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Separation of curative and preventive health programmes often impairs the coordination of primary care in developing countries. Salary differentials between organisations may aggravate non-co-operation. Implementation of a unitary national health service by South Africa's first democratically elected government has been hampered by salary differences, but no organisation possessed information on their magnitude. This paper reports on a study which estimated the distribution and conditions of service of all 224,000 public health sector personnel in South Africa, modelled options for equalising salaries between health authorities, and considered the financial and political feasibility of the options. The most important salary differential was between provincial and local authority nurses. The option to increase salaries selectively for personnel in rural and primary care would be most feasible and most in keeping with government plans. Health service unions face conflicts of interest, and professional organisations may oppose changes in nurses' roles. In a rapidly changing health system with fragmented managerial information, a combination of administrative survey, quantitative modelling and policy analysis helped clarify a key obstacle to reform. The South African case is a warning to other countries that decentralised pay bargaining may result in uncoordinated care which may be costly and difficult to overcome. Key words - personnel administration, quantitative modelling, health policy

Relationships between symptoms typical of sick building syndrome, musculoskeletal symptoms, and reported indoor environmental exposures, psychological state, work stress and interpersonal relationships at work. were investigated among 624 office workers in three buildings. Symptom prevalences were similar in the three buildings, and were slightly lower in the two buildings characterized by its inhabitants as 'sick' than in the one building not considered to be 'sick'. Women were more likely than were men to complain of most symptoms in all three buildings. Multiple regression showed psychological symptoms and sex to be significant independent predictors of symptoms. Reported odours, and uncomfortable humidity and temperature were also independently associated with symptoms. The study indicates that sex and psychological symptoms are important predictors of perceived building related illness. Key words - office workers, building related illness, indoor air quality, psychological factors, visual display units, gender differences