scholarly journals Trends in the nephrologist workforce in South Africa (2002–2017) and forecasting for 2030

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255903
Author(s):  
Dominic Dzamesi Kumashie ◽  
Ritika Tiwari ◽  
Muhammed Hassen ◽  
Usuf M. E. Chikte ◽  
Mogamat Razeen Davids
Keyword(s):  
South Africa ◽  
Public Sector ◽  
Middle Income ◽  
North West ◽  
The Public ◽  
The North ◽  
Training Capacity ◽  
Northern Cape ◽  
Public And Private Sector ◽  
Kidney Health

Background The growing global health burden of kidney disease is substantial and the nephrology workforce is critical to managing it. There are concerns that the nephrology workforce appears to be shrinking in many countries. This study analyses trends in South Africa for the period 2002–2017, describes current training capacity and uses this as a basis for forecasting the nephrology workforce for 2030. Methods Data on registered nephrologists for the period 2002 to 2017 was obtained from the Health Professions Council of South Africa and the Colleges of Medicine of South Africa. Training capacity was assessed using data on government-funded posts for nephrologists and nephrology trainees, as well as training post numbers (the latter reflecting potential training capacity). Based on the trends, the gap in the supply of nephrologists was forecast for 2030 based on three targets: reducing the inequalities in provincial nephrologist densities, reducing the gap between public and private sector nephrologist densities, and international benchmarking using the Global Kidney Health Atlas and British Renal Society recommendations. Results The number of nephrologists increased from 53 to 141 (paediatric nephrologists increased from 9 to 22) over the period 2002–2017. The density in 2017 was 2.5 nephrologists per million population (pmp). In 2002, the median age of nephrologists was 46 years (interquartile range (IQR) 39–56 years) and in 2017 the median age was 48 years (IQR 41–56 years). The number of female nephrologists increased from 4 to 43 and the number of Black nephrologists increased from 3 to 24. There have been no nephrologists practising in the North West and Mpumalanga provinces and only one each in Limpopo and the Northern Cape. The current rate of production of nephrologists is eight per year. At this rate, and considering estimates of nephrologists exiting the workforce, there will be 2.6 nephrologists pmp in 2030. There are 17 government-funded nephrology trainee posts while the potential number based on the prescribed trainer-trainee ratio is 72. To increase the nephrologist density of all provinces to at least the level of KwaZulu-Natal (2.8 pmp), which has a density closest to the country average, a projected 72 additional nephrologists (six per year) would be needed by 2030. Benchmarking against the 25th centile (5.1 pmp) of upper-middle-income countries (UMICs) reported in the Global Kidney Health Atlas would require the training of an additional eight nephrologists per year. Conclusions South Africa has insufficient nephrologists, especially in the public sector and in certain provinces. A substantial increase in the production of new nephrologists is required. This requires an increase in funded training posts and posts for qualified nephrologists in the public sector. This study has estimated the numbers and distribution of nephrologists needed to address provincial inequalities and achieve realistic nephrologist density targets.

scholarly journals Aggregate Public-Private Remuneration Patterns in South Africa

2020 ◽  
Author(s):  
Andreas Wörgötter ◽  
Sihle Nomdebevana
Keyword(s):  
South Africa ◽  
Public Sector ◽  
Private Sector ◽  
Inflation Targeting ◽  
Public And Private ◽  
The Public ◽  
Causal Direction ◽  
Long Run ◽  
Causality Tests ◽  
Public And Private Sector

AbstractThis paper investigates the public-private remuneration patterns in South Africa with time-series methods for the first time since the introduction of an inflation-targeting framework in 2000. Co-integration tests and analysis confirm that there is a stable, long-run relationship between nominal and real remuneration in the public and private sector. The adjustment to the deviations from this long-run relationship is strong and significant for public-sector remuneration, while private-sector wages neither respond to deviations from the long-run relationship nor lagged changes in public-sector remuneration. The causal direction from private- to public-sector remuneration does not change if real earnings are calculated with the gross domestic product deflator. This is confirmed by simple Granger-causality tests.

scholarly journals An audit tool for relicensing inspection for private hospitals in eThekwini district, South Africa

2020 ◽  
Vol 20 (2) ◽  
pp. 936-947
Author(s):  
Jamila Chellan ◽  
Maureen Nokuthula Sibiya
Keyword(s):  
South Africa ◽  
Public Sector ◽  
Care Patient ◽  
Mixed Method Research ◽  
Health Coverage ◽  
Audit Tool ◽  
Private Hospitals ◽  
Safety Standards ◽  
The Public ◽  
Public And Private Sector

