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Management in the South African public health sector: An x-inefficiency perspective


  • Carmen Sue Christian
  • Nicholas Crisp


Inefficiency in the South African public health sector contributes significantly to the country's relatively poor health outcomes, yet it is poorly understood and overshadowed by health care financing and payment issues. This paper explores this situation from the perspective that the public health sector forms part of a complex adaptive system from which inefficiencies emerge endogenously. Leibenstein's seminal work provides the basis for a conceptual framework that explores and describes management in the public health sector from an x-inefficiency perspective. Further research into x-inefficiency and its underlying causes may be useful to guide the design of appropriate health policies in the South African context. Unless reforms targeted at improving x-efficiency are prioritised, increased revenue allocation to the public health sector will have a sub-optimal impact on health outcomes.

Suggested Citation

  • Carmen Sue Christian & Nicholas Crisp, 2012. "Management in the South African public health sector: An x-inefficiency perspective," Development Southern Africa, Taylor & Francis Journals, vol. 29(5), pages 725-737, December.
  • Handle: RePEc:taf:deveza:v:29:y:2012:i:5:p:725-737
    DOI: 10.1080/0376835X.2012.730972

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    Cited by:

    1. Carlos Pestana Barros & Emanuel Reis Leão & Nkanga Pedro João Macanda & Zorro Mendes, 2016. "A Bayesian Efficiency Analysis of Angolan Banks," South African Journal of Economics, Economic Society of South Africa, vol. 84(3), pages 484-498, September.

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