Where are we Short and who are we Short of? A Review of the Human Resources for Health in South Africa

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

Nursing Shortage Paradigm: The Bayelsa State Situation

This paper attempted to educate the reader about the shortage of nursing staff and how it affects Bayelsa State's health sector. Bayelsa State like any other state in Nigeria has enormous health challenges associated with manpower shortage. Bayelsa's situation is unique because of its terrain. Some factors such as cost of river transport; insecurity of lives and properties due to incessant attacks from sea pirates; poor housing; lack of portable water; deplorable state of hospitals and health centres; erratic or lack of power supply; inadequate nursing personnel; and uneven distribution of the few nurses available; were identified to be peculiar with Bayelsa terrain. This consequently resulted in increased nurse- patient load; risk for error; infection spread; high mortality rate; quackery and chances of nurses being over stressed. Recommendation such as increase in the rural posting allowance for nurses; provision of social amenities in rural areas; employment of more nurses from various states of the federation among others were made

Do Ugandan Medical Students Intend to Work in Rural Health Facilities after Training?

There is a persistent shortage of qualified health workers globally; but worse in developing countries; where it is even worse in rural areas than urban and peri-urban areas. Health workers refuse to be deployed in rural areas or migrate to urban areas in search of better physical facilities and to avoid professional isolation; among other reasons. Health workers brought up in urban areas have not experienced rural life and find it difficult to countenance a professional life in rural areas. Several training institutions have engaged in programmes to expose pre-service health workers to rural health work to demystify it and to enable the professionals make an informed choice on practice location after qualification. In this study; the intentions of Ugandan medical students to work in rural health facilities after qualification were sounded out; together with the factors that affect them and their perception of rural areas. The study covered five government medical schools (2 for doctors and 3 for Clinical Officers). Students of all years of study in the different courses were interviewed; as well as key informants in the administration of the schools. At least one half of all the respondents (50or 167/336) were clear that they did not intend to work in the rural facilities after training; while the other half was divided equally among those who wanted and those who were not sure yet. Whereas the proportion of those intending to work in rural areas rose progressively from the first year of studies; it reached a peak in the pre-final year (fourth year for student doctors and second year for clinical officers) and plummeted in the final year after the students had residential field experience. The majority of the students had a negative perception about working in the rural areas and associated them with lack of physical facilities; social services and communication. Personal demographic characteristics and previous exposure to a rural life did not seem to be related to a choice about work in rural areas. Most of the few students who intended to work in rural areas hoped to stay for not more than three years; before going either for further studies or for self-employment in urban areas. The paper recommends review of the community exposure programmes of the medical schools; with a view to improve support supervision in the field and logistical support for the students during attachment. It also recommends better facilitation of rural health facilities and better incentives and remuneration for rural health workers

Rural Origin Health Science Students in South African Universities

Background. Rural areas in all countries suffer from a shortage of health care professionals. In South Africa; the shortage is particularly marked; some rural areas have a doctor-topopulation ratio of 5.5:100 000. Similar patterns apply to other health professionals. Increasing the proportion of rural-origin students in faculties of health sciences has been shown to be one way of addressing such shortages; as the students are more likely to work in rural areas after graduating. Objective. To determine the proportion of rural- origin students at all medical schools in South Africa. Design. A retrospective descriptive study was conducted in 2003. Lists of undergraduate students admitted from 1999 to 2002 for medicine; dentistry; physiotherapy and occupational therapy were obtained from 9 health science faculties. Origins of students were classified as city; town and rural by means of postal codes. The proportion of rural-origin students was determined and compared with the percentage of rural people in South Africa (46.3). Results. Of the 7 358 students; 4 341 (59) were from cities; 1 107 (15) from towns and 1 910 (26) from rural areas. The proportion of rural-origin students in the different courses nationally were: medicine - 27.4; physiotherapy - 22.4; occupational therapy - 26.7; and dentistry - 24.8. Conclusion. The proportion of rural-origin students in South Africa was considerably lower than the national rural population ratio. Strategies are needed to increase the number of rural-origin students in universities via preferential admission to alleviate the shortage of health professionals in rural areas

The Human Resource Crisis in the Zambian Health Sector a Discussion paper

Objectives: The human resource crisis facing the Zambian health sector has potential to derail existing health programs including millennium development goals. This paper will highlight the underpinning factors; analyze current interventions and propose alternative solutions to this crisis. Design: The study was done through a review of articles and reports covering the topic. Main outcomes/results: The human resource crisis has been recognized by the Zambian government; Zambian organizations and the international community as the greatest challenge that threatens the entire healthcare system. The situation is getting worse and solutions implemented thus far have neither been totally effective nor comprehensive in arresting; let alone reversing the trend. Conclusion: The human resource crisis in Zambia has reached a disastrous stage with the health system at breaking point. Corrective measures have been started but these need to be strengthened and as comprehensive as can be. There is also need for innovation to consider other solutions that have not been tried before. This is important in order to safeguard Zambia's development and all the other investments that the country has made into its future through programs such as the fight against HIV/ AIDS. Although there is need for stronger international cooperation; the primary solutions can and must come from within Zambia