RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 1
NO
1
ITEMS
External and Internal Stakeholders and their
PAGE NO
4-5
responsibilities
2
Introduction
5
2.1
Background
6-9
2.2
Vision
10
2.3
Mission
10
2.4
Legal Mandates and Other Policy Mandates
10-11
2.6
Departmental Programmes
12-16
3.
Departmental Strategic Goals
16-19
4.
Strategic Objectives of the
19
Recruitment and Retention Strategy
5.
 Environmental Scan (External & Internal Scan)
20-27
 Factors that contribute to Staff Turnover
28-29
 Examples of what some Health Professionals say
30
on Exit Interviews.
6.
Best Practises as Recommended by World Health
31
Organisation (WHO)
Relevance of the WHO recommendations to the
Departmental Recruitment and Retention Strategy
7.
Intervention Strategies
33-36
8.1.1
Recruitment Plan
8.1.2
Bursary Projections and Costs
39-40
8.2
Infrastructures Development
41-44
9.
Monitoring and evaluation
10.
Implementation Plan
11.
Financial Implications
52
12.
Impact of Strategy on Service Delivery
53
38
45
46-51
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 2
SENIOR GENERAL MANAGER: CORPORATE SERVICES (SIGN OFF)
This Recruitment and Retention Strategy for Health Professionals, has been
Reviewed by Ms. MJ Mojapelo in my capacity as Senior General Manager:
Corporate Services.
I am satisfied and concur with the content of this Recruitment and retention
Strategy for Health Professionals and will ensure that the Department
achieves the strategic objectives as outlined in the strategy.
SIGNED
DESIGNATION
DATE
HEAD OF DEPARTMENT (SIGN OFF)
This Recruitment and Retention Strategy has been Approved by Ms. Daisy
Mafubelu in my capacity as the HOD for Limpopo Department of Health.
I am satisfied and concur with the content of this Recruitment and Retention
Strategy for Health Professionals.
SIGNED
DESIGNATION
DATE
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 3
1.
STAKEHOLDERS AND THEIR RESPONSIBILITIES
In line with the Guidelines introduced by the Department of Public
Service and Administration (DPSA), the Department has identified key
stakeholders in the development, implementation, monitoring and
evaluation of the Recruitment and Retention Strategy of Health
Professionals. Below are the key stakeholders and their responsibilities:
Internal Stakeholders:
STAKEHOLDERS
RESPONSIBILITIES
 Is accountable for the overall management
Head of Department
of Recruitment and Retention Strategy.
 Providing
Executive Management
strategic
direction
and
monitoring the implementation of
the
Recruitment and Retention Strategy.
 Ensuring compliance with Recruitment and
Senior Management Service
Retention Strategic within their respective
Divisions.
 Ensuring compliance with Recruitment and
Districts
and
Management Services
Institutions
Retention
the
District
Offices and Institutions.
 Are
Managers
Strategy within
individually
responsible
for
and
the
collectively
implementation,
management, monitoring and evaluation of
the Recruitment and Retention Strategy in
their respective Business Units.
 Employee representatives in the form of
Labour
organised labour. They play a role in the
process of consultation, monitoring and
evaluation
of
the
Recruitment
and
Retention Strategy.
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 4
External Stakeholders:
STAKEHOLDERS
RESPONSIBILITIES
Department of Public Service and • Provide technical advice and support on
Administration
the development and implementation of
Public Policies.
Office of the Premier
• Coordinating body for the Province.
National Department of Health
• Provide technical advice and support on
the development and implementation of
Health Policies.
Institutions of Higher Learning
• Sources
of
supply
for
Health
Professionals.
Foreign Countries such as Cuba
• Training and Development of Health
Professionals.
2.
INTRODUCTION
Limpopo Department of Health is situated in Limpopo Province which is 80%
rural and 20% semi-urban with less recreational facilities. The Department is
struggling to recruit and retain Health Professionals such as Medical Officers,
Nursing Personnel, Pharmacists and Allied Health in order to meet the health
care needs of this Province.
The high turnover of the above mentioned Health Professionals remains a
challenge in the Department. This situation informed the development of
Recruitment and Retention Strategy aimed at ensuring that the Department is
able to attract, recruit, and retain Health Professionals.
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 5
2.1 BACKGROUND
a)
Population Profile
FIGURE 1
80+
75-79
70-74
Male
Female
65-69
60-64
55-59
50-54
45-49
40-44
35-39
30-34
25-29
20-24
15-19
10-14
5-9
0-4
-8.00
-6.00
-4.00
-2.00
0.00
2.00
4.00
6.00
8.00
Percent
The Province of Limpopo is situated in the north of the Republic of South Africa. It
shares borders with the provinces of Gauteng, Mpumalanga and North West. It also
shares borders with the Republic of Mozambique in the east, Zimbabwe in the north and
Botswana in the west. The estimated population is 5.23 million (Stats SA,2009). The
population of Limpopo is youthful, with 35.7% (2,5 million) being children under the age
of 15 years. Close to six out of ten people (59.6%) are economically active, while
elderly people are in the minority, making up 4.7% of the provinces’s population.
Females consitute the majority, making up 52.3% (2,73 million) of the province’s
population. The age and gender scenario decribed in this paragraph, is shown in the
Figure 1 above.
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 6
ESTIMATED POPULATION FOR LIMPOPO BY DISTRICT AND GENDER, 2009
District
Male
Female
Total
Percentage share of
population
the provincial
estimate
population
Capricorn
595 369
645 199
1 240 569
23.73
Vhembe
582 122
655 203
1 237 324
23.67
Waterberg
299 798
295 193
594 991
11.38
Mopani
510 695
555 629
1 066 324
20.40
Sekhukhune
507 116
580 876
1 087 992
20.81
Total
2 495 100
2 732 100
5 227 200
100.0
From a district perspective, Limpopo consists of five districts as indicated in the Table
above. The province’s population is unevenly distributed among the districts, with 47.4%
of the population concentrated in Vhembe and Capricorn Districts. However, there is
slight change in the population distribution, and Vhembe District is no longer the most
populated District in the province as indicated in the Table above. Proportionally, more
people are currently found in Capricorn District than in Vhembe District. The 2009
population estimates highlight migration as a key demographic process in the
explanation of the current population distribution in Limpopo. When it comes to gender
structure, districts generally emulate the provincial picture – females outnumbering
males - with the exception of Waterberg District where males slightly outnumber the
females (50.4%).
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 7
Malaria Cases & Cfr per Financial Year:
Limpopo: 1999/2000 to 2010/11
12000
1.8
1.6
10000
8000
1.2
1
6000
0.8
4000
0.6
Case Fatality Rate
# of cases
1.4
0.4
2000
0.2
0
0
2010/11
2009/10
2008/09
2007/08
2006/07
2005/06
2004/05
2003/04
2002/03
2001/02
2000/01
1999/00
Financial Year
Financial Year
Case fatality rate
Trendline of cases
FIGURE 2 :Burden of diseases
As shown in Figure 2 above, there were a few outbreaks of communicable diseases
and severe emerging infectious diseases, particularly severe acute watery diarrhoea’s
(cholera) and more recently H1N1 influenza. Limpopo reported a total of 4 634 cholera
cases, with 30 laboratory confirmed deaths (case fatality rate of 0.65%) from 15 th
November 2008 to 01 June 2009. The majority of the cases were females which
accounted for 51% (2 667) whilst children less than five years of age accounted for
14.2% (652).
Human rabies is the most fatal disease in Limpopo as it has a case fatality of 100%.
Most dog bites and confirmed human rabies cases are reported in Vhembe District. The
incidence of confirmed human rabies in Limpopo has decreased from 22 in 2006, to two
in 2007, two in 2008, and one in 2009. A total of 7122 animal bites were reported from
health facilities in Limpopo for the financial year 2008/2009. The large proportion of
cases were reported from Vhembe (75%), followed by Mopani (15.9%), and Capricorn
(5.6%). The least number of cases were reported from Sekhukhune (2.1%) and
Waterberg (1.4%) districts.
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 8
Although malaria cases have shown a gradual decline over the past 10 years, the
malaria case fatality rate remains above the National Target of 0.5 %. Seasonal malaria
increases are also experienced during the malaria season, with upsurges experienced
during the 2010/2011 financial year.
FIGURE 3
35
30
% Prevalence
25
20
15
10
5
0
Capricorn
Mopani
Sekhukhune
Vhembe
Waterberg
Limpopo
Province
2007
19.8
23.8
21.3
15.1
25.4
20.4
2008
21
25.2
21.8
14.7
23.6
20.7
2009
23.8
26.2
16.6
14.3
28.8
21.4
Districts
2007
2008
2009
FIGURE 3: Limpopo HIV prevalence among antenatal women by district, 20062010.
The prevalence of HIV varies among districts in Limpopo, and this is not a unique
feature for this particular province. Figure 3 above shows the prevalence of HIV by
district in Limpopo during the period 2006-2010. The information in Figure 3 shows that
the prevalence varies not only between districts but also within districts over time.
Generally HIV prevalence is higher in Waterberg and Mopani districts than in the
remaining three districts, with Vhembe district registering the lowest prevalence since
1990 (National Department of Health, 2010).
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2.2 VISION
An optimal and sustainable health care service in Limpopo
2.3 MISSION
The provision and promotion of a comprehensive, accessible and affordable
quality health care service to improve the life expectancy of the people
2.4 LEGAL MANDATES
 The Constitution of South Africa, Act 108 of 1996
 National Health Act, 61 of 2003
 The Public Finance Management Act, 1 of 1999
 Basic Conditions of Employment Act, 75 of 1997
 Public Service Act,103 of 1997 as amended
 Employment Equity Act,55 of 1998
 Skills Development Act of 1998
 Public Service Regulations 2001 as amended
 Promotion of Access and information Act, 2 of 2000
 Labour Relation Act, 66 of 1995
 Occupational Health Safety Act, 85 of 1993
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 10
2.5 OTHER POLICY FRAMEWORKS

