HIVAN/ECI May 2006 Journal Club

Prof Steve Reid from the Centre for Rural Health, UKZN, spoke on ?“Human Resources for Health in Underserved Areas?” at the Journal Club held at the Nelson R Mandela Medical School on 12 May. This was an unusual presentation as it was not specifically focused on HIV and AIDS, but it dealt with human resources in the public sector which constrains the sector?’s ability to deliver health services, including those related to HIV. ?“Why focus on human resources??” one might ask. Prof Reid stated that this issue was important for access to healthcare, quality of healthcare, equity in terms of the availability of health care to the population, and the impact or effectiveness of the care provided.

The Centre for Rural Health did a study in northern KwaZulu-Natal and found a 46% vacancy rate for Professional Nurses, a 41% vacancy rate for Medical Officers, and a 55% vacancy rate for Senior Medical Officers and more senior health workers. Most posts were filled in relatively urban areas which meant that in rural areas, the vacancy rates were even higher. A conclusion drawn by this particular piece of research was that the Community Health Programme was failing to meet the health needs of people in the most underserved areas, where they were most required. For example, at Ekombe Hospital in Nkandla District of the KZN Midlands, there was only one medical officer and no community health workers, a dire situation in this already resource-constrained setting.

Prof Reid went on to talk about the main topic of the day?’s presentation, which was a journal article from a study done in North Viet Nam (see reference given). The exploratory qualitative study was based on Herzberg?’s theory of motivation in the workplace, which identifies job satisfiers and job dissatisfiers at the individual level, and at the organizational level it postulates on a worker?’s motivation to accept or remain in a job and the motivation to improve one?’s performance. Semi-structured interviews with 14 policy makers and managers, 24 health staff and 11 patients were carried out, as well as 8 group discussions with health workers. Results showed those issues that health workers felt were main motivating factors to remain in their jobs, and those issues that acted as dissatisfiers. Interestingly, dissatisfiers tended to be extrinsic factors, while satisfiers tended to be more instrinsic.

The full report and presentation can be accessed on the righthand side of this page.