| dc.description.abstract | South Africa is one of the high burden countries for drug-resistant tuberculosis (DR-TB) globally. A
policy supporting decentralised DR-TB treatment provision was introduced in 2011 but to date
implementation has been suboptimal with variable coverage and quality. This thesis opens the ‘black
box’ explaining sub-national policy implementation of DR-TB decentralisation in two provinces of
South Africa, Western Cape and KwaZulu-Natal. The thesis is grounded in the field of policy analysis
and adopts the methodological approach of a qualitative multiple case study, comparing 15 embedded
district and subdistrict cases in the two provinces, through data collected in 94 in-depth interviews,
document reviews, and observations. Applying Walt and Gilson’s Policy Analysis Triangle framework,
the case studies of DR-TB in the two provinces revealed how aspects of actors’ engagement with the
policy instrument, influenced by organisational dynamics and the wider context, resulted in varying
effectiveness of policy implementation. | en_US |
