Call for ‘6 months to a year’ rural training for SA med students

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SA medical students should spend ‘at least  six months to a year’ in rural training programmes,  which will help address the critical shortage of rural doctors after graduation,  Stellenbosch University’s Professor Marietjie de Villiers said at the recent AFREHealth conference.

African health experts must tackle health challenges on the continent by providing innovative solutions led by the continent’s health specialists under its first health umbrella body, African Forum for Research and Education in Health (AFREhealth), reports Health24.

“Africa needs African solutions led by Africans. Through AFREHealth, the continent’s leading health figures from more than 60 medical and nursing schools have come together to improve health outcomes, build capacity and improve the education and training of health professionals across Africa.

“Our continent’s health systems are fragile, severely resource and budget constrained and to ensure our implementations are successful we must ensure that funders that share our common health goals of improving health in Africa support solutions which address local needs and are locally relevant,” AFREhealth chair, Professor Peter Donkor told delegates at the organisation’s first annual conference in Ghana since its launch a year ago.

The report says delegates attending the conference, including international funders, have all called on African-led solutions to include accountability of heads of state on the continent and more effort to ensure governments prioritise health as a key sector requiring urgent intervention.

Ghana’s health minister, Agyeman Manu gave his country’s assurance that it would support efforts by AFREhealth to address health challenges on the continent through local solutions. “AFREhealth is ideally placed to tackle the continuing concerns of diseases on the continent. We must ask ourselves why is it that Africa continues to battle against high maternal mortality rates and malaria? What we need are affordable, accessible and appropriately trained health professionals which I believe an organisation like AFREHealth can assist with and it has the full support of my ministry,” said Agyeman Manu.

The report says experts at the conference all decried the lack of resources amid robust discussions on how organisations can sustain themselves financially if they are to succeed in their goals of improving health care.

Africa currently has 24% of the world’s burden of diseases yet has only 3% of the global health workforce. Added to this challenge, was the “brain drain” of health professionals, including nurses, which continued to plague countries across Africa. To address this, AFREhealth aims to roll out training programmes and opportunities for research education for health professionals whilst providing incentives to retain them at faculty and institutional level.

“Our current health workforce required to tackle health challenges like maternal mortality and malaria is severely constrained and in short supply. In addition, health training institutions lack the capacity to meet the demand for places. The few available training schools are under-resourced with poor infrastructure and limited faculty, Curricula are often outdated and access to ICT, internet and other training tools is minimal. These are all issues AFREhealth will tackle as an Afri-centric, independent body. This is going to be a game changer for the continent,” added Donkor.

The conference also heard a leading health figure in South Africa calling for an increase in rural training for medical students, reports News24. “We found that the academic performance of students who trained in decentralised, rural areas was often similar to or better than those not involved in rural training. The experience also led to improved practical skills, higher confidence levels and better workforce retention of doctors in rural areas, which is critical considering our resource constraints,” says Stellenbosch University’s Professor Marietjie de Villiers who is also vice chair of AFREhealth.

Her comments come as South Africa prepares to move the country’s health system to a National Health Insurance plan which involves a more primary healthcare-based approach – less curative and more emphasis on prevention of diseases at community level.

The report says Stellenbosch University is the first university on the African continent to have piloted a unique programme which sends final-year medical students to train in rural areas – a project which has since also been successfully rolled out by the University of KwaZulu-Natal.

The training of medical students at rural sites is being mooted as a way to address the critical shortage of doctors in rural areas as many opt for the private sector after graduation – or are lost to foreign markets which offer more lucrative opportunities. Many cite poor conditions and the lack of resources as the biggest turnoffs in working in rural areas.

Addressing delegates at the conference, de Villiers says rural training must ensure key elements are in place to ensure its success and encourage retention of doctors. These include adequate infrastructure in rural areas, proper learning resources – online and on-site, motivated supervisors, strong community partnerships and proper accommodation.

“Medical students need more exposure to a rural context for them to appreciate its value. They cannot do this by spending just one or two weeks. Their placement must be done for at least six months to a year so that they really immerse themselves in community health issues at that level. But we must also ensure that they have all the support needed to make it work, otherwise they will not want to return as graduate doctors,” said de Villiers.

The report says South Africa currently has 25 state doctors for every 100 000 citizens, falling short of the average of 60 per 100 000. The country also lags behind India which boasts 70 doctors per 100 000 people and Brazil which has 189 per 100 000.

And, the latest reports also show that South African graduate doctors continue to lack confidence in state healthcare facilities, while foreign doctors were more willing to work there. A recent study by Econex showed up to 80% of newly-qualified doctors chose not to work in public health facilities.

Health24 report
News24 report


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