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Table 1 Emerging subthemes per health system building block

From: Public health system challenges in the Free State, South Africa: a situation appraisal to inform health system strengthening

A priori themeEmerging subthemeNumber of reportsPercent (n = 44)
Service deliveryFragmentation of services4295.5
Poor quality of service2965.9
Infrastructure challenges2965.9
No institutional road signs2250.0
Poor security in the institutions511.4
Poor referral system24.5
Dysfunctional EMS24.5
Healthcare workforceShortage of staff3988.6
Poor HRH management3886.4
RWOPS challenges1840.9
Shortage of accommodation for interns2045.5
InformationPoor information management2659.1
Medical products, vaccines and technologiesDysfunctional ICT system2761.4
Shortage of resources/equipment2659.1
Pharmaceutical system challenges2352.3
Supply chain management challenges818.2
FinancingFinancial/cash flow challenges3988.6
OSD challenges36.8
Leadership and governanceRisk to patient care3886.4
Poor leadership2965.9
Poor priority setting2761.4
Lack of governance structures2250.0
Lack of policy implementation818.2
Non-appointment of hospital board members and clinic committee members12.3