sector skills plan for the health sector in south africa

and training are directly affected. Demand for public health services is likely to increase due to job
losses (and loss of employment-linked medical insurance cover). This will add further pressure on health
professionals and workers in the public sector.
South Africa is encumbered by a quadruple burden of disease attributable to diseases of poverty, the
HIV and AIDS pandemic, high incidence of communicable diseases and tuberculosis infection, as well as
high levels of chronic diseases and inter-personal violence. This disease burden is four times larger than
in developed countries and is generally double that of other developing countries. The public sector
bears the brunt of the problems.
It is widely recognised that care levels, outcomes and management of the public health system are
under strain partly because of significant staff shortages, a mal-distribution of skills between urban and
rural areas, and an inadequate skills base. Management of the health system is under strain at almost
all levels. Wide-spread inefficiencies result in services that are unresponsive to health and patient
needs, and a lack of accountability exists on a large scale.
Almost every aspect of the health system is regulated by the national Department of Health (DoH), while
the professional councils regulate the quality of the country’s health workers. Responsibility for
developing human resources in the public sector are split between the national and provincial levels.
The national DoH has to promote adherence to norms and standards for the training of human
resources, while the nine provincial departments of health are responsible to plan, manage and develop
human resources to render health services.
A key priority for the national DoH is the introduction of a national health insurance (NHI) system
offering universal coverage and free health services to all South Africans by 2014; i.e. within the
planning horizon of this SSP. Although the proposals are still under development and subject to change,
the HWSETA should take into account the implications for human resources needs and skills
requirements, especially considering the long lead-time required to train healthcare professionals.
Although the details of the scheme are not yet known, it will extend access to private care and some
analysts expect an increase in the demand for services of general medical practitioners and specialists as
patients will move away from public clinics and hospitals. In the NHI system itself, considerable
managerial, financial and information technology management skills will be required to monitor usage
and benefits offered, as well as the distribution of resources and the costs of the scheme.
Current national health policies focus on the provision of primary care and community-based health
services; expanded HIV and AIDS and TB treatment; improving the health of mothers, babies and
children; improving management and governance of the health system; and improving human resources
planning. On the animal health side, there are increasing calls to make veterinary services more
accessible to low-income communities at local government level and to introduce mid-level veterinary
workers such as primary animal healthcare workers and community animal health workers to serve
animal health needs in impoverished communities.
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