Background: South Africa is moving towards National Health Insurance (NHI), which aims to provide access to universal health coverage for all South Africans. The NHI will only accredit and contract eligible health facilities that meet nationally approved quality standards in the public and private sector. Detailed tools for measuring compliance with the National Core Standards (NCS) and Batho Pele principles have been developed and implemented in the public sector. To date and since its implementation in the public sector, very little is known about the national audit tool and the method used to evaluate quality and patient safety standards in private hospitals in eThekwini district. Objective: The aim of the study was to develop an audit tool for relicensing inspection of private hospitals in eThekwini district based on the clinical domains of the NCS and Batho Pele principles. Methodology: An exploratory sequential mixed method research design was used with a qualitative first phase involving 24 nurse managers through purposive sampling. This was followed by a quantitative phase in which a structured questionnaire was administered to 270 nurses who were randomly sampled for the study from 4 hospitals. Results: The results revealed that the NCS and the Batho Pele principles are not fully implemented or evaluated in the se- lected hospitals in eThekwini district. Conclusion: These findings were significant and denoted the need for a standardised clinical audit tool for private hospitals in eThekwini district. Keywords: Audit tool; best practices; patient care; patient rights;, support services.

scholarly journals Universities as ‘Drivers’ of Local and Regional Development

2021 ◽  
pp. 134-152
Author(s):  
Marius Constantin PROFIROIU ◽  
Maria-Roxana BRIȘCARIU
Keyword(s):  
Public Sector ◽  
Private Sector ◽  
Legal Framework ◽  
North West ◽  
The Public ◽  
The North ◽  
Innovation And Technology ◽  
Private And Public ◽  
The University

"The society based on knowledge and innovation brings to the fore the role of universities as research and learning spaces, with the purpose for sustainable development, at local, regional, national and global levels. Following this approach, we explore the capacity of spreading the knowledge and innovation capital in the North-West region of Romania between universities, the private sector and the public sector. Also, the study explores the role taken by the university system in Romania, locally and regionally, emphasizing what type of relationship defines the exchange of outputs and what are the most useful know-how transfer mechanisms from universities to the private and public sectors. The empirical research in this paper has shown that there is a growing relationship between universities – private sector – public sector, which is characterized as ‘in an incipient phase’, ‘based on urgent needs of the parties’. All of the actors involved in this triad want to develop the links between universities – private sector – public sector in communication, research, innovation and technology, and they suggest standardization and regulation of this interaction and developing a legal framework to correspond to the actual needs at local and regional levels."

SCHOOL PRINCIPAL LEADERSHIP IN REMOTE SOUTH AFRICA: A LEADERSHIP AND MANAGEMENT CHALLENGE

2021 ◽  
pp. 301-309
Author(s):  
Leentjie Van Jaarsveld ◽  
Keyword(s):  
South Africa ◽  
Small Towns ◽  
School Principal ◽  
Structured Interviews ◽  
Technology Infrastructure ◽  
Leadership And Management ◽  
North West ◽  
Remote Areas ◽  
The North ◽  
Northern Cape

To understand the circumstances under which principals in remote areas exercise their leadership and management, an investigation was conducted in the Northern Cape province, South Africa. This province is characterised by small towns with few residents. The infrastructure is not up to par, and in some cases, the socio-economic conditions are extremely poor. Unemployment is a big problem in the villages. The uniqueness of this study lies in the fact that after 1994, with the abolition of apartheid, the farmers withdrew their children from the schools and no longer supported the schools as before. As a result, the principals experienced many more challenges. The study followed a qualitative, phenomenological design from the interpretivist paradigm. The sample consisted of ten principals. Semi-structured interviews were conductedwith the principals. The inductive data analysis process was used. The required ethical clearance was obtained from the Research Ethics Committee of the North-West University and the Department of Education of the province. The results reveal that principals in remote areas, in the absence of technology, infrastructure, and support bases, have to use their skills creatively, and they need the support of the community, teachers, school management, and governing body.

scholarly journals Availability, prices, and affordability of selected essential cancer medicines in a middle-income country – the case of Mexico

2019 ◽  
Author(s):  
Daniela Moye-Holz ◽  
Margaret Ewen ◽  
Anahi Dreser ◽  
Sergio Bautista-Arredondo ◽  
Rene Soria-Saucedo ◽  
...  
Keyword(s):  
Health Insurance ◽  
Public Sector ◽  
Private Sector ◽  
Public Hospitals ◽  
World Health ◽  
Public And Private ◽  
Middle Income ◽  
The Public ◽  
Middle Income Countries ◽  
Public And Private Sector

