South Africa: Supporting training and ensuring that healthcare workers are well remunerated can mitigate against the rising shortage of healthcare workers, according to Chief Executive Officer of Corvus Health, Dr Kate Tulenko.

Dr Tulenko says awarding funding and bursaries for training healthcare workers should be ramped up in areas where there is the greatest need, in addition to making sure these workers are incentivised to remain in the sector.

The world is facing an impending crisis of a shortage of healthcare workers, according to the World Health Organisation (WHO), and South Africa is not immune. The WHO estimates the shortage to be around 15 million, but some researchers have estimated the shortage to be as high as 43 million. This shortage is despite the fact that a healthcare workforce is one of the critical elements in any effective healthcare system.

“We need to ensure that we train people close to the communities that they will serve, so that they can serve locally,” Dr Tulenko said, adding, “We should allow private health professional schools to train and contribute to easing the health worker shortage. The government does not have the funding to train the number of healthcare workers needed, so the hostility towards private schools must end.”

She has cited unconducive working conditions and low renumeration as areas that need to be addressed to retain these scarce skills. “We must pay nurses and doctors properly. Healthcare professionals should be paid enough for them to be incentivised to stay in the sector.

“We need to ramp up the training of people in under-served communities and pay them on time. Many people who work in distressed communities leave because they are frustrated by not being paid on time and in full. Those with critical skills can also be retained and kept motivated through performance-based pay,” she added.

Dr Tulenko has attributed the deepening healthcare workforce shortage to an ageing healthcare labour force, under-investment in training, and headhunting by more developed countries.

“South Africa is at a crossroads as it plans the implementing of its universal healthcare coverage. We can either continue to sleepwalk or we can deal with the global healthcare worker deficit. Governments are not looking at the evidence of interventions that work before investing in healthcare workers. Better investment in healthcare workers will result in better outcomes,” said Dr Tulenko. She indicated that the current situation is a vicious circle. Overwork of the few health workers who remain causes a higher rate of those leaving.

According to the Board of Healthcare Funders (BHF), the current reports on the entire healthcare workforce are concerning, both locally, and globally.

Dr Katlego Mothudi, managing director of the BHF, says, “While other countries are currently implementing plans that show that there will be a reduction in the deficit by 2025 or 2030, in South Africa and the rest of Africa in general, the narrative is different, the deficit is increasing.”

He says that of concern is the fact that statistics show that by 2025 South Africa alone will face a shortage of about 34,000 registered nurses. At the moment, no immediate action has been taken to bridge this gap.

Dr Mothudi recommends that there be a significant effort to drive strategic efforts towards growing the pool of the country and continent’s healthcare workforce. This can be done by nurturing healthcare professionals through vocational guidance, and training.

Dr Tulenko highlights that governments can address these gaps by focusing on improving the quality of care while correspondingly improving training and creating more favourable conditions to retain the existing workforce.

“Education could be one of the solutions, especially the education of women. Women and minorities should receive improved access to training as they are more likely to be retained in the sector because they know the challenges of having access.”

There is also a need to train doctors and nurses together so that they can better understand their responsibilities and the division of labour, Dr Tulenko added. “By combining their training, they can gain some of the soft skills that are often learnt only after they have completed their studies.”

Dr Tulenko proposes that eligible candidates earmarked for training should be properly vetted to ensure that funds for training are invested in the right people. “Select students with an intrinsic motivation to be health workers who understand what their training means,” concludes Dr Tulenko.