scholarly journals A review of the 2030 Human Resources for Health Strategy: Implications for dentistry in South Africa

2021 ◽  
Vol 76 (06) ◽  
pp. 367-373
Author(s):  
Ahmed Bhayat ◽  
Ntombizodwa R Nkambule ◽  
Thomas K Madiba

The South African National Department of Health (NDoH) released a report in March 2020: “2030 Human Resources for Health (HRH) Strategy: Investing in the Health Workforce for Universal Health Coverage”. This report, has implications for the training of dental personnel and the planning of dental services in South Africa(SA). The aim was to summarise and critique the HRH strategic document with reference to dentistry. This was an independent review of the report and included recommendations and implications for the training of dental personnel in SA. The report employed two models to predict the number of dental personnel that will be required; one on achieving provincial equity and the other on improving access to Primary Heath Care (PHC) facilities. The calculations were based on dental personnel employed in the public sector and the number of uninsured people in SA. The first model predicted a shortfall of 486 dentists, 60 specialists, 13 Dental Technicians (Dent Tech), 162 Dental Therapists (DTs) and 104 Oral Hygienists (OHs). The second model, based on PHC utilization, predicted a surplus of 341 dentists and a shortage of 1128 OHs and 1164 DTs. In order to meet these shortages, NDoH would have to allocate R840 million or 2.3 Billion rands respectively, depending on which model is chosen. Irrespective of the model utilised, the NDoH needs to create and fill more dental posts, especially in provinces with low dental practitioner to population ratios. Dental training institutions need to align the training of dental graduates to meet the demands as set out in the report.

2012 ◽  
Vol 17 (1) ◽  
Author(s):  
Gavin George ◽  
Timothy Quinlan ◽  
Candice Reardon ◽  
Jean-François Aguilera

This review showed that thinking about the shortage of health care personnel merely in terms of insufficient numbers prevents sound strategic interventions to solve the country’s human resources for health (HRH) problem. It revealed that the numbers shortage was one facet of a broader problem that included the mal distribution of HRH, production of the wrong skills in the nursing care, the attrition of staff from the public health services and, contextually, the ever-changing demands on the health services. The challenge in South Africa was furthermore to train and retain health care personnel with skills and expertise that are commensurate with the changing demands on the public health services.Uit hierdie oorsig het dit duidelik geblyk dat die tekort van gesondheidsorgpersoneel slegs in terme van ontoereikende getalle val en ’n omvattende strategiese ingryping om die land se menslike gesondheidshulpbron krisis op te los, belemmer. Dit het aangedui dat die getalletekort  maar slegs een fasset van ’n groter probleem uitmaak, wat onder andere die volgende insluit: die oneweredige verspeiding van menslike gesondheidshulpbronne, ’n fokus op ontoepaslike vaardighede in die opleiding van verpleegpersoneel, die behoud van personeel in die openbare gesondheidsektor, asook die konstant-veranderlike eise van die gesondheidsdienste. Verder was die uitdaging in Suid Afrika die opleiding en behoud van gesondheidsorgpersoneel met kennis en vaardighede wat tred hou met die veranderlike eise van die openbare gesondheidsdienste.


Author(s):  
Ritika Tiwari ◽  
Robert Mash ◽  
Innocent Karangwa ◽  
Usuf Chikte

Abstract Background In South Africa, there is a need to clarify the human resources for health policy on family physicians (FPs) and to ensure that the educational and health systems are well aligned in terms of the production and employment of FPs. Objective To analyse the human resource situation with regard to family medicine in South Africa and evaluate the requirements for the future. Methods A retrospective review of the Health Professions Council of South Africa’s (HPCSA) database on registered family medicine practitioners from 2002 until 2019. Additional data were obtained from the South African Academy of Family Physicians and published research. Results A total of 1247 family medicine practitioners were registered with the HPCSA in 2019, including 969 specialist FPs and 278 medical practitioners on a discontinued register. Of the 969, 194 were new graduates and 775 from older programmes. The number of FPs increased from 0.04/10 000 population in 2009 to 0.16/10 000 in 2019, with only 29% in the public sector. On average, seven registrars entered each of nine training programmes per year and three graduated. New graduates and registrars reflect a growing diversity and more female FPs. The number of FPs differed significantly in terms of age, gender, provincial location and population groups. Conclusions South Africa has an inadequate supply of FPs with substantial inequalities. Training programmes need to triple their output over the next 10 years. Human resources for health policy should substantially increase opportunities for training and employment of FPs.