Outcomes 2 and 12 of the Medium Term Strategic Framework for 2009
to 2014.

Limpopo Provincial Employment, Growth and Development Plan.

Limpopo Provincial Growth and Development Strategy.

The National Human Resource for Health (HRH) Plan (2006):
o Emphases that the key to resolving the chronic HRH shortage in
South Africa lies in the increased production of skilled health
sector human resources.

The National Scarce Skills List (2006) of the Department of Labour:
o Defines Registered Nurses (RNs) and Primary Health Care
Nurses (PHCNs) as scarce skills.
2.6 ALIGNMENT WITH NATIONAL DEPARTMENT OF HEALTH 2010/112014/15 STRATEGIC PLAN.
Priority 1:
Provide strategic leadership and creation of a social
compact for better health outcomes.
Priority 2:
Implement a National Health Insurance plan.
Priority 3:
Improve quality of Health Services.
Priority 4:
Overhaul the Health Care System and improve its
management.
Priority 5:
Improve Human Resources Planning, Development,
and Management.
Priority 6:
Revitalise the physical infrastructure.
Priority 7:
Accelerate the implementation of the HIV and AIDS
Strategic Plan and increasing the focus on TB and other
communicable disease.
Priority 8:
Mass-mobilise better health for the population.
Priority 9:
Review the Drug Policy.
Priority 10:
Strengthen Research and Development.
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2.6.1 KEY ACTIVITIES FOR PRIORITY 5 ABOVE INCLUDE THE
FOLLOWING:

Refinement of the HR Plan for Health.

Re-opening of nursing schools and colleges.

Recruitment and Retention of Health Professionals, including urgent
collaboration with countries that have excess of these professionals.

Training of PHC personnel and mid-level health workers.

Assessment and review of the role of the Health Professional Training
and Development Grant (HPTDG) and the National Tertiary Services
Grant (NTSG), and

Managing the coherent integration and standardisation of all categories
of Community Health Workers.
2.7 DEPARTMENTAL PROGRAMMES
2.7.1 PROGRAMME 1: ADMINISTRATION
Purpose: to provide strategic management and overall administration of the
department including rendering of advisory, secretarial and office support
services through the sub programmes of Administration and Office of the
MEC.
Priorities:

Improving financial management and control.

Implementation of supply chain management system.

Implementation of risk management strategy.

Implementation of effective and efficient monitoring and evaluation
systems.

Implementation
of
knowledge,
records,
information
management
systems and technologies.
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 12
2.7.2 PROGRAMME 2: DISTRICT HEALTH SERVICES
Purpose: To render Primary Health Care Services and District Hospital
Services through the following sub-programmes:

Primary Health Care Services.

Districts Hospitals.

HIV and AIDS, Sexually Transmitted Infections (STI) and Tuberculosis
(TB) Control Programmes.

Mother and Child and Women’s Health (MCWH) and nutrition.

Disease Prevention and Control.
Priorities:

Improve quality of care.

Combating HIV and AIDS and decreasing the burden of diseases from
Tuberculosis.

Increase life expectancy.

