Measuring administrative integration of disease control programmes within health systems: a case study of HIV monitoring and evaluation in South Africa

Background In South Africa, integrating the management of health services at a decentralized district level within the authority of general health service (GHS) managers is a reform priority. The reforms promote administrative integration, i.e. transfer of administrative authority over disease control programmes (DCPs) from DCP managers to GHS managers and re-defining DCP manager roles from implementation to specialist support. Historically DCP activities at district level fall under the control of DCP managers and dedicated programme monitoring and evaluation (M&E) systems limit GHS managers’ access to data that they need for integrated management. Given the reform focus on administrative integration, research is needed to measure the extent to which GHS managers exercise administrative authority over DCP functions. This study addresses this gap, using the HIV programme M&E function as an exemplar.