2020 ◽  
Vol 19 (1) ◽  
Author(s):  
Joshua Munywoki ◽  
Nancy Kagwanja ◽  
Jane Chuma ◽  
Jacinta Nzinga ◽  
Edwine Barasa ◽  
...  

Abstract Background Health sector priority setting in Low and Middle-Income Countries (LMICs) entails balancing between a high demand and low supply of scarce resources. Human Resources for Health (HRH) consume the largest allocation of health sector resources in LMICs. Health sector decentralization continues to be promoted for its perceived ability to improve efficiency, relevance and participation in health sector priority setting. Following the 2013 devolution in Kenya, both health service delivery and human resource management were decentralized to county level. Little is known about priority setting practices and outcomes of HRH within decentralized health systems in LMICs. Our study sought to examine if and how the Kenyan devolution has improved health sector priority setting practices and outcomes for HRH. Methods We used a mixed methods case study design to examine health sector priority setting practices and outcomes at county level in Kenya. We used three sources of data. First, we reviewed all relevant national and county level policy and guidelines documents relating to HRH management. We then accessed and reviewed county records of HRH recruitment and distribution between 2013 and 2018. We finally conducted eight key informant interviews with various stakeholder involved in HRH priority setting within our study county. Results We found that HRH numbers in the county increased by almost two-fold since devolution. The county had two forms of HRH recruitment: one led by the County Public Services Board as outlined by policy and guidelines and a parallel, politically-driven recruitment done directly by the County Department of Health. Though there were clear guidelines on HRH recruitment, there were no similar guidelines on allocation and distribution of HRH. Since devolution, the county has preferentially staffed higher level hospitals over primary care facilities. Additionally, there has been local county level innovations to address some HRH management challenges, including recruiting doctors and other highly specialized staff on fixed term contract as opposed to permanent basis; and implementation of local incentives to attract and retain HRH to remote areas within the county. Conclusion Devolution has significantly increased county level decision-space for HRH priority setting in Kenya. However, HRH management and accountability challenges still exist at the county level. There is need for interventions to strengthen county level HRH management capacity and accountability mechanisms beyond additional resources allocation. This will boost the realization of the country’s efforts for promoting service delivery equity as a key goal – both for the devolution and the country’s quest towards Universal Health Coverage (UHC).


Author(s):  
Sameh El-Saharty ◽  
Susan Powers Sparkes ◽  
Helene Barroy ◽  
Karar Zunaid Ahsan ◽  
Syed Masud Ahmed

2019 ◽  
Vol 4 (9) ◽  

Worldwide there are different systems for providing pharmacy services. Most countries have some element of state assistance, either for all patients or selected groups such as children, and some private provisions. Medicines are financed either through cost sharing or full private. The role of the private services is therefore much more significant. Nationally, there is a mismatch between the numbers of pharmacists and where are they worked, and the demand for pharmacy services. The position is exacerbated locally where in some areas of poor; there is a real need for pharmacy services, which is not being met and where pharmacists have little spare capacity. Various changes within the health-care system require serious attention be given to the pharmacy human resources need. In order to stem the brain drain of pharmacists, it is, however, necessary to have accurate information regarding the reasons that make the pharmacists emigrate to the private sector. Such knowledge is an essential in making of informed decisions regarding the retention of qualified, skilled pharmacists in the public sector for long time. There are currently 3000 pharmacists registered with the Sudan Medical Council of whom only 10% are working with the government. The pharmacist: population ratio indicates there is one pharmacist for every 11,433 inhabitants in Sudan, compared to the World Health Organisation (WHO) average for industrialised countries of one pharmacist for 2,300 inhabitants. The situation is particularly problematic in the Southern states where there is no pharmacist at all. The distribution of pharmacists indicates the majority are concentrated in Khartoum state. When population figures are taken into consideration all states except Khartoum and Gezira states are under served compared to the WHO average. This mal-distribution requires serious action as majority of the population is served in the public sector. This study reveals the low incentives, poor working conditions, job dissatisfaction and lack of professional development programmes as main reasons for the immigration to the private-sector. The objective of this communication is to highlight and provide an overview of the reasons that lead to the immigration of the public sector pharmacists to the private-sector in Sudan. The survey has been carried out in September 2014. Data gathered by the questionnaires were analysed using Statistical Package for Social Sciences (SPSS) version 12.0 for windows. The result have been evaluated and tabulated in this study. The data presented in this theme can be considered as nucleus information for executing research and development for pharmacists and pharmacy. More measures must be introduced to attract pharmacists into the public sector. The emerging crisis in pharmacy human resources requires significant additional effort to gather knowledge and dependable data that can inform reasonable, effective, and coordinated responses from government, industry, and professional associations.


