| dc.description.abstract | This chapter reviews the progress made in recent years to strengthen human
resources to deliver health care within a Primary Health Care approach. It focuses
specifically on the availability and preparedness of old and new cadres of health
workers, their distribution within the South African health system, as well as their
training and development. Findings suggest that overall the health workforce is
substantially weaker today than it was in the mid-1990s. There are fewer doctors
and nurses available for the vast majority of public sector dependent population,
as production has not kept up with population growth, increasing care needs and
attrition. Disparities between provinces remain, and disparities between the private
and public sectors have grown. The nursing sector faces a serious crisis brought on by
an aging professional population. Progress with the development of mid-level cadres
has been slow, with pharmacy being the exception. Furthermore, the implementation
of community health worker programmes remains fragmented and uneven.
Importantly, while there has been curriculum reform in many medical schools, there
has been no fundamental shift in the orientation and resourcing of health professions.
Health workers entering primary or community care services, thus, often remain illprepared
and find themselves poorly supported and resourced. It is suggested that
the following areas must be a priority in the human resource agenda in coming years:
an accelerated production of professionals and mid-level cadres; comprehensive
curriculum audits; the regulation and integration of community health workers; and
an integrated and comprehensive reconfiguration of Primary Health Care teams. | en_US |
