Integrating Sustainability Practices and Governance Capabilities in South Africa’s Private Healthcare System for Improved Performance

This article examines how sustainability is understood and enacted within South Africa’s private healthcare sector, a setting marked by high resource intensity, concentrated ownership, and uneven regulatory guidance. The study investigates which sustainability practices matter most and how they can be systematically integrated into organisational routines. A qualitative interpretivist methodology was used, drawing on phenomenological interviews with seventeen professionals across clinical, managerial, and operational roles. Data were analysed using thematic analysis to identify patterns in the implementation of environmental, operational, and governance practices. The analysis revealed that sustainability is shaped by the interaction of leadership commitment, coordinated governance structures, resource optimisation in high consumption areas, and integrated performance feedback. These dynamics coalesced into the Sustainability Integration and Performance Model (SIPM), which advances existing scholarship by demonstrating how sustainability becomes a coherent organisational capability rather than a set of isolated initiatives. The findings provide novel insights into how private healthcare organisations navigate institutional ambiguity while aligning stakeholder expectations and developing internal capabilities. The study also highlights the distinct contextual pressures shaping sustainability in South Africa, including infrastructure constraints and varying organisational maturity. While the qualitative scope limits broader generalisation, the research provides a grounded foundation for future comparative studies and the development of measurable indicators for the integration of sustainability.