oa South African Health Review - Human resources : district hospitals : human resources
The focus of this chapter is on key human resource issues for district hospitals in 2004. The chapter describes the background of developments in the health system and the National Strategic Review. Human resource issues are considered in relation to 5 key areas: <BR><I>The changing policy framework.</I> The National Health Act has implications for district hospitals which are not yet fully realised. Key areas of development include the implementation of rural and scarce skills allowances, the full implementation of community service, and the launch of the medical assistants programme. <BR><I>Management of district hospitals.</I> Evidence suggests that district hospital managers are struggling to balance the demands of the system. The Public Finance Management Act and the drive for quality of care, in the face of insufficient skills and inadequate resources are particularly challenging. <BR><I>Recruitment and retention of staff.</I> The biggest challenge continues to be the recruitment and retention of the appropriate skilled human resources required for district hospital service delivery. Issues around foreign qualified doctors, national and international migration of health professionals and poor morale all impact on this. <BR><I>Education and training of personnel.</I> Changes in undergraduate and postgraduate training of doctors, and the new two year internship, hold out hope for improved medical staffing in district hospitals in the future. Examples and issues around the skills mix required for district hospitals are discussed. <BR><I>Quality of care.</I> Human resource issues impact on quality of care. New quality of care initiatives are supported by increased community involvement.
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