REVIEW ARTICLE

 

Where are we short and who are we short of? A review of the human resources for health in South Africa

 

 

Gavin George^I; Timothy Quinlan^I; Candice Reardon^I; Jean-François Aguilera^II

^IHealth Economics and HIV and AIDS Research Division (HEARD), University of KwaZulu-Natal, South Africa
^IIEuropean Commission Delegations, in Southern Africa

Correspondence

 

 

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ABSTRACT

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.

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OPSOMMING

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.

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References

Bateman, C., 2007, 'Slim pickings as 2008 health staff crisis looms', South African Medical Journal 97(11), 1020-1034. PMid:18250908.         [ Links ]

Breier, M., 2009, 'Doctors', in J. Erasmus & M. Breier, (eds.), Skills shortages in South Africa: Case studies of key professions, pp.113-131, HSRC Press, Cape Town.         [ Links ]

Breier, M. & Wildschut, A., 2006, Doctors in a divided society, The profession and education of medical practitioners in South Africa, HSRC Press, Cape Town. PMCid:1373667.         [ Links ]

Breier, M., Wildshut, A. & Mgqolozana, T., 2009, Nursing in a new era: The profession and education of nurses in South Africa, HSRC Press, Cape Town.         [ Links ]

Cameron, D., Gerber, A., Mbatha, M., Mutyabule, J. & Swart, H., 2012, 'Nurse initiation and maintenance of patients on antiretroviral therapy: Are nurses in primary care clinics initiating ART after attending NIMART training?' South African Medical Journal 102(2).         [ Links ]

Clemens, M. & Pettersson, G., 2008, 'New data on African health professionals abroad', Human Resources for Health 6(1), 1-11. http://dx.doi.org/10.1186/1478-4491-6-1 PMid:18186916; PMCid:2254438.         [ Links ]

Connelly, D., Veriava, Y., Roberts, S., Tsotetsi, J., Jordan, A., DeSilva, E., et al., 2007, 'Prevalence of HIV infection and median CD4 counts among health care workers in South Africa', South African Medical Journal 97(2), 115-123. PMid:17404672.         [ Links ]

Couper, I., De Villiers, M. & Sondzaba, N., 2005, 'Human resources: District hospitals', in P. Ijumba & P. Barron (eds.), South African health review 2005, Health Systems Trust, Durban, viewed 14 September 2009, from http://www.hst.org.za/sahr        [ Links ]

Day, C. & Gray, A., 2008, 'Health and related indicators', in P. Barron & J. Roma-Reardon (eds.), South African health review 2008, Health Systems Trust, Durban, viewed 14 September 2009, from http://www.hst.org.za/sahr        [ Links ]

Department of Health 2003, 'Operational plan for comprehensive HIV and AIDS care, management and treatment for South Africa', viewed 04 October 2009, from http://www.info.gov.za/issues/hiv/careplan.htm        [ Links ]

Department of Health 2006, A National Human Resources Plan for Health to provide skilled human resources for healthcare adequate to take care of all South Africans, viewed 17 August 2009, from http://www.doh.goz.za/docs/discuss-f.html        [ Links ]

Department of Health 2011, HRH Strategy for the Health Sector: 2012/13 - 2016/17, Department of Health, Pretoria.         [ Links ]

Econex, 2010a, 'Updated GP and specialist numbers for SA', Health Reform Note 7, October, 2010.         [ Links ]

Econex, 2010b, 'The human resource supply constraint: The case of doctors' Health Reform Note 8, November, 2010.         [ Links ]

Econex, 2010c, 'The human resource supply constraint: The case of Nurses' Health Reform Note 9, December, 2010.         [ Links ]

Erasmus, S., 2008, 'Exodus of SA doctors looms' News 24: Press report.         [ Links ]

Frenk, J., 2008, 'Reinventing primary health care: the need for systems integration', Lancet 374, 170-73. http://dx.doi.org/10.1016/S0140-6736(09)60693-0        [ Links ]

George, G., Quinlan, T. & Reardon, C., 2009, Human Resources for Health in South Africa: A needs and gaps analysis for HRH in South Africa, Health Economics and HIV/AIDS Research Division, University of KwaZulu-Natal.         [ Links ]

Hall, E. & Erasmus, J. 2003, Medical practitioners and nurses, in Human Resources Development Review 2003: Education, employment and skills in South Africa, pp.523-553, Cape Town, HSRC Press.         [ Links ]

Hamilton, K. & Yau, J., 2004,'The Global Tug-of-War for Health Care Workers', in HRH Global Resource Center, viewed 02 August 2009, from http://www.hrhresourcecenter.org/node/1264        [ Links ]

Health Systems Trust 2009, 'Health statistics', viewed 05 August 2009, from http://www.hst.org.za/healthstats        [ Links ]

Lawn, J., Rohde, J., Rifkin, S., Were, M., Paul, V. & Chopra, M., 2008, 'Alma-Ata 30 years on: Revolutionary, relevant, and time to revitalise', Lancet 2008(372), 917-922. http://dx.doi.org/10.1016/S0140-6736(08)61402-6        [ Links ]

