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Table 4 C-M-O summary - Free State, South Africa

From: Tool, weapon, or white elephant? A realist analysis of the five phases of a twenty-year programme of occupational health information system implementation in the health sector

Context IS (OHASIS) developed to increase capacity for improving working conditions in South Africa healthcare, launched as pilot in resource poor setting but with more human resources devoted to OH than in BC (comparable to the Manitoba setting).
  Initially strong bipartite H&S committee support, but political changes, heightened racial tensions, increased union militancy and complex governance concerns created challenges
Mechanism Governance: Partnership between Canadian and South African university-based researchers, with provincial health department.
  Technology: Similar to the BC system, but with module development emphasizing prevention and capacity-building OH activities.
Outcome While feasibility study was positive, and OH professionals keen to use system, implementation of revised system was delayed due to political power struggles (union discontent with how joint health and safety committees were established).
Conclusion System designed for prevention and empowerment of the workforce; delay in implementation because of expressed union concerns.
  “Tool” to OH practitioners, however efficiencies not realized, as new system with improved reporting functions was never implemented in this time frame.
  “Weapon” use by union militants to leverage achieving other demands.
  “White elephant” to the researchers and decision-makers who invested in the system, and so far do not have a usable system implemented.