Increase access to health care services.

Reduce Maternal and Child morbidity and mortality.

Strengthening health system effectiveness.
2.7.3 PROGRAMME 3: EMERGENCY MEDICAL & PATIENT TRANSPORT
SERVICES
The aim of this programme is to render pre-hospital Emergency Medical
Services, including Inter-Hospital transfers and Planned Patient Transport
through the sub-programmes of Emergency transport and planned patient
transport.
Priorities:

Improve quality of Health Care.
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 13

Strengthen implementation of Planned Patient Transport transfer within
EMS.

Provision of Custom built stations.

Recruit, train and retain skilled personnel.

Digitalisetion of EMS ICT systems.
2.7.4 PROGRAMME 4: PROVINCIAL HOSPITALS (REGIONAL AND
SPECIALISED)
The purpose is delivery of hospital services, which are accessible,
appropriate, and effective and provide general specialist services, including a
specialised rehabilitation service, as well as a platform for training health
professionals and research through the sub-programmes general (regional)
hospitals and specialised hospitals.
Priorities:

Expansion of secondary hospital services.

Implement quality improvement programmes in all provincial hospitals.

Implement a sustainable outreach programme.

Develop and implement the provincial nursing strategy.
2.7.5 PROGRAMME 5: CENTRAL & TERTIARY HOSPITALS
The purpose of this programme is to provide tertiary health services and
create a platform for training of health professionals and research.
Priorities:

Improve quality of Health Care.

Increase access to tertiary services.

Reduce referrals outside the Province.

Implement sustainable outreach programme.
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2.7.6 PROGRAMME 6: HEALTH SCIENCES AND TRAINING
The purpose of the programme is to render training and development
opportunities for actual and potential employees of the Department through
sub programmes human resource development.
Priorities:

Provide health professional training and other categories.

Continuing professional development programme.
2.7.7 PROGRAMME 7: HEALTH CARE SUPPORT SERVICES
The purpose of the programme is to render support services as required by
the Department, to realise its aim and to incorporate all aspects on
rehabilitation through sub-programmes:

Medical trading account (Pharmaceutical Services).

Orthotic and Prosthetic (Allied Health Care Support Service).

Oral health services, and

Forensic Pathology Services.
Priorities:

Availability of medicine and medical sundries at the depot, hospitals and
PHC facilities.

Increase facilities with full complement of Health Care support services.

Strengthen Forensic Pathology Services.
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2.7.8 PROGRAMME 8: HEALTH FACILITIES MANAGEMNT
The purpose of the programme is to plan, provide and equip new
facilities/assets, and upgrade, rehabilitate and maintain hospitals, clinics and
other facilities.
Priorities:

Upgrade of PHC facilities.

Upgrade of hospitals.

Provide new academic Hospitals.

New Malaria facilities.

New EMS facilities.

Upgrade of Forensic Pathology Services facilities.

Provide staff accommodation.

Upgrade nursing college and nursing schools.

Provide suitable Pharmaceutical Depot.

