South Africa’s two-tiered healthcare system has resulted in unequitable health outcomes, with the privileged few having disproportionate access to health services.
The Community Service Policy (CSP) was introduced in 1998 as an intervention to achieve better distribution of human resources for health in underserviced areas and to provide an enabling environment for new professionals to acquire experience. All health professions are legally required to complete a year of community service which entails remunerative work in the public sector. South Africa has since developed the Human Resources for Health (HRH) strategy (2012-2017) which takes into consideration the World Health Organisation (WHO) recommendations on the recruitment and retention of health professionals in rural and remote areas. These recommendations include rural health education interventions, enhanced regulation of rural practice, financial incentives and professional and personal support for health workers in remote and rural areas.
South Africa is in the process of working towards National Health Insurance (NHI), a health financing system designed to pool funds to provide access to quality, affordable personal health services for all South Africans based on their health needs, irrespective of their socio-economic status (National Department of Health, 2015). This will be phased in over a 14 year period, through four key interventions, namely: a complete transformation of healthcare service provision and delivery; the total overhaul of the entire healthcare system; the radical change of administration and management; and the provision of a comprehensive package of care underpinned by a reengineered primary health care.
It is within this context that a series of seminars were envisioned, starting with the Community Service for Health Professionals Summit held in April 2015. Its aim was to initiate stakeholder engagement for the systematic review of the CSP using available evidence from a number of independent studies. The summit set out to understand community service in the context of the National HRH Strategy, to review the last 15 years of experience of community service doctors and dentists, to review the objectives of the CSP in South Africa, to review the guidelines and provincial implementation of the CSP in South Africa and to make appropriate recommendations.
The second seminar “Doctors for PHC Symposium” was held in the City of Tshwane at the Foundation for Professional Development’s (FPD) Head Offices on 28 March 2017. The symposium was hosted by FPD and the National Department of Health. The symposium focused on all categories of health professionals, but mainly on doctors’ roles in a multi-disciplinary public sector primary health care (PHC) team.
This year’s symposium set out to achieve the following objectives:
- To review studies on the placement of doctors in a public sector PHC setting
- To identify models and strategies to optimise the role of doctors in a multi-disciplinary team
- To identify knowledge gaps and areas for research.