Contribution of a bonded scholarship scheme to staffing rural health facilities.

BACKGROUND: Local and international research has identified rural origin as an important reason why healthcare professionals (HCPs) work in rural areas, and in South Africa (SA) considerable effort has gone into recruiting and training rural-origin students. However, there is little information in the SA literature on where graduates supported by these initiatives work, and whether they contribute to the rural workforce long term. OBJECTIVE: To determine the number of years that rural-origin Umthombo Youth Development Foundation (UYDF)-supported graduates of different disciplines worked at rural public healthcare facilities (PHCFs). METHODS: A retrospective descriptive study reviewed work record data of 405 UYDF graduates, to calculate the number of years they worked at a rural PHCF. Data were analysed descriptively and presented in tables with totals and percentages. RESULTS: Ninety percent (363/405) of UYDF-supported graduates returned to work at a rural PHCF. High percentages of social workers (85%), optometrists (80%), speech therapists, nurses (72%) and dental therapists (70%) worked for ≥5 years at a rural PHCF, while only 13% of audiologists, 14% of doctors, 29% of pharmacists, and 28% of dentists and occupational therapists worked at a rural PHCF for ≥5 years. Ten percent (42/405) of graduates did not work at a rural PHCF at all. A total of 110/124 (89%) of doctors supported by UYDF had worked at a rural PHCF, with 32% (40/124) working at a rural PHCF for ≥3 years. Overall, 54% of UYDF-supported graduates (219/405) worked for ≥3 years at a rural PHCF, and 38.5% (157/405) worked for ≥5 years at rural PHCFs. The majority of UYDF graduates had contributed towards long-term staffing of rural PHCFs. Lack of professional development opportunities at rural PHCFs as well as the reduced number of funded posts at rural PHCFs reduced the effectiveness of the UYDF initiative. CONCLUSION: The UYDF Scholarship Scheme has shown that investment in rural students through a bonded scholarship can contribute to staffing rural PHCFs, as >90% of graduates worked at rural PHCFs, and for some disciplines >70% of graduates worked for ≥5 years at a rural PHCF. Allied HCPs worked on average for longer periods at rural PHCFs than doctors.

The training of healthcare professionals: An expense or an investment?

BACKGROUND: There is little information on the financial return of investment when funding the tertiary education of healthcare professionals (HCPs) in South Africa (SA). OBJECTIVES: To assess the cost-benefit of the Umthombo Youth Development Foundation (UYDF) scholarship scheme, which has supported the training of HCPs from rural areas in KwaZulu-Natal Province, SA, for the past 19 years, and to establish whether it is a worthwhile investment. METHODS: This was an economic analysis to estimate the costs and economic value of UYDF's investment in the training of HCPs, using a deterministic model developed in Excel 2010 (Microsoft, USA) to analyse the UYDF's historical, numerical and economic data. Costs were measured in monetary terms, and a rate of return on investment was calculated over the working life of HCPs who had been supported by the UYDF. RESULTS: With a >90% pass rate, the total cost of training the 254 graduates supported by the UYDF from 2009 to 2015 was estimated to be ZAR186 million. Graduates are expected to generate an estimated ZAR15 billion in lifetime earnings, which is equal to ZAR4 billion at 2015 prices, and represents an internal rate of return of 63%. Income tax paid on future earnings will be ~ZAR4 billion, assuming a 20 - 30% tax rate. CONCLUSIONS: The analysis has shown that the cost of HCPs' education, where the annual pass rate is >90%, and >98% of graduates are employed, is an excellent investment. Consideration should be given to finding ways of improving the pass rate at institutions of higher learning and ensuring that graduates obtain meaningful employment if such returns on investment are to be seen on a national level.

Evaluation of calving date and calving interval as measures of reproductive efficiency in beef cows.

Five hundred and thirty-five calving records were analysed to determine the relationship and factors influencing calving date (CD) and calving interval (CI) so as to determine which of the two is the best measure of reproductive efficiency in beef cows mated during a restricted breeding season. Effects included in the model for the analysis of effects of CD and CI were: age of dam, year, previous sex of calf (PSex), previous calving date (PCD), previous calf birthmass (PBM) and previous calf weaning mass (PWM) and the interactions PBM x PSex and PWM x PSex. PCD and year had a highly significant influence on CD and CI. PCD had a significantly larger influence on calving interval than on calving date as evidenced by the larger mean square associated with calving interval. It was found that cows that calved earliest during the calving season had the longest calving intervals, whilst cows that calved latest had the shortest calving intervals. Calving interval was found to be reduced by 0.61 +/- 0.05 days for each one day delay in PCD, whilst CD was delayed by 0.09 +/- 0.07 days for each one day delay in PCD. It was concluded, since calving date was influenced to a smaller extent than calving interval by previous calving date, that calving date is a more reliable reproductive measure where restricted mating is practised.