The management of medical records in the context of service delivery in the public sector in KwaZulu-Natal, South Africa: the case of Ngwelezana hospital

In South Africa, under the public sector reforms, issues of public service delivery are anchored to by Batho Pele principles that were introduced in 1997 to entrench public service delivery in order to underscore transparency and accountability. Among other issues, the Batho Pele principles espouse efficient and effective public health sector delivery services which, in context, can be propelled by a reliable and trustworthy medical records regime. Several studies conducted at national level and particularly at provincial level (Limpopo, Gauteng, Eastern Cape and Western Cape) point to the fact that good and efficient records management is critical in realising accountable and transparent health service delivery. There has been the recognition of this synergy between medical records management and service delivery, yet there are few empirical studies which examine the role of records management in KwaZulu-Natal province; more particularly, with specific reference to the Ngwelezana Public Hospital. This study, therefore, presents empirical results of an investigation into the implementation of good records management services and the extent to which this contributes to corresponding citizen satisfaction of good health delivery at the community level. The ultimate goal of the study is to understand the scale and dimension of good medical records management in determining issues of accountability in health care for citizens at local or community level in the quest for optimal health service delivery and governance. Overall, the evidence shows that poor records management could undermine the service delivery, particularly transparency and accountability in health delivery. The study endorses, based on best practice, recommendations that underscore good records management governance, recordkeeping system, records management technology and infrastructure, records archival processes, and records management human resource capabilities