02.03.01. Size and structure of the workforce | South Africa

02.03.01. Size and structure of the workforce | South Africa

13 Aug 2022

South Africa is one of five top ranking countries in Africa regarding density of physicians and nurses per 1000 population. However, the country still experiences staff shortages especially in rural areas (Rispel & Padarath, 2018).

The urban-bias in skilled health professionals leaves 44% of the country’s rural population with 19% of the country’s physicians and 12% of its nurses (Rawat, 2012).

Available sources describe South Africa’s health workforce are as follows (DOH, 2011):

Table 11: Total public and private clinical professions in South Africa, 2010

Workforce category Total

(Public and private sector)

Total per 10 000 population

(Public and private sector)

(1)            Doctors

–       Medical practitioners

–        Medical Specialists

 

18 147

9637

 

3.70

1.96

(2)            Nurses

–       Nursing assistants

–       Professional nurses

 

56 039

93 049

 

11.42

18.97

Table 12: Practitioners in public sector for uninsured population

Practitioner Per 100 000 for uninsured population
Psychologists 0.97
Occupational therapists 1.53
Social workers 1.83

Source: (Docrat, Besada, Cleary, Daviaud & Lund, 2019).

Other sources such as published research articles in South Africa note the following for other medical categories below:

  • Psychiatrists 0.1 per 100 000 people (Kalula & Petros, 2011);
  • Less than 5 specialists in old-age psychiatry (Kalula & Petros, 2011);
  • In 2010, 8 geriatricians were registered for a population of 4 million people of 60 years and older (Lloyd-Sherlock, 2019a).

There was no information found on the number of neurologists registered in South Africa as specialist categories are composite under the category “medical specialists” in the Department of Health and categorised broadly under “medical practitioner” with the Health Professions Council of South Africa (HPCSA).

Gerontology was removed by the South African Nursing Council (SANC) from its specialist training curriculum (Lloyd-Sherlock, 2019a), and despite being urged by the South African Human Rights Commission (SAHRC) to reconsider (SAHRC, 2015), it has not been restored to nursing curriculums.

Officials estimate that approximately 64.7% of the South African population live in rural areas (Mahlathi & Dlamini, 2015) and are served by 12% of doctors and 19% of nurses practicing in the country (DOH, 2011). There are 2.12 medical practitioners per 1000 population that comprise of 0.92 general practitioners and 0.83 specialists (per 1000) in the private sector (Competition Commission SA, 2018). It is estimated that 79% of physicians (Rawat, 2012) and 41.4% of nurses work in the private sector (DOH, 2011). Medical practitioners (i.e., general practitioners) in South Africa are found mostly in the private sector (3.76/10 000 population) compared to the public sector (3.66/10 000 population), with more noticeable imbalances in the Western Cape and Gauteng provinces with 7.64 and 7.32 per 10 0000 population found in the private sector, respectively (DOH, 2011).

References:

Competition Commission SA. (2018). Health market injuiry. Available from:  http://www.compcom.co.za/wp-content/uploads/2018/07/Executive-Summary.pdf

Docrat, S., Besada, D., Cleary, S., Daviaud, E. & Lund, C. (2019). Mental Health system costs, resources and constraints in South Africa: a national survey. Health Policy and Planning, 34, 706-719. https://doi.org/10.1093/heapol/czz085

DOH. (2011). HUMAN RESOURCES FOR HEALTH SOUTH AFRICA (HRH) Department of Health. Available from: http://www.hst.org.za/publications/NonHST Publications/hrh_strategy-2.pdf

Kalula, S. Z., & Petros, G. (2011). Responses to Dementia in Less Developed Countries with a focus on South Africa. Global Aging, 7(1), 31–40.

Lloyd-Sherlock, P. (2019a). Long-term Care for Older People in South Africa: The Enduring Legacies of Apartheid and HIV/AIDS. Journal of Social Policy, 48(1), 147–167. https://doi.org/10.1017/S0047279418000326

Mahlathi, P., & Dlamini, J. (2015). MINIMUM DATA SETS FOR HUMAN RESOURCES FOR HEALTH AND THE SURGICAL WORKFORCE IN SOUTH AFRICA’S HEALTH SYSTEM: A rapid analysis of stock and migration. Available from: http://www.prographic.com/wp-content/uploads/2016/07/0316-south-africa-case-studies-web.pdf

Rawat, A. (2012). Gaps and shortages in South Africa’s health workforce. Backgrounder, 31(June), 1–8. https://doi.org/10.13140/RG.2.1.4424.0805

Rispel, L. ., & Padarath, A. (2018). South African Health Review 2018. Available from: http://www.hst.org.za/publications/South African Health Reviews/SAHR 2018.pdf

SAHRC. (2015). Investigative Hearing Report: Investigating hearing into systemic complaints relating to the treatment of Older Persons. Available from: http://www.sahrc.org.za/construction-site/home/21/files/SAHRC Investigative hearing report.pdf