Centre for Health Policy, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand Johannesburg, South Africa.
Glob Health Action. 2013 Jan 24;6:19289. doi: 10.3402/gha.v6i0.19289.
In 2007, the South African government introduced the occupation-specific dispensation (OSD), a financial incentive strategy, to attract, motivate, and retain health professionals in the public sector. Implementation commenced with the nursing sector, but there have been unintended negative consequences.
First, to examine implementation of the OSD for nurses using Hogwood and Gunn's framework that outlines 'perfect implementation' pre-conditions. Second, to highlight the conditions for the successful implementation of financial incentives.
A qualitative case study design using a combination of a document review and in-depth interviews with 42 key informants.
The study found that there were several implementation weaknesses. Only a few of the pre-conditions were met for OSD policy implementation. The information systems required for successful policy implementation, such as the public sector human resource data base and the South African Nursing Council register of specialised nurses were incomplete and inaccurate, thus undermining the process. Insufficient attention was paid to time and resources, dependency relationships, task specification, and communication and coordination.
The implementation of financial incentives requires careful planning and management in order to avoid loss of morale and staff grievances.
2007 年，南非政府推出了职业特惠制（OSD），这是一种财政激励策略，旨在吸引、激励和留住公共部门的卫生专业人员。该计划首先在护理部门实施，但产生了一些意想不到的负面后果。
首先，利用霍格伍德和冈恩的框架，检查护士职业特惠制的实施情况，该框架概述了“完美实施”的前提条件。其次，强调成功实施财政激励的条件。
采用定性案例研究设计，结合文件审查和对 42 名关键知情者的深入访谈。
研究发现，实施过程中存在若干弱点。OSD 政策的实施只满足了少数前提条件。成功实施政策所需的信息系统，如公共部门人力资源数据库和南非护理委员会的专科护士登记册，不完整且不准确，从而破坏了这一进程。对时间和资源、依存关系、任务规范以及沟通和协调重视不够。
实施财政激励措施需要精心规划和管理，以避免士气低落和员工不满。