Provide water, sanitation and electrical services (new and upgrade).
3.
DEPARTMENTAL STRATEGIC GOALS
The Department’s strategic goals are identified as follows:
Strategic goal
Goal statement
Rationale
Expected
outcomes
1. Effective corporate
governance provided
Ensure an effective
Support the
Improve quality of
corporate
implementation of health services
governance system
the Departmental
by 2014.
plans and
by 2014.
programs to
improve service
delivery.
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Strategic goal
Goal statement
Rationale
Expected
outcomes
2. Appropriate human
Ensure appropriate
A need to
Improve
resources
HRM and
optimise the
realisation of the
management and
development
realisation of the
Department’s
development provided.
services by 2014.
strategic
objectives.
objectives of the
Department
through human
resource
management and
development
services.
3. Sound financial
Ensure efficient and
A need to ensure
Improved
management practice
effective financial
fiscal discipline
accountability on
promoted.
and supply chain
and optimisation
financial
management by
of resource
resources
2014.
allocation.
resulting in wellfunded and
managed health
services.
4. Implementation of
Develop and
A need to reduce
Reduce morbidity
comprehensive care
implement plans for
morbidity and
and mortality.
and management of
the provincial
mortality related
HIV and AIDS, TB,
priority programs by
to the burden of
STIs and other
2014.
diseases.
Ensure
A need to reduce
Reduced
implementation of
morbidity and
morbidity and
programmes
mortality in
mortality.
targeting women
pregnant women
and children.
and children.
communicable
diseases accelerated.
5. Decreasing Maternal
and Child mortality.
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Strategic goal
Goal statement
Rationale
Expected
outcomes
6. Strengthen District
Implement 80% of
A need to ensure
Improved access
health and hospital
DHS components in
equitable access
to health
services.
all districts and
to health care
services.
sustainable
services.
outreach
programme at all
levels of care by
2014.
7. Improve quality of
health care.
Implement quality
Improve client
Reduced
improvement plans
satisfaction and
morbidity and
in the districts and
clinical outcomes. mortality in the
hospitals by 2014.
province.
Improved client
satisfaction and
patient safety.
8. Improve Emergency
Medical Services.
Ensure that 90% of
A need to
Reduce morbidity
EMS calls are
respond to calls
and mortality in
responded to within
within the norm in
the province.
nation norm of 15
order to save
minutes in rural
lives.
areas and 40
minutes in urban
areas by 2014.
9. Tertiary services
Tertiary/academic
Improved and
Increased access
development.
services increased
increased access
to tertiary
from 22 to 37 in line
to tertiary
services.
with the
services in the
Modernisation of
province.
Tertiary Services
Developed
Document.
teaching platform
in the province.
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Reduced referrals
to other
provinces.
Strategic goal
Goal statement
Rationale
Expected
outcomes
10 Improve
Implement a
Health services
Improved access
infrastructure
reviewed 5 year
delivery needs for and quality of
development
infrastructure
additional
and
development and
infrastructure
maintenance
maintenance plan
expansion.
health services.
by 2014.
4.
STRATEGIC OBJECTIVES OF THE RECRUITMENT AND
RETENTION STRATEGY:
To identify best ways/methods that can be used and applied to attract,
recruit and retain health professionals within the Department.
To improve and strengthen the existing methods used to address
problems pertaining to recruitment and retention within the Department.
To develop and promote flexible ways of working within the
Department.
To design a flexible retirement plan that will encourage staff reaching
retirement age to remain at work longer, or alternatively to return to
work post-retirement.
To provide high quality learning and development for all Health
Professionals.
To identify strategies and mechanisms that can be used and applied to
the improvement of the infrastructure.
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5.
ENVIRONMENTAL SCAN (EXTERN & INTERNAL SCAN)
5.1
APPLICABLE EXTERNAL FACTORS
5.1.1 Political Factors
New political deployments and legislations, may lead to substantial changes
in the Department. If changes are not implemented within the Department,
they may have a detrimental impact on the provision of Health care services.
Additionally, new mandates and policies may require the Department to
review its strategic objectives. The challenge is that some of the new
mandates might be difficult to achieve without adequate resources. This is,
therefore, viewed as a threat to the Department. Alternatively, the new
mandates might move the Department forward as employees may be required
to change their way of doing things.
5.1.2 Economic Factors
High interest rates, unemployment rates, inflation rates and tax revenues
have a negative impact on the Department. In view of these economic trends,
it might be difficult to achieve the Department’s strategic objectives. The
Department might be unable to acquire drugs, medical supplies, and even to
recruit the required skills due to the above mentioned economic factors. The
impact of these factors will, therefore, have a negative impact on the
Department if weaknesses internal to the Department are not identified and
completely addressed.
5.1.3 Social Factors
Limpopo province is almost 80% rural, and most of the communities are faced
with poverty. Increasing infections related to HIV and AIDS in the communities
will put severe pressure on the Department as the Department is faced with
the shortage of Health Professionals. The extent of migration or loss of Health
Professionals is difficult to quantify. However, the effects of this are
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 20
multifaceted and have far reaching consequences for both the economy and
the maintenance of health services in the Department. Furthermore, the
effects of “brain drain” limits service delivery and general population’s access
to health services.
Population movement from other countries into the Province poses the
greatest challenges for the Provincial Government’s planning, service
provision, and social cohesion. This is viewed as a threat to the Department
as it will have to provide Health Care Services to the increased population due
to population movement into the Province.
The above mentioned social factors are particularly evident where
understaffing leads to personnel utilised outside their scope of practice,
unethical conducts, low morale, and create high-risk environment for the
patient, employees and employer.
5.1.4 Technological Factors
Technological advancement will require that the Department trains its existing
employees or recruit new employees with the required skills. The challenge is
that the required skills might not be available in the external and internal
labour market due to excessive demand for IT personnel. The implication is
that implementation of new systems within the Department might be delayed
or not supported due to lack of the required skills.
By contrast, introduction of new systems might simplify processes and
procedures in the Department and enable the Department to achieve its
strategic objectives. For instance, implementation of Telemedicine has the
following benefits:
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BENEFITS OF TELEMEDICINE
BENEFITS
1. Advancements in delivery of services.
ELABORATION
Certain health services can be greatly
enhanced via telemedicine. For instance,
rural patients can now have access to
specialists.
2. Workforce development / jobs
Local healthcare facilities will be equipped
with advanced telecommunications services
for telemedicine purposes and will then share
the
videoconferencing
capability
in
a
partnership with educational institutions to
train more local people for jobs in health care
that are available locally.
3. Quality of life and longevity gains are
worth a lot.
Use of telemedicine can have a significant
impact on individual health and can therefore,
favourably impact longevity.
4. Access to quality healthcare
Access to quality healthcare in underserved
areas, such as rural communities, is one of
the most important promised benefits of
telemedicine.
5. Saves time, travel and other expenses.
There is an opportunity for transportation cost
savings, such as the potential for saving a
portion of the millions spent annually on
patient
automobile
travel
expenses,
emergency air evacuations or other forms of
transporting
patients
across
the
large
expanses of rural South Africa.
6. Accuracy of diagnosis / reduction of
medical errors.
Reduction of medical errors is a huge
concern for the medical community. With
“tele-assistance”, it is hoped that it will be
easier for a doctor to get a “second opinion”
on their diagnosis of a patient.
7. Continuing Medical Education / Lifelong
learning
Telemedicine
opportunities
can
for
enhance
health
care
educational
providers,
patients, and families, improving clinical
outcomes and reducing hospitalizations.
Source: http://www.atsp.org/business/otalink/homepage.asp
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 22
5.1.5 Environmental Factors
Approximately 80% of the population lives in rural settlement. This kind of
environment greatly dictates the nature of their lives that might impose
threats to their well-being. According to the Departmental reports, Vhembe
and Mopani Districts are facing high number of malaria infections due to
their environments. This is an issue of serious concern for the Department
because malaria has a negative effect on the well-being of the population.
High malaria morbidity cases, therefore, implies that the Department
increases its investment in malaria prevention and treatment, as this is
crucial for the well-being of the population.
5.1.6 Legal Factors
Acts of parliament, draft bills, regulations and white papers as per paragraph
2.4 above, provide the mandate to all departments. The law makers would
amend certain legal mandates in order to improve service delivery. This may
require the Department to also review its existing internal policies to comply
with the new/amended regulations. This would imply that the required skills
especially for policy making and implementation be continuously improved.
Alternatively, reviewing of the existing policies might bring opportunities for
the Department and lead to improvement in the provision of Health Care
services.
5.2
APPLICABLE INTERNAL FACTORS
5.2.1 Rural allowance and Occupational Specific Dispensation (OSD) as
incentives to attract recruit and retain Health Professionals:
The introduction of the Rural Allowance and Occupational Specific
Dispensation (OSD), which is a National Department of Health’s efforts to
recruit and retain Health Professionals, does not give the Province a
competitive urge over other Provinces, since this is implemented across
government. This is supported by the fact that during 2010/2011, according to
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 23
the Department’s Annual Report for the specified period, the Department lost
18 percent of Medical Specialists, 11 percent of Dentists, and 25 percent of
Allied Health Professionals, just to mention a few.
Implementation of Rural Allowance in the Department has a negative effect
especially in the institutions where it is not implemented. Health Professionals
in the institutions where this allowance is not implemented are of the view that
Limpopo Province is 100% rural, and therefore, they suggest that rural
