Human Resources Public Health & Health Systems

Experiences in public health

Written by Health-e News

Africa Health Placements (AHP) conducted interviews with local and foreign-qualified doctors to determine what factors attracted them to South Africa and what factors could potentially push them away from working in the public sector, to examine their thoughts on management, team work and perceptions in public healthcare facilities in South Africa, as well as their experiences both in and outside the hospital.

Some of the main issues raised:

  • Clinical experiences

Foreign-qualified doctors said that it was quite difficult to cope with the high rate of HIV and TB as they do not see it as much in their home countries. Doctors said that they have more responsibilities and the clinical work is more diverse due to staff shortages. The lack of education on health issues was also highlighted ‘€“ a UK doctor said that patients in his home country are more informed about their conditions because they do their own research on the internet. In South Africa he has to do a lot more education. The high number of trauma cases in comparison to other countries was highlighted. Language barriers were also stressed as a major challenge.

  • Outside the hospital

Doctors were generally very positive about South Africa. They have the opportunity to travel and explore the country and felt that people were friendly. The general red tape and bureaucracy were mentioned as challenges.

Click here to read the interview:

  • Pull factors

    The relaxed lifestyle in rural areas, South Africa’€™s natural beauty, and gaining medical experience in a different healthcare setting were the main reasons foreign-qualified doctors came to South Africa. Doctors from African countries came here more out of necessity ‘€“ political and economic reasons play a bigger role in their decision to work in South Africa. A local doctor that made the move to the public sector after working in the private sector for years mentioned the desire to make a difference and treat patients that really needed medical care. He also mentioned the work satisfaction and the relaxed lifestyle as major attractions. Although language barriers and staff shortages were mentioned as barriers, foreign-qualified doctors also said that these challenges attracted them to South Africa.

    • Push factors

    Money was not mentioned as a major factor. Two doctors mentioned struggling with different drug names as an initial challenge. A Nigerian doctor said that management, especially in deep rural areas, don’€™t always recognize the important contribution made by foreign-qualified doctors in improving healthcare. Another Nigerian doctor complained about the lengthy exam process and the lack of guidance on the actual exam.

    Click here to read the interview:

  • Poor management

    Poor management is one of the main reasons doctors don’€™t want to work in the public sector. This was again highlighted by the doctors interviewed. Two South African doctors and a European midwife who are working or had worked in Gauteng, the Eastern Cape and KwaZulu-Natal said that the right people are not hired as managers. Frustrations with poor HR and administration were also stressed. Two of these healthcare workers resigned as a result of poor management. Their experiences highlight the serious effect that poor management and a lack of accountability can potentially have on the retention of doctors in rural South Africa.

    • Relationships

    A Zimbabwean doctor was asked about relationships among doctors to determine whether he had ever experienced xenophobia. He said the attitudes of foreign-qualified doctors play a huge role in whether they are accepted by local doctors. If foreign-qualified doctors learn a bit of the language and culture, they are by and large more easily accepted, he said. Patients, however, didn’€™t seem to have a problem with foreign-qualified doctors and were overall just happy to see a doctor.

    • National Health Insurance

    Both local doctors agreed that the idea is a good one in principle, but that the public sector would have to improve the quality of care significantly for the plan to stand any chance of success.

    Click here to read the interview:


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    Health-e News

    Health-e News is South Africa's dedicated health news service and home to OurHealth citizen journalism. Follow us on Twitter @HealtheNews