2020 ◽  
Vol 20 (2) ◽  
pp. 936-947
Author(s):  
Jamila Chellan ◽  
Maureen Nokuthula Sibiya

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.


2014 ◽  
Vol 19 (1) ◽  
Author(s):  
Nadeem Cassim ◽  
Shaun Ruggunan

Background: The aim of the present study was to identify the factors that influence the global migration of South African anatomical pathologists working in the province of KwaZulu-Natal.Objective: The present study answered the question ‘what factors influence Kwazulu-Natal-based histopathologists to emigrate out of South Africa?’, thus providing insight into an under-researched medical specialisation.Methods: A qualitative approach and purposive sampling were used. Data included 11 in-depth interviews with histopathologists working in KwaZulu-Natal (KZN), and one interview with a former KZN-based histopathologist now working in the United States. The interviews were recorded and transcribed. The data were coded for patterns, and these patterns generated themes. The processes of coding and thematic generation were iterative.Results: Six themes were discovered from the data. Of these, five themes suggested reasons for the potential emigration of histopathologists. These included: lack of recognition by clinical doctors, lack of career-pathing opportunities, the deterrent of compulsory service in the public sector upon qualifying, socio-economic and political instability in South Africa, and endemic levels of crime. A sixth theme revealed that remuneration was not a deciding factor as to whether histopathologists choose to emigrate.Conclusions: Remuneration was not revealed to be a reason for emigration, as these specialists’ salaries are commensurate with global salaries. The findings, whilst not generalisable, suggest that more work needs to be done on the human relations aspects of retention for these medical specialists. This has implications for human resources for health policy. Agtergrond: Die doel van hierdie artikel is om die faktore te identifiseer wat die globale migrasie van Suid-Afrikaanse anatomiese patoloë wat in die provinsie van KwaZulu-Natal werk, beïnvloed.Doelwit: Hierdie artikel beantwoord die vraag: ‘Watter faktore beïnvloed histopatoloë wat in KwaZulu-Natal gebaseer is om uit Suid-Afrika te migreer?’, en verskaf sodoende insig in ’n ondernagevorste mediese spesialisasie.Metodes: ’n Kwalitatiewe benadering en doelgerigte steekproefneming is gebruik. Die data het 11 diepgaande onderhoude met histopatoloë wat in KwaZulu-Natal (KZN) werk en een onderhoud met ’n voormalige KZN-gebaseerde histopatoloog wat nou in die Verenigde State werk, ingesluit. Die onderhoude is opgeneem en getranskribeer. Die data is vir patrone gekodeer en hierdie patrone het temas gegenereer. Die koderingsproses en tematiese generering was herhalend.Resultate: Ses temas is in hierdie data ontdek. Hiervan het vyf temas redes vir die moontlike migrasie van histopatoloë voorgestel. Dit sluit in gebrek aan erkenning deur kliniese dokters, gebrek aan loopbaangeleenthede, die afskrikmiddel van verpligte diens in die openbare sektor na kwalifisering, sosio-ekonomiese en politieke onstabiliteit in Suid-Afrika, en endemiese misdaadvlakke. ’n Sesde tema het aan die lig gebring dat vergoeding nie ’n beslissende faktor is in histopatoloë se keuse om te migreer nie.Gevolgtrekkings: Vergoeding blyk nie ’n rede vir migrasie te wees nie, aangesien die salarisse van hierdie spesialiste in ooreenstemming met globale salarisse is. Hoewel dit nie veralgemeenbaar is nie, stel die bevindings voor dat meer werk aan die menseverhouding-aspekte gedoen moet word om hierdie mediese spesialiste te behou. Dit het implikasies vir menslike hulpbronne in gesondheidsbeleid.


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