allowance be implemented in all the intuitions.
Based on the above, this strategy is designed to respond to the challenges
facing Health Professionals such as the ones identified in the preceding
paragraphs.
5.2.2 Bursary Awards as Recruitment and Retention strategy:
Awarding of bursaries to health professionals is one of the departmental
strategies to recruit health professionals in the Department. However, the
challenge is that, after completion of their studies, students opt to terminate
their contracts with the Department instead of serving their contractual service
obligations. This challenge provides an opportunity to explore the possibility of
evaluating bursary strategies, to ensure that all identified gaps are properly
attended to. This Recruitment and Retention strategy examines amongst
others, the role of bursaries in the retention of Health Care Professionals, and
discusses the impact of the use of bursaries in reducing staff turnover rate
within the Department of Health.
5.2.3 HRD and Training as retention strategy
The department has developed HRD and Training strategy, such as
learnerships as a tool to address the skills gaps within the department.
However, many trained health professionals are leaving the Department for
other greener pastures, which leads to brain drain. This recruitment and
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 24
retention strategy will identify mechanisms to ensure that career mobility is
strengthened within the department.
5.2.4 Performance Management and Development System
The Department is currently implementing performance management and
development system to monitor employees’ performance and reward good
performance, and to address employees’ developmental needs. However,
the system is still subject to manipulation in that most employees view it as
financial rewarding system than managing performance.
5.2.6 SUMMARY OF THE STATE HOUSING POLICY
In terms of the State Housing Policy, par. 1.1, preference will be given to the
obligatory (e.g. Doctors, Specialists) when providing State Housing. Par.1.3,
states that the Department of Health has made state houses available to only
Essential Healthcare workers. This is available on an appropriate rental
especially in circumstances where certain work activities of the state
necessitate the provision thereof and / or where it is in the interest of the
state. Par.1.4, portrays that utilisation of state housing under these
circumstances should not be regarded as a service benefit but as a work
facility.
In addition, Par.7.1, stipulates that the Department of Health is responsible for
the maintenance and repairs of all State Housing, which are purchases or
erected, as well as the permanent fixtures. In terms of Par. 7.2, the
Department of Health is responsible for the cleaning of the interior and
exterior (i.e. Gardens and Grounds) that form part thereof.
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 25
5.2.7
SUMMARY OF DEPARTMENTAL BURSARY POLICY
In terms of Par 8.1.1, of the current Departmental Bursary Policy, applicants
must be permanent residents of Limpopo Province. Par. 8.1.4, stipulates that
preference will be given to applicants who were historically disadvantaged
from designated groups who meet minimum requirements (deep rural).
Additionally, Par. 8.1.5, stipulates that selection has to ensure equitable
distribution of bursaries in line with population and modality of districts.
In terms of Par. 4.1.7 of the Bursary Agreement Undertaking, the bursary
holders on completion of the course undertakes to serve exclusively the
Department for a continuous / uninterrupted period within a month at any
institution nearest to the initial domicilum citandi et executandi of the bursar in
any capacity for which the Department may consider the bursar suitable within
the field of study as part of service obligations in terms of the agreement.
Par. 4.1.8 of the Bursary Agreement Undertaking stipulates that should the
bursar fail to honour bursary service obligation in terms of the Bursary
Agreement, he/she must repay immediately the bursary amounts paid to the
academic / tertiary institution on his / her behalf in terms of clause 3.1.1 (c) of
the Bursary Agreement plus interest on the amounts at the ruling rate of
interest applicable from time to time to debts due to the Department, as
determined by or in terms of the relevant financial prescripts of the National
Treasury, calculated from the date on which the obligation to pay arose in
terms of clause 3.1.1 (e) of the Bursary Agreement.
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 26
The table below shows field of studies which are supported by the
Departmental Bursary Policy (Bursary allocations in terms of numbers and
estimated cost are reflected in table 8.1.2, in pages 40-41):
NUMBER
FIELD OF STUDY
1.
MBCHB
2.
Cuban Medical Scholarship
3.
BDS
4.
Pharmacy
5.
Occupational Therapy
6.
Physiotherapy
7.
Dietetics
8.
Speech and Hearing
9.
Orthotic/Prosthetic
10.
Clinical Engineering
11.
Dental Therapy
12.
Podiatry
13.
Optometry
14.
M.A Clinical Psychology
15.
Nutrition
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 27
5.2.8 STAFF TURN OVER RATE TRENDS
Occupational
Classification
2008/09
2009/10
2010/11
Filled
Losses
Rate
Filled
Losses
Rate
Filled
Losses
Rate
Medical Specialist
81
5
6.17
80
9
11.25
83
14
17.50
Medical Officers
783
201
25.67
858
313
36.48
843
336
39.86
Dentist
90
10
11.11
99
22
22.22
128
20
15.63
Professional Nurse
6782
54
0.80
7190
464
6.45
7663
512
6.68
Staff Nurse
2753
82
2.98
2776
70
2.52
3885
119
3.06
Nursing Assistant
4715
73
1.55
4534
130
2.87
6140
133
2.17
Pharmacist
230
113
49.13
266
232
82.22
313
166
53.04
Allied Health Prof.
859
120
13.92
1107
289
26.11
1188
275
23.15
Total
16293
658
16910
1529
20243
1575
-
-
FIGURE 4: STAFF TURNOVER RATE TRENDS
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 28
-
Allied
Pharmacist
NA
Y3
SN
Y2
PN
Y1
Dentist
Medical Off
Medical Spec
0
20
40
60
80
100
ANALYSIS
Figure 4 above shows the Department’s Staff Turnover Rate for the past
three years. As shown by this figure, the Department has experienced high
turnover rates during the period 2010/2011. That was, 39.86% for Medical
Officers and 53.04% for Pharmacists.
The figure above further indicates that the Department experienced low
turnover rates with regard to Staff Nurses, Nursing Assistants and
Professional Nurses.
Implementation of this strategy will help the Department to address issues
such as high turnover rates of Health Professionals, as indicated by the
diagram above.
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 29
5.2.8.1 FACTORS THAT CONTRIBUTE TO STAFF TURNOVER: HEALTH
PROFESSIONALS.
The situational analysis identified the following factors as barriers to attract,
recruit and retain health professionals:
FACTORS
1. Advertising positions with poor
responses
ELABORATIONS
Positions for Medical Officers,
Medical Specialists, and Registrars
have poor responses when
advertised due to shortage of
qualified applicants.
2. Rural and urban imbalances
That is inequitable distribution of
Health Professionals in urban and
rural areas.
3. Leadership and Management style
Poor management style (attitudes
of some managers against Health
Professionals) in some institutions.
4. Lack of opportunities for
professional development
Some Health Professionals are not
given opportunities for professional
development within the
Department.
5. Financial Consideration
Health Professionals moving to
other provinces due to attractive
packages in those provinces, such
as Gauteng and KZN.
6. Lack of office space, and
residential accommodation
There is shortage and or
inadequate residential
accommodation for Health
Professionals in some of the
Institutions.
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 30
FACTORS
ELABORATION
7. Shortage of equipment
For instance, Medical Equipment.
8. Poor working conditions
Due to old equipment in some
Institutions, and old infrastructures.
9. Unclear roles and responsibilities
Due to lack of support for the
development of job description.
10. Inadequate management of
Some of the Departmental Health
Remunerated Work outside Public
Professionals practice work outside
Service
Public Service, and this is not
properly managed.
11. Non-Implementation of Cellphone
No cellphones at the institutions for
Allowance for Health Professionals
Health Professionals (such as
on call and standby.
Medical Officers) on duty or
standby.
12. Inadequate support from HR
Personnel
13. Discrepancy in the Implementation
Delays in addressing issues such
as payment of acting allowance.
Due to the fact that Limpopo is
of Rural Allowance in the
considered to be 80% Rural, and
Department.
20% Urban.
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 31
5.2.8.2 EXAMPLES OF WHAT SOME HEALTH PROFESSIONALS SAY ON
EXIT INTERVIEWS.
QUESTIONS
1. What was most satisfying about your
job?
2. Was your workload fair? Yes / No. If No
RESPONSES
I enjoy to be working in theatre, more especially in the operating room. I
love to be next to the patient.
The supervisor must learn to improve the delegation of Job, because
what can be done to improve the
they want us to do each and JOB coming our way. This puts us under
situation?
extremely pressure to deliver quality work.
3. Were your Key Results Areas, Key
Results Indicators and Targets in your
Yes, but our supervisors want us to do the jobs above our scope of
practice and they don’t cover us.
Performance instrument / Performance
Agreement addressed? Yes / No, please
explain why below.
4. Were quarterly reviews with your
Yes, but the problem is that they don’t want to assist us with were we
supervisor conducted as agreed in the
are failing to comply. But yet they want to rate us at the end of the
performance instrument / Performance
quarter.
Agreement? Yes / No. If No, please
explain why?
5. Were your duties clearly defined? Yes /
No. Was the job description accurate?
No, if there is a problem in other sections, supervisors want us to go
and do that particular job.
Yes / No, if No, please explain why?
6. Did your duties turn out to be as
No, the issue is that our supervisors want to give us with lot of work
expected? Yes / No. If No, please
which is stressing. These days we do lot of paper work than patient
explain why?
care.
7. Did you receive enough training /
Yes, but the problem is that at the in-service training at our institution,
adequate support (both on the job and
they allocate professional nurses to go and attend in-service training.
specialised) to perform your job
We are not given equal opportunity to attend in-service training.
effectively? Yes / No, if No, please
explain why?
8. Were you satisfied with the department‘s
performance review system? If No what
Not at all, our department should hire the appropriate people to do the
job e.g. washing of instrument.
can be done to improve the situation?
9. Any other things you need us to know
The problem is that people are getting old without proper training to
about the institution including the
deliver quality health services. Other employees have potential to teach,
management?
like myself I can teach my community with what I have gained with
regard to health issues. There is a lot of stress which is caused by
some supervisors because they don’t want to take responsibility, and
they don’t handle issues in a right way. They always want us to make
mistakes so that they can suspend us or take us to hearing which is not
good.
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 32
6.
BEST PRACTICES AS RECOMMENDED BY WORLD HEALTH
ORGANISATION (WHO REPORT 2006):
QUESTIONS
6.1 Workforce: Enhancing performance
RESPONSES

