NATIONAL NEWS - Sufficient ratios of doctors and nurses relative to a country’s overall population prefigure quality healthcare and patient safety. With only 23 healthcare workers (HCWs) to every 10 000 people, South africa falls short of UN targets.
Experts suggest, however, that the figure is misleading, and while the overall proportion may seem manageable – especially compared to neighbouring SADC states – the crux of the problem is the unequal distribution of HCWs and healthcare services.
While South Africa's private sector has 17.5 doctors per 10 000 people – approximately the global average – the public sector has just 3.
A recent World Health Organisation (WHO) ‘State of World Nursing’ report highlights the need for every nation to train 8% more nurses each year to avoid a potentially catastrophic global shortfall of over 10 million nurses by 2030.
“Many young South Africans are seeking livelihoods in healthcare, but all too often their aspirations are thwarted by structural obstacles – bureaucratic red-tape; poor or dangerous workplace circumstances; and other socio-economic difficulties outside of the work environment,” says Cynthia Makarutse, event organiser for the Africa Health 2022 Conference.
“When they do find jobs, they often face unsustainable working conditions. Resource and supply shortages make it impossible for them to ensure an adequate standard of care, which leads to a high incidence of burnout and depression, especially among public sector nurses."
New HCWs not absorbed
Makarutse explains that, on one hand, South Africa has significantly escalated issues around HCW training and retention, leading to a 61% increase in medical graduates commencing public hospital internships since 2017.
“This year alone some 2500 new doctors, nurses, pharmacists, interns, and community service personnel have joined the HCW workforce. Unfortunately, however, provincial health department budgets have not kept pace with the number of newly trained HCW, and public facilities find themselves unable to absorb the new doctors.”
Backlog of accreditation dates back to 2015
Makarutse says an under-resourced public sector, inadequate training programs, and the backlog in accreditation for training institutions that dates back to 2015, are some of the hurdles young would-be doctors and nurses in SA face.
"Unsurprisingly, the country faces a ‘brain drain’ as many HCWs are emigrating."
At this year’s nursing track at Africa Health 2022 in Johannesburg, industry figureheads like Fasie Smith, Dr. Sharon Vasuthevan, and Dr. Sue Armstrong will delve into the challenges of ensuring that we train enough nurses.
Makarutse says an urgent increase in a training capacity is a key component of the proposed solutions to the HCW shortage, but equally, policymakers must act to address the systemic fault lines and structural barriers – working conditions, facility infrastructure, and supply chain stability - to ensure that all the already trained currently unemployed HCWs are placed in positions.
Studies show that reaching target minimum ratios of HCWs in various specialisations would drive substantial cost savings to the national health system, improving patient outcomes, reducing readmissions, and avoiding currently pervasive negligence litigation against the state.
“The gap in HCWs requires a systems approach, including improving general education right down to school level. It’s a structural issue requiring inclusive paradigms to solve. Many of the socio-economic drivers behind the HCW shortages in SA are the very same issues behind the increased burden of disease in developing nations. The solutions we’re exploring are interdisciplinary, involving multiple stakeholders and sectors, including patients themselves.”
* Africa Health is organised by the Informa Markets’ Global Healthcare Group. It takes place at Gallagher Estate in Gauteng (South Africa) between 26 and 28 October 2022. The event will host 12 CPD accredited conferences that are aimed at bridging the gap in medical knowledge by providing the very latest insights into cutting-edge procedures, techniques, and skills.
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