Correction: Mabunda et al. Development, Objectives and Operation of Return-of-Service Bursary Schemes as an Investment to Build Health Workforce Capacity in South Africa: A Multi-Methods Study. Healthcare 2023, 11, 2821.

In the original publication [...].

Development, Objectives and Operation of Return-of-Service Bursary Schemes as an Investment to Build Health Workforce Capacity in South Africa: A Multi-Methods Study.

BACKGROUND: South Africa uses government-funded return-of-service (RoS) schemes to train, recruit and retain skilled health professionals in underserved areas. These educate health professionals locally or internationally in return for a commitment to serve in a specified area for an agreed period. While such schemes are used widely and are funded by substantial public funds, their exact makeup differs across jurisdictions, and little is known about why these differences have emerged or how they influence their effectiveness or impact on the health system. We aimed to fill these gaps through an analysis of the origins, architecture, and evolution of RoS schemes in South Africa. METHODS: A multimethod research study including a policy review, a literature review, and semi-structured interviews of policymakers was undertaken between October 2020 and August 2022. The included policy documents and literature were analysed using the Walt and Gilson framework and narrative synthesis. Qualitative data were analysed using inductive, thematic analysis in NVIVO 12. RESULTS: RoS schemes are used as a recruitment and retention strategy and a mechanism to address equity in access to medical education. Whilst there is evidence of RoS schemes existing in 1950, no evidence of beneficiaries was found in databases until 1989. The impact of these schemes is likely being limited by sub-optimal institutional arrangements and poor transparency in their design and implementation. CONCLUSION: Despite rigorous research methods, the origins of RoS policies in South Africa could not be established due to poor preservation of institutional memory. Opportunities to monitor the value of public investment into RoS programs are being missed and often the underlying objective of the programs has not been well-specified. Policies were found to have been developed and operate in isolation from other health workforce planning activities and thus may not be maximising their impact as a retention and training tool.

Competency-based Training Needs Assessment for Research Managers and Administrators in Africa and the United Kingdom to Strengthen Equitable Partnerships.

Background: The need for competent research managers and administrators (RMAs) has increased due to the complexity in managing research projects between disparate and international partners. To facilitate the creation of robust training and professional development programmes it is essential to first understand the status quo. A collaborative project, Sustainable Management and Administration for Research: Training across the project Lifecycle (SMARTLife), made up of RMAs from South Africa, Zimbabwe and the United Kingdom (UK) developed a set of competencies to conduct an RMA competency-based training needs assessment scoping tool. Method: Nine areas were identified: Equitable partnership; Finance Management; Project Management; Monitoring and Evaluation; Reporting and Communications; Equity, Diversity & Inclusion; Training and Capacity Development; Impact a& Sustainability; and Ethical, Social, Legal a& Social Implications.  Tasks for each competency area were identified to develop an scoping tool that had 168 data collection points. The tool was advertised through press releases, mailing lists and social media. Results:  108 responses were obtained:  with 49% from 15 Africa countries/the remainder from the UK. The UK (71%) had more permanent RMA staff members compared to Africa (39%). There were more respondents in Africa with the title of Research Manager/Coordinator(p=0.0132) compared to the UK where most of the RMAs were employed as Finance/Contract officers. 60% of respondents from the UK had more than three years experience while only 35% from Africa had experience. While most RMAs had formal higher education qualifications, their training was not in research management and administration, which requires a diverse range of skills. Confidence in specific tasks varied between the UK and Africa whereas collaborative partnerships challenges and enablers were similar. Conclusion This work highlights differences in RMA training and experience RMA  between Africa and UK, this work could inform much needed competency-based training for RMAs and partnership strategies that aid mutual-learning.

A qualitative enquiry into the meaning and experiences of wellbeing among young people living with and without HIV in KwaZulu-Natal, South Africa.

Young people in sub-Saharan Africa encounter health and livelihood challenges which may compromise their wellbeing. Understanding how young people's wellbeing is defined could strengthen wellbeing policies. We investigated perceptions and experiences of young people's wellbeing, and whether these aligned with Ryff's psychological wellbeing (PWB) model. Data were collected between January-August 2018 through focus-group discussions (n = 12) and in-depth interviews (n = 16) with young people living with and without HIV, selected purposively from South African healthcare facilities. Key informant interviews (n = 14) were conducted with healthcare workers and subject-matter experts. Using a framework approach, we situated our analysis around dimensions of Ryff's PWB model: autonomy, self-acceptance, purpose in life, environmental mastery, positive relationships, personal growth. Young people's wellbeing was rooted in family and peer relationships. Acceptance and belongingness received from these networks fostered social integration. HIV-related stigma, crime and violence reduced their perceived control and social trust. For males, fulfilling gendered roles made them feel socially valued. Self-perceived failure to uphold sexual norms undermined women's social contribution and autonomy. Social integration and contribution framed young people's wellbeing. However, these dimensions were not fully captured by Ryff's PWB model. Models that consider relationality across socio-ecological levels may be relevant for understanding young people's wellbeing.