Strategies to improve the performance of the health workforce must initially be focused on existing staff
because of the time lag in training new health workers.

Substantial improvements in the availability, competence, responsiveness and productivity of the
workforce can be rapidly achieved through an array of low-cost and practical instruments.
6.2 Supervision makes a big difference

Supportive, yet firm and fair supervision is one of the most effective instruments available to improve the
competence of individual health workers, especially when coupled with clear job descriptions and
feedback on performance. Moreover, supervision can build a practical integration of new skills acquired
through on-the-job training.
6.3 Fair and reliable compensation

Decent pay that arrives on time is crucial. The way in which workers are paid, for example, salaried or
fee-for-service, has effect on productivity and quality of care that require careful monitoring. Financial and
non-financial incentives such as study leave or child care are more effective when packaged, than when
provided on their own.
6.4 Critical support systems

No matter how motivated and skilled health workers are, they cannot do their jobs properly in facilities that
lack clean water, adequate lighting, heating, vehicles, drugs, working equipment and other supplies.
Decisions to introduce new technologies for diagnosis, treatment or communication should be informed in
part by an assessment of their implications for the health workforce.
6.5 Lifelong learning should be

inculcated in the workplace
This may include short-term training, encouraging staff to innovate, and fostering teamwork. Frequently,
staff- devises simple but effective solutions to improve performance and should be encouraged to share
and act on their ideas.
6.6 Exit: Managing migration and

attrition
Unplanned or excessive exits may cause significant losses of workers and compromise the system’s
knowledge, memory and culture. In some regions, worker illness, deaths and migration, together,
constitute a haemorrhaging that overwhelms training capacity and threatens workforce stability.
Strategies to counteract workforce attrition include managing migration, making health a career of choice,
and stemming premature sickness and retirement.

Managing migration of health workers involves balancing the freedom of individuals to pursue work where
they choose, with the need to stem excessive losses from both internal migration (urban concentration
and rural neglect) and International movements from underdeveloped to developed countries.

Some international migration is planned, for example, the import of professionals into the Eastern
Mediterranean Region, while other migrations are unplanned with deleterious health consequences. For
unplanned migration, tailoring education and recruitment to rural realities, improving working conditions
more generally and facilitating the return of migrants represent important retention strategies. Richer
countries receiving migrants from poorer countries should adopt responsible recruitment policies, treat
migrant health workers fairly, and consider entering into bilateral agreements.

Health work as a career of choice: majority of health workers are women and “feminisation” trends are
well established in the male dominated field of medicine. To accommodate female health workers better,
more attention must be paid to their safety, including protecting them from violence. Other measures must
be put in place. These include more flexible work arrangements to accommodate family considerations,
and career tracks that promote women towards senior faculty and leadership positions more effectively.

Ensuring safe work environments: Outflows from the workforce caused by illness, disability and death
are unnecessarily high and demand priority attention, especially in areas of high HIV prevalence.
Strategies to minimise occupational hazards include the recognition and appropriate management of
physical risks and mental stress, as well as full compliance with prevention and protection guidelines.
Provision of effective prevention services and access to treatment for all health workers who become HIVpositive are the only reasonable way forward in the pursuit of universal access to HIV prevention,
treatment and care.

