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Mapping the implementation of formal cross-border patient migration from Eswatini to South Africa through the Phalala Fund: an interpretive policy analysis

The rise of pandemics and epidemics underscores the global nature of health systems, transcending national boundaries across low- and middle-income countries (LMICs). This study delves into Eswatini's health system's challenges in implementing formal cross-border patient migration to South Africa th...

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Main Author: Dlamini, Funwako Bakhile
Other Authors: Olivier, Jill
Format: Thesis
Language:English
English
Published: Department of Public Health and Family Medicine 2025
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access_status_str Open Access
author Dlamini, Funwako Bakhile
author2 Olivier, Jill
author_browse Dlamini, Funwako Bakhile
Olivier, Jill
author_facet Olivier, Jill
Dlamini, Funwako Bakhile
author_sort Dlamini, Funwako Bakhile
collection Thesis
description The rise of pandemics and epidemics underscores the global nature of health systems, transcending national boundaries across low- and middle-income countries (LMICs). This study delves into Eswatini's health system's challenges in implementing formal cross-border patient migration to South Africa through the Phalala Fund. This is a flexible qualitative study conducted in two phases. Evidence was gathered from primary, secondary, and grey literature to conduct a scoping review and an interpretive policy analysis (IPA) on cross-border patient migration and the Phalala Fund. Key stakeholders in implementing Phalala Fund's cross-border patient migration and their influence on the policy implementation process were identified. This was key in understanding the inter-subjective meanings shared across stakeholders. In implementing Phalala Fund's cross-border patient migration, stakeholders had varied systems of meaning shaped by their values and reality judgements. Thisinfluenced stakeholder actions, priorities, resource allocation strategies, and communication approaches, which have presented various challenges in implementing Phalala Fund's cross-border patient migration. Some challenges have further strained stakeholder relations, resulting in limited negotiation power of the Government of Eswatini with South African health providers. Although regional cooperation policy frameworks of the Southern African Development Community (SADC) were seen as necessary in shaping cross-border patient migration, they do not necessarily mirror the legal and regulatory provisions that address the specific changing needs in health migration. The findings echo the importance of longer-term strategising in implementing Phalala's cross-border patient migration and recognising the complexities and varied meanings across stakeholders. Policymakers in similar contexts should consider the existing stakeholder relations and use them to strengthen the implementation of cross border patient migration. Further areas of research on 'systems overlap' is suggested
format Thesis
id oai:open.uct.ac.za:11427/41494
institution University of Cape Town (South Africa)
language English
eng
last_indexed 2026-06-10T12:33:04.194Z
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2025
publishDateRange 2025
publishDateSort 2025
publisher Department of Public Health and Family Medicine
publisherStr Department of Public Health and Family Medicine
record_format dspace
source_str UCTD — University of Cape Town Open Access Repository
spelling oai:open.uct.ac.za:11427/41494 Mapping the implementation of formal cross-border patient migration from Eswatini to South Africa through the Phalala Fund: an interpretive policy analysis Dlamini, Funwako Bakhile Olivier, Jill Health policy The rise of pandemics and epidemics underscores the global nature of health systems, transcending national boundaries across low- and middle-income countries (LMICs). This study delves into Eswatini's health system's challenges in implementing formal cross-border patient migration to South Africa through the Phalala Fund. This is a flexible qualitative study conducted in two phases. Evidence was gathered from primary, secondary, and grey literature to conduct a scoping review and an interpretive policy analysis (IPA) on cross-border patient migration and the Phalala Fund. Key stakeholders in implementing Phalala Fund's cross-border patient migration and their influence on the policy implementation process were identified. This was key in understanding the inter-subjective meanings shared across stakeholders. In implementing Phalala Fund's cross-border patient migration, stakeholders had varied systems of meaning shaped by their values and reality judgements. Thisinfluenced stakeholder actions, priorities, resource allocation strategies, and communication approaches, which have presented various challenges in implementing Phalala Fund's cross-border patient migration. Some challenges have further strained stakeholder relations, resulting in limited negotiation power of the Government of Eswatini with South African health providers. Although regional cooperation policy frameworks of the Southern African Development Community (SADC) were seen as necessary in shaping cross-border patient migration, they do not necessarily mirror the legal and regulatory provisions that address the specific changing needs in health migration. The findings echo the importance of longer-term strategising in implementing Phalala's cross-border patient migration and recognising the complexities and varied meanings across stakeholders. Policymakers in similar contexts should consider the existing stakeholder relations and use them to strengthen the implementation of cross border patient migration. Further areas of research on 'systems overlap' is suggested 2025-06-30T07:46:14Z 2025-06-30T07:46:14Z 2025 2025-06-27T15:03:55Z Thesis / Dissertation Masters MPH http://hdl.handle.net/11427/41494 en eng application/pdf Department of Public Health and Family Medicine Faculty of Health Sciences University of Cape Town
spellingShingle Health policy
Dlamini, Funwako Bakhile
Mapping the implementation of formal cross-border patient migration from Eswatini to South Africa through the Phalala Fund: an interpretive policy analysis
thesis_degree_str Master's
title Mapping the implementation of formal cross-border patient migration from Eswatini to South Africa through the Phalala Fund: an interpretive policy analysis
title_full Mapping the implementation of formal cross-border patient migration from Eswatini to South Africa through the Phalala Fund: an interpretive policy analysis
title_fullStr Mapping the implementation of formal cross-border patient migration from Eswatini to South Africa through the Phalala Fund: an interpretive policy analysis
title_full_unstemmed Mapping the implementation of formal cross-border patient migration from Eswatini to South Africa through the Phalala Fund: an interpretive policy analysis
title_short Mapping the implementation of formal cross-border patient migration from Eswatini to South Africa through the Phalala Fund: an interpretive policy analysis
title_sort mapping the implementation of formal cross border patient migration from eswatini to south africa through the phalala fund an interpretive policy analysis
topic Health policy
url http://hdl.handle.net/11427/41494
work_keys_str_mv AT dlaminifunwakobakhile mappingtheimplementationofformalcrossborderpatientmigrationfromeswatinitosouthafricathroughthephalalafundaninterpretivepolicyanalysis