Safeguarding patient and personnel safety and improving care quality has emerged as a critical priority for healthcare systems globally. In response to persistent challenges in healthcare delivery, many countries have adopted clinical governance frameworks and organisational learning processes to strengthen accountability and promote continuous improvement. Robust clinical governance frameworks provide the processes and accountability measures necessary to foster a culture of knowledge-sharing and evidence-based decision-making, all of which are key characteristics of a learning organisation. This study seeks to investigate the role of clinical governance in improving hospital performance through three interconnected sub-studies. The first sub-study will explore how non-clinical managers in selected public sector hospitals leverage clinical governance to improve hospital performance. The second sub-study will evaluate the impact of clinical governance interventions on clinical outcomes and identify opportunities for organisational learning within these hospitals. The third sub-study will serve as an embedded experimental component, monitoring changes in complaint resolution indicators before and after interventions to assess improvements in clinical governance through both intra- and inter-hospital comparisons. Qualitative data will be analysed using NVivo version 15, with inductive thematic analysis employed to uncover emergent patterns and interpretive themes.

Background/Objectives: The concept of learning organisations, which rely on research-based evidence and emphasise employees’ continuous learning and professional development, is essential for effectively managing change and enhancing the quality of services. To better understand the effects of implementing learning organisation principles in hospital settings, this study aimed to compare the perceptions of selected health professionals regarding learning organisations across five sub-districts in South Africa’s Eastern Cape province. Methods: This study employed a quantitative, cross-sectional survey design to collect data from selected health professionals in 9 hospitals in Eastern Cape province. Results: Overall, the study showed wide variations in how different healthcare professionals perceived the commitment and communication of department leaders regarding the importance of learning. Key findings showed that 90.9% of dentists agreed that department leaders communicate the importance of learning. In comparison, 68.8% of allied health professionals and 56.5% of pharmacists agreed that department leaders communicated the importance of learning; 21.7% of pharmacists and 25% of allied health professionals disagreed. Conclusions: The study has highlighted significant disparities in the perceptions of selected hospital-based health professionals toward introducing a learning organisation in healthcare facilities. This divergence points to the need for tailored approaches in communicating and implementing LO strategies within hospital settings to ensure that all health professionals are equally engaged and that the benefits of continuous learning are fully realised across disciplines.

* The efficient functioning of surgical services in public hospitals is a cornerstone of effective healthcare delivery, influencing not only operational performance but also patient outcomes and the overall utilisation of resources within the health system. Elective surgical case cancellations represent a persistent and complex challenge faced by healthcare systems globally, often reflecting systemic inefficiencies and resource limitations. While existing research has predominantly focused on quantifying cancellation rates and categorising causes through retrospective institutional data, few studies have explored the insights of healthcare professionals, key frontline stakeholders who play a critical role in identifying and addressing cancellations. This study seeks to address this gap by examining healthcare professionals’ perspectives on elective surgical case cancellations within selected public hospitals in South Africa. This study will employ a quantitative cross-sectional survey to identify and understand the factors contributing to the cancellations of theatre cases from healthcare professionals’ perspectives. A convenience non-probability sampling technique will be utilised to collect data using a structured questionnaire from healthcare professionals who are readily available and willing to participate during the study period. Quantitative data analysis will involve entering survey data into Microsoft Excel 2021 for Windows and subsequently exporting it to STATA version 18.5 for advanced analysis. Descriptive and categorical data will be compared using frequencies, percentages, and graphical representations. Ethical clearance has been granted by the Human Research Ethics Committee of the Faculty of Medicine and Health Sciences at Walter Sisulu University, Ref: WSU HREC 051/2025. Approval to access the research sites has been obtained from both the Provincial Health Research Committees of the Eastern Cape (Ref: EC_202505_029) and Mpumalanga (Ref: MP_202506_003) departments. Results will be shared with key stakeholders through public presentations, conferences, and published in peer-reviewed journals.