Retirement planning: In an era of ageing workforces and trends towards earlier retirement, unwanted
attrition can be stemmed by a range of policies. These policies can reduce incentives for early retirement,
decrease the cost of employing older people, recruit retirees back to work and improve conditions for
older workers. Succession planning is central to preserving key competencies and skills in the workforce.
(World Health Organisation (WHO) Report 2006)
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 33
RELEVANCE OF THE WHO RECOMMENDATIONS TO THE
DEPARTMENTAL RECRUITMENT AND RETENTION STRATEGY
Implementation of this strategy will assist the Department in improving
the performance of the existing Health Professionals as one of the best
practice recommended by World Health Organisation.
Firm and fair supervision in the Department will be strengthened as this
is, according to World Health Organisation, one of the most effective
instruments available to improve the competence of individual health
workers.
This Recruitment and Retention Strategy will give the Department an
opportunity to enhance its existing processes in terms of rewarding
Health Professionals, and recognising the contribution they make.
The implementation of this strategy will ensure that Staff involvement as
a key factor influencing staff moral in the Department, will be effectively
maintained at all levels in the Department, through adequate
communication at all levels.
The strategy will also encourage flexible working patterns, flexible
working careers as one of the best practice recommended by the World
Health Organisation. Additionally, the strategy will help the Department
to continue to work creatively to meet the needs of Health Professionals
and patients / communities.
Safe working environment as one of the best practices to retain Health
Professionals will be ensured.
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 34
7. STRATEGIC INTERVENTIONS TO CLOSE IDENTIFIED GAPS
7.1 GOAL: STRENGTHEN RECRUITMENT OF HEALTH PROFESSIONALS
Output
7.1.1 Strengthened
Indicator
Number of health
Activity
Advertisement of posts
Outcomes
Improved health
Recruitment of
professionals recruited in

The advertisement of posts
service delivery in
Health professionals
the Department.
will be posted in the media
the Province.
in the Department.
coverage in order to reach
diverse applicants identified
as follows:

Print media such as
newspapers.

Journals such as:
•
Medical journals
•
Nursing journals
•
Pharmacy journals

Electronic media:
•
On line recruitment
•
Radio slots

Open advertisement for
recruitment of Health
professionals whereby
qualified individuals can
present themselves
directly at various
institutions for
appointment after
screening process has
been done.
7.1.2
 Medical Doctors are recruited
Health professionals
Number of health
recruited through
professionals recruited in
through Government to
service delivery in
Government to
the Department.
Government contract from
the Province.
Government contract
Improved health
Cuba, Tunisia and Iran.
 This is done through the
National Department of
Health.
7.1.3
 This can be achieved through
Facilitate the return
Number of returns of
Improved health
of Health
health professionals
the utilization of South African
service delivery in
professionals
recruited and retained in
Embassies of the host
the Province.
the department
countries.
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 35
 For Health professionals
returning from local and
outside the country
remuneration could be based
on the recognition of current
and previous experience.
Output
7.1.4
Indicator
Activity
Outcomes
The UNDP assist the
Improved health
Health professionals

UNV medical doctors;
recruited through

UNV clinical
Department through
service delivery in
engineers
recruitment and placement of
the Province.
UNV pharmacists;
United Nations Volunteer
and
health professionals to
UNV specialist Nurses
accelerate transfer of skills
recruited and placed
and development of local
within the health
practitioners to improve the
facilities
delivery of service in the
United Nations
Volunteer

Programme (UNV)


Province.
7.1.5
Awarding of
Number of bursaries
bursaries to study in
awarded
health related