Lehmann, U., 2008, 'Strengthening human resources for primary health care', in P. Barron & J. Roma-Reardon (eds.), South African health review 2008, Health Systems Trust, Durban, viewed 14 September 2009, from http://www.hst.org.za/sahr.         [ Links ]

Magobe, N.B.D., Beukes, S. & Müller, A., 2010, 'Reasons for students' poor clinical competencies in the Primary Health Care: Clinical nursing, diagnosis treatment and care programme', Health SA Gesondheid 15(1). http://dx.doi.org/10.4102/hsag.v15i1.525        [ Links ]

Mallaby, S., 2004, How Africa subsidises US health care, Washington Post, 29 November, Washington, D.C.         [ Links ]

McIntyre, D. & Klugman, B., 2003, 'The human face of decentralisation and integration of health services: Experience from South Africa', Reproductive Health Matters 11(21), 108-119. http://dx.doi.org/10.1016/S0968-8080(03)02166-9        [ Links ]

NHI 2009, 'National Health Insurance Policy Proposal', viewed 10 September 2009, from http://wikileaks.org/leak/anc-nhi-submission-nec-july2009.pdf        [ Links ]

Pfeiffer, J., Montoya, P., Baptista, A.J., Karagianis, M., Pugas, Mde, M., et al., 2010, 'Integration of HIV/AIDS services into African primary health care: Lessons learned for health system strengthening in Mozambique - a case study', Journal of the International AIDS Society 13, 3, viewed 16 August 2009, from http://www.jiasociety.org/content/13/1/3        [ Links ]

SANC 2009, Geographical and age distribution of nurses in South Africa, 06 August 2009, from http://www.sanc.co.za/stats/        [ Links ]

SANC 2010, South African Nursing Council statistics, viewed 06 August 2009, from http://www.sanc.co.za/stats/        [ Links ]

Sanders, D. n.d., 'National health insurance: Can it solve South Africa's health crisis?' in The Harold Wolpe Memorial Trust, viewed 06 August 2009, from http://www.wolpetrust.org.za/dialogue2009/presentation        [ Links ]

Sanders, D. & Lloyd, B., 2009, 'Major and focussed investment in health personnel is needed to solve the Health Care Crisis', In Amandla!, viewed 14 September 2009, from http://www.amandlapublishers.co.za/special-features/the-nhi-debate?start=15        [ Links ]

Schneider, H., Blaauw, D., Gilson, L., Chabikuli, N. & Goudge, J., 2006, 'Health Systems and Access to Antiretroviral Drugs for HIV in Southern Africa: Service Delivery and Human Resources Challenges', Reproductive Health Matters 14, (27), 12-23. http://dx.doi.org/10.1016/S0968-8080(06)27232-X        [ Links ]

Shishana, O., Hall, E., Maluleke, R., Chauveau, J. & Schwabe, C., 2004, 'HIV/AIDS prevalence among South African health workers', South African Medical Journal 94 (10), 846-850.         [ Links ]

Subedar, H., 2005, 'The nursing profession: Production of nurses and proposed scope of practise', in P. Ijumba & P. Barron (eds.), South African health review 2005, Durban, Health Systems Trust, viewed 14 September 2009, from http://www.hst.org.za/sahr        [ Links ]

Van Rensburg, D., Steyn, F., Schneider, H. & Loffstadt, L., 2008, 'Human resource development and antiretroviral treatment in Free State province, South Africa', Human Resources for Health 6(15). PMid:18662390; PMCid:2531133.         [ Links ]

Wadee, H. & Khan, F., 2007, 'Human resources for health', in S. Harrison, R. Bhana & A. Ntuli (eds.), South African health review, 2007, Durban, Health Systems Trust, viewed 14 September 2009, from http://www.hst.org.za/sahr        [ Links ]

Wildschut, A. & Mgqolozana, T., 2009, 'Nurses', in J. Erasmus & M. Breier (eds.), Skills shortage in South Africa: Case studies of key professions, HSRC Press, Cape Town.         [ Links ]

WHO 2005, Stage is set for a polio-free world, Polio News, 25, viewed 11 September 2009, from http://www.polioeradication.org/content/polionews/PolioNews25.pdf        [ Links ]

WHO 2006a, 'The World Health Report 2006: Working together for health', Geneva, World Health Organisation, viewed 10 August 2009, from http://www.who.int/whr/2006/en/        [ Links ]

WHO 2006b, 'Taking stock: Health worker shortages and the response to AIDS', viewed 10 August 2009, from http://www.who.int/hiv/pub/advocacy/ttr/en/index.html        [ Links ]

WHO 2007, 'The Global Fund expands its role', Bulletin of the World Health Organisation 85, 742-743. PMid:18038053; PMCid:2636497.         [ Links ]

WHO 2010, 'Framework for the implementation of the Ougadougo declaration on primary health care and health systems in Africa', World Health Organisation Regional Office, Brazzaville.         [ Links ]

 

 

Correspondence:
Gavin George
HEARD
4th Floor J Block
Westville Campus
Durban 4041
South Africa
Email: georgeg@ukzn.ac.za

Received: 19 Sept. 2011
Accepted: 01 Oct. 2012
Published: 11 Dec. 2012