Date of Conferral



Doctor of Business Administration (D.B.A.)


Business Administration


Janice Garfield


Small businesses are critical to the success of a country's economy. The leaders of the South African government focus on the role of small and medium-sized enterprises (SMEs) to boost the economy and eradicate inequality, poverty, and unemployment. However, the sustainability track record of South African SMEs remains one of the worst records in the world. Therefore, it is essential that stakeholders improve the sustainability of SMEs. Using the resource-based view conceptual framework, the aim of this multiple case study was to explore the strategies that occupational health SME leaders use to manage cash flow to achieve sustainability for longer than 5 years. The participants were 4 Gauteng occupational health business leaders who had operated their businesses for longer than 5 years. Data were collected by means of semistructured interviews and document reviews, which were followed by data analysis, member checking, coding, and thematic analysis. The 7 themes that emerged were: external professional team, budgeting, systems and processes, payment terms and contracting, management of surplus funds and reserves, understanding the client procurement process, and the model for cash-flow management strategies. From the data analysis, additional themes emerged including the professional team, the processes and systems, and the business owner, which were central to cash-flow management strategies in occupational health SMEs. Business practitioners may use the results of this study to create social change by developing and implementing key cash-flow management strategies to enhance and improve the sustainability of their occupational health businesses.