Table 2.

Management pathways of doctors and nurses

NARRATIVE 1 (P16: female, black, nurse)

At the age of 18, she started as an enrolled nurse and progressed to general nursing and midwifery and later studied advanced midwifery. Her first management post was as a nurse-in-charge of a maternity ward, but she left the position on account of her husband who received a job promotion, which required relocation. During that time, for approximately 3 years, she worked in non-management positions in clinics and hospital and tutored at a nursing college). She then got a position in government as sectional manager responsible for all municipal clinics and remained there for two-and-a-half years. She continued to study further (management, financial management). With restructuring of the provincial Department of Health, she applied for the post of sub-district manager and remained in the post for nine months before applying for and getting the post of chief executive officer (CEO) of a hospital and remained in post for 3 years. She then applied for provincial post of director of PHC and remained for a further 3 years. She resigned again, on account of her husband who was relocated again and worked as director of Primary Health Care (PHC) in an urban district and later became an acting chief-director (very senior management position). She finally applied, successfully, for a chief director post in 2014.

NARRATIVE 2 (P14: male, black, doctor)

After qualifying as a medical doctor, he worked as a private general-practitioner (GP). He was also involved in political activism, was a counsellor in the local municipality and served on the health committee. As a GP, he was “involved in running the hospital” and later stepped into a formal management position as CEO in managing the hospital. He still maintained a private practice and managed the hospital part-time. After almost a decade, he relinquished his private practice to manage the hospital full-time. Since 2003, he is also a sub-district manager overseeing 8 primary care facilities.