Abstract Background: More alternatives have become available for the diagnosis and treatment of cancer in low- and middle-income countries. Because of increasing demands, governments are now facing a problem of limited affordability and availability of essential cancer medicines. Yet, precise information about the access to these medicines is limited, and the methodology is not very well developed. Objective: To assess the availability and affordability of essential cancer medicines in Mexico, and compare their prices against those in other countries of the region. Methods: We surveyed 21 public hospitals and 19 private pharmacies in 8 states of Mexico. Data were collected on the availability and prices of 49 essential cancer medicines. Prices were compared against those in Chile, Peru, Brazil, Colombia and PAHO’s Strategic Fund. Results: Of the various medicines, mean availability in public and private sector outlets was 61.2% and 67.5%, respectively. In the public sector, medicines covered by the public health insurance “People’s Health Insurance” were more available. Only seven (public sector) and five (private sector) out of the 49 medicines were considered affordable. Public sector procurement prices were 41% lower than in other countries of the region. Conclusions: The availability of essential cancer medicines, in the public and private sector, falls below World Health Organization’s 80% target. The affordability remains suboptimal as well. A national health insurance scheme could serve as a mechanism to improve access to cancer medicines in the public sector. Comprehensive pricing policies are warranted to improve the affordability of cancer medicines in the private sector.

scholarly journals Doctor retention and distribution in post-apartheid South Africa: tracking medical graduates (2007–2011) from one university

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Ann George ◽  
Duane Blaauw ◽  
Jarred Thompson ◽  
Lionel Green-Thompson
Keyword(s):  
South Africa ◽  
Public Sector ◽  
South African ◽  
Rural Areas ◽  
Specialist Training ◽  
Financial Loss ◽  
Cross Sectional ◽  
Middle Income ◽  
The Public ◽  
The Impact

Abstract Background Doctor emigration from low- and middle-income countries represents a financial loss and threatens the equitable delivery of healthcare. In response to government imperatives to produce more health professionals to meet the country’s needs, South African medical schools increased their student intake and changed their selection criteria, but little is known about the impact of these changes. This paper reports on the retention and distribution of doctors who graduated from the University of the Witwatersrand, South Africa (SA), between 2007 and 2011. Methods Data on 988 graduates were accessed from university databases. A cross-sectional descriptive email survey was used to gather information about graduates’ demographics, work histories, and current work settings. Frequency and proportion counts and multiple logistic regressions of predictors of working in a rural area were conducted. Open-ended data were analysed using content analysis. Results The survey response rate was 51.8%. Foreign nationals were excluded from the analysis because of restrictions on them working in SA. Of 497 South African respondents, 60% had completed their vocational training in underserved areas. At the time of the study, 89% (444) worked as doctors in SA, 6.8% (34) practised medicine outside the country, and 3.8% (19) no longer practised medicine. Eighty percent of the 444 doctors still in SA worked in the public sector. Only 33 respondents (6.6%) worked in rural areas, of which 20 (60.6%) were Black. Almost half (47.7%) of the 497 doctors still in SA were in specialist training appointments. Conclusions Most of the graduates were still in the country, with an overwhelmingly urban and public sector bias to their distribution. Most doctors in the public sector were still in specialist training at the time of the study and may move to the private sector or leave the country. Black graduates, who were preferentially selected in this graduate cohort, constituted the majority of the doctors practising in rural areas. The study confirms the importance of selecting students with rural backgrounds to provide doctors for underserved areas. The study provides a baseline for future tracking studies to inform the training of doctors for underserved areas.

scholarly journals Availability, Prices and Affordability of Selected Essential Cancer Medicines in a Middle-Income Country: The Case of Mexico

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 220s-220s
Author(s):  
D. Moye Holz ◽  
M. Ewen ◽  
A. Dreser ◽  
S. Bautista ◽  
R. Soria ◽  
...  
Keyword(s):  
Health Insurance ◽  
Public Sector ◽  
Private Sector ◽  
Public Hospitals ◽  
Public And Private ◽  
Middle Income ◽  
The Public ◽  
Middle Income Countries ◽  
Public And Private Sector ◽  
Dose Form

Background: More alternatives are becoming available for the diagnosis and treatment of cancer in low- and middle-income countries. Yet, because of increasing demands, many governments are now facing the dilemma of making essential cancer medicines available to all while keeping them affordable. Precise information about current access to these medicines is limited, and there's no systematic methodology in place to do so. Aim: To assess the availability and affordability of essential cancer medicines in Mexico, and compare their prices (public sector procurement and patient prices) against those in other countries of the region. Methods: We adapted the WHO/HAI methodology. We surveyed 21 public hospitals and 19 private pharmacies in 8 states of Mexico. Data were collected on the availability and prices of 49 essential cancer medicines (each strength and dose-form specific). Prices were compared against those in Chile, Peru, Brazil, Colombia and PAHO's Strategic Fund. Results: Of the various medicines, mean availability in public and private sector outlets was 61.2% and 67.5%, respectively. In the public sector, medicines covered by the public health insurance “People's Health Insurance” (SPS) were slightly more available. Only 7 (public sector) and 5 (private sector) out of 49 medicines were deemed affordable. Overall, public sector procurement prices were 41% lower than in other countries of the region. Conclusion: The availability of essential cancer medicines, in the public and private sector, falls below WHO's 80% target. The affordability remains suboptimal as well. A national health insurance scheme could serve as a mechanism to improve access to cancer medicines in the public sector. Comprehensive pricing policies are warranted to improve the affordability of cancer medicines in the private sector.

