Week 7: Human Resources

Session 1 - Human Resources: An Overview

  1. Spark Questions
  2. Session summary and reflection
  3. Learning Outcome
  4. Concluding Questions

Spark Questions

What do you think we need in order to have a well-functioning health workforce

We need to remove the whole pressure of money.

If medical profesionals got better insentves, ie better living conditions for better work they would be more motivated to work for less pay. 

Less pay means cheaper healthcare meaning more accessible health care.

 

Budget needs to be allocated to insentives, training, emotional stability of health care workers. 

Often the care giver is the one that needs support.

Session summary and reflection

The healthcare workforce consists of the following cadres, amongst others:

  • Physicians
  • Nurses and midwives
  • Dentists and dental assistants
  • Pharmacists
  • Laboratory scientists and technicians
  • Environment and public health workers
  • Community health workers and traditional healers
  • Other health care providers
  • Health managers and support workers

Global Distribution of Health Workforce:

  • A well-functioning health system requires a minimum number of healthcare workers for every 10,000 people (critical threshold).
  • Currently, 57 countries face critical health workforce shortages, especially in the Global South, where disease burdens are highest.
  • This imbalance, where regions with the greatest health needs have the fewest resources, is known as the “inverse care law” (Hart, 1971). For instance, countries with high maternal mortality often lack sufficient nurses.

Health Workforce in South Africa:

  • South Africa requires approximately 46,000 nurses and 12,500 doctors for its public health sector. However, workforce shortages persist, with 42.5% of public sector health posts unfilled as of 2010.
  • The workforce distribution reveals disparities:
    • Primary Health Care vs Hospital Care: Resources are often more concentrated in hospitals than in community-based primary care.
    • Urban vs Rural: Urban areas have more healthcare workers than required, whereas rural areas have significant shortages.
    • Public vs Private Sector: The private sector is better resourced, while the public sector faces severe staff shortages.
Reasons for Workforce Shortage in South Africa:
  • Educational Shortfall: Training institutions haven’t scaled to meet the rising healthcare demands.
  • Low Retention: Healthcare professionals, especially doctors, often leave the public sector or the country due to better opportunities elsewhere.
  • Funding Constraints: Financial limitations lead to insufficient posts in the public sector, contributing to workforce shortages.
Push Factors in the Public Sector:
  • Poor working conditions, low pay, lack of available and funded positions, and inadequate safety measures deter professionals from staying in the public sector.
  • Additionally, inadequate supervision and limited opportunities for young doctors and consultants contribute to high turnover rates.
 
Definition of Health Workforce: The World Health Organization (WHO) defines health workers as individuals engaged in activities primarily intended to enhance health, covering both health service providers and management/support staff in public and private sectors.
 
Components of a Well-Performing Workforce: A responsive, fair, and efficient health workforce is essential. It requires adequate staffing, fair distribution, competency, and productivity to meet health needs effectively.
 
Global Health Workforce Distribution: There is an uneven distribution of health workers globally, with shortages primarily in the Global South, where the disease burden is highest. This disparity aligns with the “inverse care law,” where regions with the most significant health needs often have the fewest resources.
 
South African Health Workforce Challenges:
  • Disparities: Differences in workforce availability between primary care and hospital care, urban and rural areas, and public vs. private sectors.
  • Shortages: Due to insufficient training capacity, low retention in the public sector, and limited job openings because of financial constraints.

Learning outcome

  • Describe and define what constitutes a health workforce.
    • The health workforce includes all individuals engaged in actions aimed at promoting, protecting, and improving health. This encompasses healthcare providers, management, and support staff in both public and private sectors.
  • Discuss local and global differences in the health workforce
    • Global: There is an uneven distribution, with shortages in the Global South, where the disease burden is highest. This leads to an “inverse care law” where those with the greatest health needs often have the fewest resources.
    • Local (South Africa): Within South Africa, disparities exist between urban and rural areas, public and private sectors, and primary vs. hospital care, with rural and public sectors facing significant shortages and under-resourcing.

Conclusion questions

  • What constitutes a health workforce?
    • The health workforce includes all individuals engaged in actions to enhance health, including doctors, nurses, midwives, technicians, and support staff.
  • How is the health work force different in South Africa?
    • South Africa’s health workforce has a dual system of private and public sectors, with unequal distribution, often leading to a shortage of healthcare workers in rural and public areas.
  • What are the challenges facing the Human Resources for Health in South Africa?
    • Disparities: Differences in workforce availability between primary care and hospital care, urban and rural areas, and public vs. private sectors.
    • Shortages: Due to insufficient training capacity, low retention in the public sector, and limited job openings because of financial constraints.
Week 6 - Session 5
Session 2