The Health Systems Trust has released the eighth edition of the South African Health Review. The review focuses on progress made in restructuring the South African health system and provides an annual and longer-term review of the implementation of South African health policies. Twenty one chapters are grouped into the following four themes: framework for transformation, human resources, priority programmes and support systems. The Review acts as a barometer for assessing the transformation processes and their impact on provision of equitable health care to all South Africans, and provides the most recent data on health status and health services, key opinions, and current thinking in Health in SA. Chapters 7 to 10, discuss issues pertinent to human resources development, including implementation of Community Service for Health Professionals, the deployment of community based health workers in dealing with essential health and social issues, and the experiences of primary health care facility workers.
Human Resources
Not only is the HIV/AIDS pandemic a "humanitarian disaster," but the disease could also cause an "economic crisis" in "emerging markets" such as South Africa, China and the former Soviet Union, where the virus is "spreading fast," the Toronto Globe and Mail reports. Labor-intensive industries, such as mining, have been particularly hard hit by HIV/AIDS, and service industries such as banking and food products may have to project slower growth in coming years due to a declining consumer base.
Private hospitals are pulling out all the stops to keep nurses from taking up lucrative offers overseas. Salary incentives and training programmes are just some of the carrots being dangled before staff to keep them loyal. Nursing Update, the journal of the Democratic Nursing Organisation of South Africa (Denosa), is overflowing with adverts for nursing positions in the UK (where the training background is similar), Canada, the US, Australia and New Zealand. Saudi Arabia also pays big money.
This publication is designed to guide government departments in South Africa on the minimum requirements to effectively manage HIV/AIDS in the workplace and ensure a coordinated public service response. It is expected to assist departments in planning, developing, implementing, monitoring and evaluating workplace HIV/AIDS policies and programs.
In a recent article in the South African Medical Journal, Nicki Fouché of the Division of Nursing and Midwifery at the Faculty of Health Sciences at the University of Cape Town warned that the haemorrhaging of professional nursing staff would have a catastrophic effect on the delivery of health care in South Africa over the next decade. She added that it was estimated that there are 2 300 registered nurses working overseas and that they receive about 200 applications per month for overseas registration. In 1999, 3 300 nurses left South Africa.
How is the AIDS pandemic affecting growth and distribution in South Africa, and what are the economic impacts for workers likely to be? While the overall picture is murky, certain worrying trends and findings present themselves: If firms react by continuing to decrease their reliance on unskilled labour and by moving out of economic sectors whose customer-base comprises lower income consumers, then poor households will find themselves doubly disadvantaged, as their access to the labour market becomes ever more tenuous and the products that they purchase may become scarcer and more costly.
This report is the result of research into the current impact of HIV/AIDS on NGOs and CBOs in KwaZulu-Natal, the worst-affected province of South Africa. A survey of organisations found that most were aware that they eventually would have to grapple with HIV/AIDS among their own staff and volunteers, and they knew this could have serious consequences for their organisations' effectiveness and sustainability. This report aims to provide not just information on the status of the surveyed organisations, but also tools to help organisations in South Africa and elsewhere plan for and manage the epidemic among their own staff and volunteers.
Many decision-makers readily point to human resource problems as the chief bottleneck they face in attempting to scale up health systems. Yet time and again the reform agenda neatly skirts around the sensitive and difficult issues involved—not least because there are major gaps in the knowledge base required for a realistic workforce strategy. This editorial of the World Health Organisation Bulletin provides an overview of the role of human resources within the health sector, regardless of whether it is public or private. The editorial discusses the importance of human resources management within the health sector, and suggests that policy-makers and donors concerned with human resources problems may want to request those proposing a major new project or policy to make a systematic and formal ‘human resource impact assessment’ during its preparation. Such assessments would examine the likely effects of the proposed project or policy on the health workforce.
South African law protects the rights of employees living with HIV/AIDS on paper, but the reality is that discrimination and denial still prevails in the workplace in a country which has one of the highest HIV/AIDS rates in the world. "We have the best legal frameworks around but this hasn't changed mindsets. People still get dismissed because of their HIV status. I handle HIV/AIDS discrimination cases almost every day," Jennifer Joni, an attorney for the AIDS Law Project told IRIN.
It is widely believed that children who are directly affected by AIDS are greatly disadvantaged at school and that teachers are a high risk group for HIV infection. Research in Botswana, Malawi and Uganda suggests that the situation is much more complex. An international team of researchers surveyed 41 primary and secondary schools across the three countries and interviewed education managers, teachers and other stakeholders. They investigated the effectiveness of HIV prevention programmes and the impact of the AIDS epidemic on pupils and teachers. They found little evidence that education on HIV/AIDS, sexual and reproductive health (SRH) and life skills has a major impact on behaviour. Economic and social pressures that fuel unsafe sexual practices among adolescents remain high. Teachers lack the training and commitment to integrate HIV/AIDS education into carrier subjects. The study identified an urgent need for full-time SRH/life skills teachers in both primary and secondary schools giving regular timetabled lessons.