Some 46% of South Africa’s population
lives in rural areas, relying on remotely
situated public hospitals and clinics.
A R9-million (US$1.2-million) grant has been awarded to South Africa’s Wits University to set up a medical education campus in the North West province to train more rural-based healthcare workers, of which there is a dire shortage.
The grant was awarded to Wits on 4 November by Atlantic Philanthropies, a private foundation created in 1982 by US billionaire and philanthropist Charles Feeney.
It will enable about 60 students to be enrolled for a Bachelor of Clinical Medical Practice degree at the campus over the next three years.
The degree, introduced at Wits in early 2009, trains students to become clinical associates and work as part of a team of professionals in district hospitals under the supervision of a doctor.
Graduates complement the role of the primary care nurse.
The campus will be a piloted within the Lehurutshe-Zeerust Hospital Complex in the remote north-eastern part of the province.
It is hoped that over time the model will also be implemented in the other districts of North West.
The initiative is part of the recently launched Wits Centre for Rural Health, which works to grow the complement of healthcare workers in outlying areas of South Africa.
Impact on rural communities
The shortage of rural-based professionals in the country can be attributed to a number of factors. Professor Ian Couper, director of the Centre for Rural Health, says: “Traditionally, health science professionals have been taught in large tertiary, academic hospitals, which contribute to the reluctance of these professionals to work in unfamiliar settings and the perpetual shortage in rural areas.”
Better salaries offered overseas and by the private healthcare sector have further contributed to the exodus from state health institutions and most notably those in rural areas. “The maldistribution of healthcare professionals has a dire impact on rural communities,” Couper says.
The Wits rural-based education initiative is a response to international research showing that retaining sufficient healthcare professionals in rural areas requires an integrated comprehensive approach, according to Couper.
“This starts with the right selection criteria for health sciences students, decentralised health professional education in the areas and ongoing support for rural healthcare professionals.”
Relief for North West
South Africa’s Health Systems Trust, which provides a range of health-related indicators, states that an estimated 46% of the country’s population lives in rural areas. This means that almost half of the population relies on remotely situated public hospitals and clinics, posing a serious challenge to equitable healthcare delivery.
North West is no exception, with one of the lowest doctor and nurse to population ratios in the country.
According to the South African government information service, more than 65% of North West inhabitants are based in rural areas.
There are only 11 public sector doctors per 100 000 people there, which is in stark contrast to the 30:100 000 ratio in more urbanised provinces, such as Gauteng.
While the North West medical education campus will initially focus on training clinical associates, it will provide an impetus for further development and training of medical students, family physicians, nurses and other healthcare professionals in the province, Wits says.
The provincial health department has thrown its weight behind the initiative and has already created posts for future clinical associates in its staffing structure. It’s also making bursaries available for prospective local students who complete their training in North West.