The world is facing a healthcare workforce crisis, and the available number of health workers does not meet the demand for accessible medical care. The current number of health practitioners, both globally and locally, is wholly inadequate to tackle the burden of disease.
South Africa’s health system is overburdened, and this has a significant impact on the health of the nation, resulting in poor national health outcomes, poor standards of service delivery, long patient waiting times and high rates of healthcare worker burnout.
However, the dire situation can be greatly alleviated with the recognition of the important supporting – but overlooked – role that public health graduates can play, says Dr Jackie Witthuhn, Programme Manager: Public Health at IIE MSA, a brand of The Independent Institute of Education, SA’s leading private higher education provider.
“The role that undergraduate public health graduates, especially non-clinical staff, can play in the healthcare system is often overlooked. However, their skills can make a huge difference to increase public health capacity, freeing up medical staff to focus on patients, while also focusing on primary interventions,” she says.
Undergraduate public health qualifications differ from medical or healthcare degrees by focusing to a large extent on the detection, surveillance and prevention of disease. The objective of the field or discipline is to reach populations and communities and to detect and prevent health problems before they start, rather than waiting to work with people once they are already sick. The public health approach is therefore based on a preventative health model rather than a curative health model, explains Dr Witthuhn.
“There are many reasons for the health workforce crisis which need to be explored, including the Covid pandemic which highlighted the structural weaknesses in our healthcare system, including neglecting primary care and prevention. Other reasons for the healthcare workforce crisis include poor workforce planning, and a lack of proper planning including task shifting which is an approach to help address the shortage of healthcare workers by reallocating available and skilled resources.
“The burden of chronic diseases, including cardiovascular disease, obesity and diabetes which are increasing at alarming rates, increases the pressure on the healthcare system. These diseases can largely be prevented by primary prevention, an approach that emphasises the need for a preventative public health focus and approach. The significant role that undergraduate public health graduates can play in this regard is often underestimated.”
RECOMMENDATIONS
By utilising existing public health resources more effectively and focusing on non-clinical Public Health graduates, South Africa can ensure a proactive approach. The question of how to ensure an adequate health workforce is a pertinent one. A clear strategy is necessary, and can include:
- A more integrated approach to the planning and allocation of health workers as well as task shifting to make use of non-clinical public health graduates.
- Higher education institutions and health services working together to achieve distributed training and develop norms and standards.
- A more competent mix of staff per level of care to take stock of the available workforce, their training and skills.
- Government and industry recognising qualified staff such as public health undergraduate students who can be responsible for delivering a defined package of essential health interventions aligned to their skills and based on their qualification’s core discipline.
- Health authorities and governmental leaders addressing scepticism around preventive interventions and realigning incentives towards preventive actions and those that promote healthy choices.
- An increased focus on the overall awareness of the Public Health undergraduate’s role, core competencies, and skill sets.
- Greater evidence-based research to highlight the impact of preventative and public health prevention programmes to ensure increased spending and funding.
- The creation of a competent and caring multidisciplinary health workforce through an equity-oriented, socially accountable education and training system.
- Accountable strategic leadership and management in the health system to build an enabled, productive, motivated, and empowered health workforce.
- The restructuring of available resources and infrastructure to achieve priority health goals and objectives, as opposed to a reliance on further funds.
- The development of an institutionalised data-driven and research-informed health workforce policy to inform planning, management, and investment.
“We have the resources, but we need to start creating a system that can make optimal use of all of them,” says Dr Witthuhn.
“Future health workforce plans should focus on the utilisation of existing healthcare resources and infrastructure considering South Africa’s developmental status. All of the conditions that can make change possible are already in place. Investing in the supporting role of public health graduates and the focus on primary prevention can greatly address the current healthcare workforce shortage to deliver significant health and economic dividends.”