The efficient functioning of surgical services in public hospitals is a cornerstone of effective healthcare delivery, influencing not only operational performance but also patient outcomes and the overall utilisation of resources within the health system. Elective surgical case cancellations represent a persistent and complex challenge faced by healthcare systems globally, often reflecting systemic inefficiencies and resource limitations. While existing research has predominantly focused on quantifying cancellation rates and categorising causes through retrospective institutional data, few studies have explored the insights of healthcare professionals, key frontline stakeholders who play a critical role in identifying and addressing cancellations. This study seeks to address this gap by examining healthcare professionals’ perspectives on elective surgical case cancellations within selected public hospitals in South Africa. This study will employ a quantitative cross-sectional survey to identify and understand the factors contributing to the cancellations of theatre cases from healthcare professionals’ perspectives. A convenient non-probability sampling technique will be utilised to collect data using a structured questionnaire from healthcare professionals who are readily available and willing to participate during the study period. Quantitative data analysis will involve entering survey data into Microsoft Excel 2021 for Windows and subsequently exporting it to STATA version 18.5 for advanced analysis. Descriptive and categorical data will be compared using frequencies, percentages, and graphical representations. Ethical clearance has been granted by the Human Research Ethics Committee of the Faculty of Medicine and Health Sciences at Walter Sisulu University, Ref: WSU HREC 051/2025. Approval to access the research sites has been obtained from both the Provincial Health Research Committees of the Eastern Cape (Ref: EC_202505_029) and Mpumalanga (Ref: MP_202506_003) departments. Results will be shared with key stakeholders through public presentations, conferences, and published in peer-reviewed journals.

Background: Maternal healthcare access is a critical determinant of women’s and neonatal health, especially in rural areas of low- and middle-income countries. Despite high reported utilization in South Africa, rural communities continue to experience adverse childbirth outcomes. Objective: To evaluate the association between maternal healthcare access and childbirth outcomes in Ingquza Hill Local Municipality, Eastern Cape Province of South Africa. Methods: A cross-sectional study was conducted among 213 pregnant and postpartum women receiving maternal healthcare services at St Elizabeth Hospital, a regional referral hospital serving multiple primary healthcare clinics across the municipality. Data were collected using structured questionnaires and maternity access indicators (including ANC attendance, timing of first ANC visit, number of visits, physical accessibility, and place of delivery), and childbirth outcomes. Logic regression analyses were performed to identify associations between access indicators and unfavorable childbirth outcomes. Results: Utilization of maternal healthcare services was high, with 96% of participants reporting ANC attendance, 92% receiving skilled care during pregnancy, and 91% delivering in a health facility. Unfavorable childbirth outcomes were observed in 12% of participants. Conventional indicators of maternal healthcare access, including ANC attendance, number of visits, physical accessibility, and place of delivery, were not statistically associated with childbirth outcomes in regression analyses. However, initiation of antenatal care was notably delayed, with a mean gestational age at first ANC visit of 21.7 weeks. The limited number of adverse outcomes constrained statistical power to detect modest associations. Conclusions: High maternal healthcare utilization alone did not ensure improved childbirth outcomes in this rural setting. Delayed initiation of antenatal care emerged as a critical gap that may limit the effectiveness of subsequent care, highlighting the limitations of coverage-based access indicators. Strategies to improve maternal and neonatal outcomes should prioritize early antenatal engagement, quality and continuity of care, and move beyond utilization metrics toward measures of effective coverage in rural and resource-limited contexts.

Circumcision is a long-standing and frequently performed surgical procedure which holds significant cultural significance among AmaXhosa people in South Africa. Due to cultural reasons in some parts of Africa, the integration of medical male circumcision with traditional manhood initiation rituals still lacks acceptance. This study examined the level of knowledge and acceptance of voluntary male medical circumcision (VMMC) among young males in a selected high school in the Nyandeni District of the Eastern Cape Province, South Africa. A descriptive, quantitative, cross-sectional study was conducted, and a self-administered questionnaire was used to obtain information on sociodemographic characteristics, knowledge of VMMC, percep-tions of VMMC, and circumcision practices. One Hundred participants were recruited from both grades 11 and 12, and 82% of the participants indicated that they had received information about VMMC. Most of the respondents (88%) preferred traditional male circumcision (TMC) and only 12% of respondents preferred VMMC. The participants displayed a good understanding of the distinction between VMMC and TMC. However, results from the study showed that most re-spondents exhibited low acceptability towards VMMC. These findings highlight the need to develop evidence-based strategies to enhance learners’ knowledge and acceptance of VMMC.