Human resources

A review of structures, competencies and training interventions to strengthen district management in the national health system of South Africa.

The aim of the study is to undertake a national assessment of existing district management structures, competencies and current training programmes in order to inform a national strategy and plan to strengthen district management capacity to ensure effective delivery of primary health care in South Africa.

Closing date: 15 September 2006
The Health Systems Trust is a non-government organisation (NGO) that supports the development of an equitable and comprehensive health system that provides quality health care. We have a senior vacancy for Manager: Support Services in the organisation.

Recruitment and Selection of required personnel is the first step to a superb workforce. Retention is step two and critical for long-term success of your organisation for effective provision of healthcare service delivery.

South Africa faces the most intricate human resource challenges characteristic of health systems in many other countries. Ensuring an adequate human resource pool for the staffing of especially the public health sector is a major task that is complicated by many global and disease burden challenges. Even though the private health sector is not experiencing the same pressures to the same degree, maldistribution within this sector is a serious challenge. Developing a human resource plan for health is very high on the agenda of the National Department of Health. It is globally recognized that a focused human resource strategy backed up by an appropriate implementation plan is a critical ingredient of positive change in health care. Success in this area helps create a positive image and an environment conducive for health care to flourish. Equity, efficiency and effectiveness of the health system depend on the two elements a visionary strategy and a focused plan being appropriately developed and implemented.

A study by South Africa's Human Sciences Research Council (HSRC) has confirmed earlier findings regarding the under reporting of emigration by highly skilled South Africans to major consuming countries such as the United States, Canada, the United Kingdom, Australia and New Zealand, with the flow up to four times higher than the official figures of Statistics South Africa. Releasing the study, entitled Flight of the Flamingos, the Study on Mobility of Research and Development (R&D) workers in Cape Town on Wednesday, the HSRC said a key finding was that, although emigration figures of highly skilled researchers remain high, the greatest mobility of high-level skills is now within the country. The study was commissioned by the National Advisory Council on Innovation (NACI). He says a well-functioning science and technology system is a recognised contributor to economic growth and is in turn dependent upon a competent and productive R&D workforce. The loss, gain and circulation of this workforce presents both a threat (when it entails permanent loss) and an opportunity through brain gain and career development. While official migration statistics show that 16,725 highly skilled South Africans emigrated between 1994 and 2001, this represented less than 1% of South Africa's highly skilled human resources in 2001. However, the study found evidence that movements of R&D workers within South Africa were significantly more of an issue than international mobility. The pull of management and financial occupations was noted as being particularly strong, with many organisations referring to this as the 'MBA drain'. Data from the 2001/2 R&D Survey supported this, as only 11% of R&D personnel departing from the science councils were reported as going overseas. Thomas Pogue, senior researcher at CSIR, says the study approached the issues of brain drain, brain gain, brain circulation, and brain development not as disasters, but as component realities of mobility that must be managed for what they are, both good and bad. South Africa, like other emerging economies such as Russia and India, faces special problems in managing mobility. Moreover, re-emergence from isolation, the restructuring of the economy and the impact of globalisation have altered our international trade relations, financial position and the mobility of human resources, especially in the science, technology and innovation fields. Until now there has been an 'information chasm' concerning the data needed to inform our thinking on R&D human resources, Kahn said. This study and the national R&D Survey 2001/2 (published early in January 2004) that HSRC carried out for the Department of Science and Technology, go some way to addressing these problems. (Source: Lynn Bolin, Business Day, 28 January 2004) Link http://www.hsrc.ac.za/media/2004/ http://www.hsrc.ac.za/media/2004/1/20040115Survey.pdf (28 pages)

By 2011 South Africa will have an estimated shortfall of 19 000 nurses, and while the country trains enough doctors to serve the population, the problem of a huge shortage of doctors in the public sector will probably not be solved in the near future. These are some of the conclusions in a range of studies on skills development and shortages commissioned or conducted by the HSRC’s Human Resources Development research programme. The studies aim at providing the best empirical overview of the nature and extent of the scarce skills issue and form part of the Human Resources Review 2003, which will be published later this year. This research falls within the ambit of one of the key development challenges facing South Africa, as identified by President Mbeki. The issue has been taken up elsewhere in the government too, most notably in the development of the new Immigration Act, where a new strategy for attracting such skills from outside the country has been developed. In a preview of the Human Resources Review’s findings in two areas, namely health and engineering, researchers Johan Erasmus and Elsje Hall of the HSRC’s Economic and Employment Policy Research (EEPR) programme, examines the likely extent of shortages of doctors and nurses in the next decade. Even with recruitment to address the 25% vacancy rate in the public system, Erasmus and Hall predict a shortfall of nearly 19 000 nurses by 2011. Erasmus and Hall found that the supply of new doctors from medical schools is likely to slightly outweigh the loss of staff through retirement, illness and emigration. However, this positive picture needs to be carefully qualified: firstly, recent statements by representatives of junior doctors and medical students suggest that the already high levels of migration of doctors may increase significantly; secondly, the projected growth in supply of doctors would not address the major problem that 27% of posts for doctors in the public sector are unfilled; and thirdly, the projections assume that the current disparities and weaknesses within the health system will not be addressed. This would leave unchanged a ratio of doctors to overall population and a situation where only 29% of doctors meet the needs of the 84% of the population not covered by medical aid schemes. It would also not redress the massive inter-provincial and rural-urban disparities in the supply of doctors. In the case of the nursing profession, the bulk of nurses have remained within the public system and have more successfully been deployed across the country. The ratio of nurses to overall population is also more favourable. (Source: Simon McGrath, HSRC Review Vol1 no 2) Dr Simon McGrath is a research director in the Human Resources Development research programme. The Human Resources Review 2003 will be published towards the end of 2003.