scholarly journals Availability, prices, and affordability of selected essential cancer medicines in a middle-income country – the case of Mexico

2020 ◽  
Author(s):  
Daniela Moye-Holz ◽  
Margaret Ewen ◽  
Anahi Dreser ◽  
Sergio Bautista-Arredondo ◽  
Rene Soria-Saucedo ◽  
...  
Keyword(s):  
Health Insurance ◽  
Public Sector ◽  
Private Sector ◽  
Public Hospitals ◽  
World Health ◽  
Public And Private ◽  
Middle Income ◽  
The Public ◽  
Middle Income Countries ◽  
Public And Private Sector

Abstract Background: More alternatives have become available for the diagnosis and treatment of cancer in low- and middle-income countries. Because of increasing demands, governments are now facing a problem of limited affordability and availability of essential cancer medicines. Yet, precise information about the access to these medicines is limited, and the methodology is not very well developed. Objective: To assess the availability and affordability of essential cancer medicines in Mexico, and compare their prices against those in other countries of the region. Methods: We surveyed 21 public hospitals and 19 private pharmacies in 8 states of Mexico. Data were collected on the availability and prices of 49 essential cancer medicines. Prices were compared against those in Chile, Peru, Brazil, Colombia and PAHO’s Strategic Fund. Results: Of the various medicines, mean availability in public and private sector outlets was 61.2% and 67.5%, respectively. In the public sector, medicines covered by the public health insurance “People’s Health Insurance” were more available. Only seven (public sector) and five (private sector) out of the 49 medicines were considered affordable. Public sector procurement prices were 41% lower than in other countries of the region. Conclusions: The availability of essential cancer medicines, in the public and private sector, falls below World Health Organization’s 80% target. The affordability remains suboptimal as well. A national health insurance scheme could serve as a mechanism to improve access to cancer medicines in the public sector. Comprehensive pricing policies are warranted to improve the affordability of cancer medicines in the private sector.

scholarly journals Influence of foreign alliances on the performance of small-scale agricultural businesses in South Africa: A new institutional economics perspective

2018 ◽  
Vol 21 (1) ◽  
Author(s):  
Patient Rambe ◽  
Livingstone A.K. Agbotame
Keyword(s):  
South Africa ◽  
Institutional Economics ◽  
Economic Benefits ◽  
New Institutional Economics ◽  
Small Scale ◽  
North West ◽  
The North ◽  
Northern Cape ◽  
Post Hoc ◽  
Better Than

Background: Globalisation has accentuated the need for small-scale agricultural businesses (SSABs) to network horizontally and vertically into world markets. However, the capacity of SSABs to cement foreign alliances to capitalise on business opportunities that the expansion of global markets presents, while simultaneously mitigating against the negative forces of globalisation remains a grey area.Aim: The study sought to contribute to internationalisation literature by examining: (1) the extent to which SSABs’ owner and/or managers in selected South African provinces establish foreign alliances, (2) whether there are any statistically significant differences in SSABs’ performance based on their extent of establishment of foreign alliances.Setting: The setting for this study was Vryburg-Pokwani in the North West and Northern Cape provinces of South Africa, respectively.Method: A survey was conducted on 151 SSAB owner and/or managers in the aforementioned study area.Results: The results revealed that although a majority (51.7%) had some (i.e. few) foreign alliances, 48.3% of SSABs had no foreign alliances at all. The results also demonstrated that the establishment of foreign alliances was positively and statistically significantly related to the performance of SSABs in the Vryburg-Pokwani area. Post-hoc comparisons (Bonferroni) results showed that while SSABs with 1–2 foreign alliances perform better than those with no foreign alliances at all, those SSABs with 6–10 foreign alliances perform better than those with none, 1–2 and 3–5 foreign linkages respectively.Conclusion: Since SSABs with foreign alliances tended to outperform those that were dependent on domestic links, the extent to which the economic benefits derived from internationalisation are reinvested into the businesses for the continued sustenance of businesses needs more rigorous investigation.

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