sector skills plan for the health sector in south africa

4.4 FUTURE DEMAND
4.4.1 SKILLS DEVELOPMENT TARGETS SET BY THE NATIONAL DEPARTMENT OF HEALTH
In 2006, as part of a document entitled Human Resources for Health: A Strategic Plan, the national DoH
set targets for the production of human resources by health sciences education and training institutions
to primarily address public sector needs. At the time those targets were developed with reference to
public sector vacancies, outputs at education institutions and the potential for increased outputs,
estimated replacement needs and limited financial resources. The DoH acknowledged that the targets
should have been influenced by actual healthcare needs identified in provincial health service plans,
rather than by the affordability of services in a resource-constrained environment. 161 Further studies
were required, especially on capacity at academic institutions to meet the proposed targets. One of the
targets the DoH set was to increase the number of medical practitioners that would qualify each year
from the approximately 1 200 per year to 2 400 per year. The production of professional nurses had to
increase from 1 900 to 3 000 per year and enrolled (staff) nurses had to increase from 5 000 to 8 000 per
year.
Experts warned in 2008 that South Africa has no system in place to ensure that the production of health
professionals occurs in relation to their need and that decisions on skills development for health are
made independently of national policy. 162 Others remarked that the above targets were set, without an
implementation plan to achieve them. 163 At the time of writing this SSP, the DoH was in the process of
revisiting its Strategic Plan.
4.5 FACTORS THAT IMPACT ON THE DEMAND FOR HEALTHCARE WORKERS
In Chapter 3 several changes and challenges were discussed that will have an impact on the number of
healthcare workers needed in the country, the occupational mix needed and the actual skills required of
people within specific occupations. The most important of these are summarised below:
4.5.1 HIV AND AIDS TREATMENT POLICIES
Expanding the access to ART will impact largely at the district level. Patients will have to be introduced
to ART, advised of the risks of non-compliance with the treatment regime, followed up for risks, and
monitored for side-effects. Since there are not enough doctors to do so, the bulk of the work is
expected to shift to nurses – a professional group already in short supply and under pressure in the
161 Department of Health. 2006. “Chapter 5: Priority Areas for Implementation”. Human Resources for Health: A Strategic Plan.
Published at http://www.doh.gov.za/docs/discuss/2006/hrh_plan/. (Accessed August 2010).
162 Development Bank of South Africa. 2008. A Roadmap for the Reform of the South African Health System.
163 Wolvaardt, G., Van Niftnik, J., Beira, B. et. Al. 2008. “The Role of Private and Other Non-Governmental Organisations in
Primary Health Care”. South African Health Review 2008. Health Systems Trust. Published at www.hst.org.za/publications/841.
(Accessed August 2010).
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