networks and intimate understanding of local dynamics to deliver essential services, advocate for change, and empower communities.

However, the burden should not fall solely on the shoulders of civil society. As the nation prepares for a new phase of post-election governance, incoming national and provincial governments must acknowledge and appreciate the pivotal role played by these organisations. They must recognise the wealth of expertise, connections, and trust that civil society brings to the table.  By rebuilding the fractured relationship between government and communities, which is fundamental to effective community-based governance, a collaborative approach is therefore required. Moreover, governments must move beyond mere acknowledgement and actively engage with civil society organisations as equal partners in the pursuit of sustainable development and social justice. This entails fostering open channels of communication, soliciting input from communities and civil society in policy formulation and decision-making processes, and allocating and then PROVIDING resources to support the initiatives and projects driven by these organisations.

By embracing community-based governance and forging genuine partnerships with civil society, provincial governments can tap into a valuable reservoir of knowledge and experience that is essential to addressing the complex challenges facing South African society. Together, they can work towards a future where governance is not just about top-down directives, but is rooted in the principles of inclusivity, responsiveness, and accountability. South Africans are not experiencing such partnerships at all in most provinces. Voters MUST reflect on this before they cast their votes.

Reimagine governance in South Africa

Voters must not forget the impact an ineffective national and provincial government has had on their communities. We must vote with the expectation that our national government's ultimate goal must be to ensure that communities at the grassroots level receive the services and support they need for the people living there to thrive. This includes providing essential utility services such as water, electricity, and sanitation; social services such as health care, education, and welfare; and fostering economic growth through investment towards job creation and infrastructure development.

Provincial governments are supposed to play a crucial intermediary role by bringing national objectives to the regional level, tailoring strategies and policies to the specific needs and circumstances of their areas. They therefore set the tone for local governance, and by extension, community-based governance, by interpreting national policies and ensuring their implementation in a way that addresses local priorities. South Africans have not experienced this level of good governance in recent years; some never have.

So, if this interpretation and implementation does not happen – which is the case in most provinces – the tone set for community-based governance is one of disarray, failure, and suffering. There are of course a few cases that are the exception.  South African voters can change this by voting for a national and provincial government that will impact communities in constructive ways and pave the way for the local government elections to follow.

We are on the cusp of a new electoral cycle. As voters, we must seize this opportunity to reimagine governance in South Africa – governance that puts the needs and aspirations of communities at its core, nurtures collaboration between government and civil society, and paves the way for a more equitable and prosperous future for all. With this vision, we can truly realise the promise of democracy and ensure that no community is left behind. These may be national and provincial elections, but you are voting for your community!

News Archive

Heart diseases a time bomb in Africa, says UFS expert
2010-05-17

 Prof. Francis Smit

There are a lot of cardiac problems in Africa. Sub-Saharan Africa is home to the largest population of rheumatic heart disease patients in the world and therefore hosts the largest rheumatic heart valve population in the world. They are more than one million, compared to 33 000 in the whole of the industrialised world, says Prof. Francis Smit, Head of the Department of Cardiothoracic Surgery at the Faculty of Health Sciences at the University of the Free State (UFS).

He delivered an inaugural lecture on the topic Cardiothoracic Surgery: Complex simplicity, or simple complexity?

“We are also sitting on a time bomb of ischemic heart disease with the WHO (World Health Organisation) estimating that CAD (coronary artery disease) will become the number-one killer in our region by 2020. HIV/Aids is expected to go down to number 7.”

Very little is done about it. There is neither a clear nor coordinated programme to address this expected epidemic and CAD is regarded as an expensive disease, confined to Caucasians in the industrialised world. “We are ignoring alarming statistics about incidences of adult obesity, diabetes and endemic hypertension in our black population and a rising incidence of coronary artery interventions and incidents in our indigenous population,” Prof. Smit says.

Outside South Africa – with 44 units – very few units (about seven) perform low volumes of basic cardiac surgery. The South African units at all academic institutions are under severe threat and about 70% of cardiac procedures are performed in the private sector.

He says the main challenge in Africa has become sustainability, which needs to be addressed through education. Cardiothoracic surgery must become part of everyday surgery in Africa through alternative education programmes. That will make this specialty relevant at all levels of healthcare and it must be involved in resource allocation to medicine in general and cardiothoracic surgery specifically.

The African surgeon should make the maximum impact at the lowest possible cost to as many people in a society as possible. “Our training in fields like intensive care and insight into pulmonology, gastroenterology and cardiology give us the possibility of expanding our roles in African medicine. We must also remember that we are trained physicians as well.

“Should people die or suffer tremendously while we can train a group of surgical specialists or retraining general surgeons to expand our impact on cardiothoracic disease in Africa using available technology maybe more creatively? We have made great progress in establishing an African School for Cardiothoracic Surgery.”

Prof. Smit also highlighted the role of the annual Hannes Meyer National Registrar Symposium that culminated in having an eight-strong international panel sponsored by the ICC of EACTS to present a scientific course as well as advanced surgical techniques in conjunction with the Hannes Meyer Symposium in 2010.

Prof. Smit says South Africa is fast becoming the driving force in cardiothoracic surgery in Africa. South Africa is the only country that has the knowledge, technology and skills base to act as the springboard for the development of cardiothoracic surgery in Africa.

South Africa, however, is experiencing its own problems. Mortality has doubled in the years from 1997 to 2005 and half the population in the Free State dies between 40 to 44 years of age.

“If we do not need health professionals to determine the quality and quantity of service delivery to the population and do not want to involve them in this process, we can get rid of them, but then the political leaders making that decision must accept responsibility for the clinical outcomes and life expectancies of their fellow citizens.

“We surely cannot expect to impose the same medical legal principles on professionals working in unsafe hospitals and who have complained and made authorities aware of these conditions than upon those working in functional institutions. Either fixes the institutions or indemnifies medical personnel working in these conditions and defends the decision publicly.

“Why do I have to choose the three out of four patients that cannot have a lifesaving operation and will have to die on their own while the system pretends to deliver treatment to all?”

Prof. Smit says developing a service package with guidelines in the public domain will go a long way towards addressing this issue. It is also about time that we have to admit that things are simply not the same. Standards are deteriorating and training outcomes are or will be affected.

The people who make decisions that affect healthcare service delivery and outcomes, the quality of training platforms and research, in a word, the future of South African medicine, firstly need rules and boundaries. He also suggested that maybe the government should develop health policy in the public domain and then outsource healthcare delivery to people who can actually deliver including thousands of experts employed but ignored by the State at present.

“It is time that we all have to accept our responsibilities at all levels… and act decisively on matters that will determine the quality and quantity of medical care for this and future generations in South Africa and Africa. Time is running out,” Prof. Smit says.
 

We use cookies to make interactions with our websites and services easy and meaningful. To better understand how they are used, read more about the UFS cookie policy. By continuing to use this site you are giving us your consent to do this.

Accept