Review the Departmental
Bursary Holders
Bursary Policy, to bind the
Retained
bursary holders.
professional fields.
Improved health
service delivery in
the Province.
7.1.6
Awarding of
Number of learnerships
Learnerships
awarded
 The Department, as a
Improved health
recruitment measure awards
service delivery in
learnerships in various health
the Province.
related training fields
whereupon completion the
learners are absorbed in the
system
7.1.7
Marketing of
Hospital profiles
hospitals
developed
 Development of Marketing
Strategy.
 Updating of the Departmental
Improved health
service delivery in
the Province.
website.
 All hospital profiles to be
posted on the Departmental
website.
 Hospital newspapers and
video/DVD clips to be played
on hospital TV’s.
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 36
7.2
GOAL: RETENTION OF HEALTH PROFESSIONALS
Output
Indicator
Activity
Outcomes
7.2.1 Rural Allowances
Rural Allowances
 Implement Rural Allowances
Health
implemented equally to all
equally to all Medical
Professionals
Medical Officers, Medical
Officers, Medical Specialists,
attracted, recruited
Specialists, Dentists,
Dentists, Registrars and
and retained
Registrars and
Pharmacists.
Pharmacists.
7.2.2 Cell Phone Allowance
One cell phone at each
institution for Health
Professionals on call or
standby.
7.2.3 Strengthening
OSDs implemented
 Review current cell phone
policy.
 Implement reviewed cell
phone policy.
 Implement reviewed salary
Health
professionals
attracted, recruited
and retained
Health
Implementation of
across all Health
packages aligned to OSDs
Professionals
OSDs
Categories.
across all Health Categories.
attracted, recruited
and retained.
7.2.4 Infrastructures
Improved infrastructures
Improvement
 Implement hospitals
revitalisation programmes.
 Purchase required
equipment in the hospitals.
7.2.5 Staff Accommodation
Fully furnished staff
 Conduct assessment on the
Health
Professionals
attracted, recruited
and retained.
Health
accommodation for Health
existing staff
Professionals
Professionals.
accommodation.
attracted, recruited
 Compile a report with
and retained.
recommendations.
 Implementation of the
recommendations.
7.2.6 Recreational facilities
Increased number of
 Conduct an audit on the
Health
recreational facilities at
existing recreational facilities
Professionals
the hospitals.
at the hospitals.
attracted, recruited
 Compile a report with
and retained.
recommendations.
 Implementation of the
recommendations.
7.2.7 Hospital resource
centres
Fully equipped hospital
resource centres.
 Establish fully equipped
Health
hospital resource centres
Professionals
with computers and clinical
attracted, recruited
reference material.
and retained.
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 37
Output
Indicator
7.2.8 Strengthening Security
Increased number of safe
measures at the health
facilities.
health facilities.
Activity
 Provide 24 hours of effective
Outcomes
Safety of personnel
security and effective
and property
coverage of the facilities and
ensured.
premises.
 Maintain and record all
occurrences in the
occurrence register and
pocket books.
 To conduct regular checks /
patrolling duties around the
premises as required.
 Guarding the premises
against intrusion on
unauthorised entries.
 Maintain a high standard of
disciplines and smartness in
appearance at all times.
 Palisade fence at all health
facilities.
 Installation of surveillance
cameras at sensitive points.
 Appointments of ground man
to maintain the grounds in
the institution.
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 38
8.
RECRUITMENT PLAN
8.1.1 HR PROJECTIONS AND COSTS
Job Title
Approved
posts
Filled
Vacant
Target
2012/13
Estimated
Costs
(2012/2013)
R
Target
2013/14
Medical
Specialists
419
84
335
14
11,162,802
20
15,946,860
30
23,920,290
Medical
Officers &
Dentists
2931
619
1379
111
48,969,618
120
52,940,040
130
57,351,710
Professional
Nurses
13217
7727
5490
253
44,096,635
260
45,316,700
270
47,059,650
Pharmacists
419
232
187
45
16,069,575
60
21,423,420
70
24,993,990
Allied Health
Professionals
3210
1289
1921
115
13,909,135
130
15,723,370
170
20,561,330
EMS
Practitioners
3035
1980
1055
25
2,081,850
40
3,330,960
50
4,163,700
Total
36039
22192
12914
563
136, 286, 615
630
Estimated
Costs
(2013/2014)
R
154,681,350
Target
2014/15
720
Estimated
Costs
(2014/20150)
R
178,050,670
ANALYSIS:
The table above excludes projections for community service professionals and
interns due to budget constraints, and implementation of containment measures for
Limpopo Provincial Departments. In addition, the above figures exclude all the
approved and filled posts for community service professionals and interns.
Amendments will be made to the above table as and when the required budget is
made available, possibly in the next financial year (s).
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 39
8.1.2 BURSARY PROJECTIONS AND COSTS
Study field
Baseline
2011/2012
Target
2012/2013
Cost
Per
Student
Expenditure
to be
incurred
(2012/2013)
Target
2013/14
Cost
Per
Student
Expenditure
to be
incurred
(2013/2014)
Target
2014/15
Cost
Per
Student
Expenditure
to be
incurred
(2014/2015)
MBCHB
1248
138
R66,520
R9,179,760
150
R66,520
R9,978,000
150
R66,520
R9,978,000
Cuban Medical
scholarship
198
25
R49,920
R1,248,000
25
R49,920
R1,248,000
35
R49,920
R1,248,000
BDS
99
15
R56,448
R846,720
20
R56,448
R1,128,960
20
R56,448
R1,128,960
Pharmacy
255
67
R49,613
R3,324,071
39
R49,613
R1,934,907
39
R49,613
R1,934,907
Occupational
Therapy
62
10
R54,850
R548,500
10
R54,850
R548,500
10
R54,850
R548,500
Physiotherapy
69
14
R53,372
R747,208
10
R53,372
R533,720
10
R53,372
R533,720
Radiography
60
10
R46,856
R468,560
10
R46,856
R468,560
10
R46,856
R468,560
Dietetics
63
8
R54,574
R436,592
10
R54,574
R545,740
10
R54,574
R545,740
Speech and
Hearing
96
6
R42,392
R254,352
10
R42,392
R423,920
10
R42,392
R423,920
Orthotic/prosth
etic
22
0
R40,517
0
10
R40,517
R405,170
10
R40,517
R405,170
Clinical
Engineering
Dental
Therapy
20
0
R43,859
0
10
R43,859
R438,590
10
R43,859
R438,590
11
2
R43,825
R87,650
10
R43,825
R438,250
10
R43,825
R438,250
Podiatry
20
1
R38,808
R38,808
10
R38,808
R388,080
10
R38,808
R388,080
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 40
Study field
Baseline
2011/12
Target
2012/13
Cost
Per
Student
Expenditure
to be
incurred
(2012/2013)
Target
2013/2014
Cost
Per
Student
Expenditure
to be
incurred
(2013/2014)
Target
2014/15
Cost
Per
Student
Expenditure
to be
incurred
(2014/2015)
Optometry
36
0
R54,740
0
4
R54,740
R218,960
4
R54,740
R218,960
M.A Clinical
Psychology
34
8
R45,754
R366,032
8
R45,754
R366,032
8
R45,754
R366,032
Nutrition
16
21
R27,629
R580,209
4
R27,629
R110,516
4
R27,629
R110,516
325
-
340
-
TOTAL
2309
R18,126,462
R19, 175, 905
350
-
R19,175,905
The estimated expenditure in the table above is only for new intake and it excludes budget for maintenance of the existing bursary
holders.
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 41
8.1.3 INFRASTRUCTURE DEVELOPMENT / AND OR IMPROVEMENTS:
PROJECT NAME
Thabamoopo
Hospital
Thabamoopo
Hospital
MUNICIPALITY /
REGION
TYPE OF
INFRASTRUCTURE
PROJECT
DESCRIPTION
Capricorn
Hospital Specialised
Construction water
supply lines and
Reservoir, parking
areas, and related
works
Capricorn
Hospital - Specialised
TOTAL
PROJECT
COST
R,000
MTEF FORWARD ESTIMATES
2012/2013
R,000
2013/2014
R,000
2014/2015
R,000
1 500
500
0
0
Security ward
3 086
182
0
0
3 840
361
0
0
Thabamoopo
Hospital
Capricorn
Hospital - Specialised
Staff
accommodation,
Kiosk, Pharmacy,
Halfway House
Thabamoopo
Hospital
Capricorn
Hospital - Specialised
Construction of
medical and
geriatric ward
17 024
1 280
300
0
Capricorn
Hospital - Specialised
Construction of
kitchen and dining
Hall
18 976
1 311
0
0
Thabamoopo
Hospital
Capricorn
Hospital - Specialised
Transport Control
10 000
4 000
3 000
1 000
Thabamoopo
Hospital
Capricorn
Hospital - Specialised
Construction of
Health Support
8 700
4 000
2 000
Thabamoopo
Hospital
Capricorn
Hospital - Specialised
Construction of
male acute ward
18 194
1 523
0
0
Thabamoopo
Hospital
Capricorn
Hospital - Specialised
Construction of the
female acute ward
9 731
1 000
0
0
Thabamoopo
Hospital
Capricorn
Hospital - Specialised
Construction
Substance abuse
and Adolescent
ward
5 206
1 347
395
0
28 517
9 008
0
0
5 900
1 090
0
0
Thabamoopo
Hospital
WF Knobel
Hospital Enabling
Capricorn
Hospital - District
WF Knobel
Theatre Complex Enabling Works
Program
Zebediela
Hospital
Capricorn
Mortuary
New Hospital M2
Mortuary
Pietersburg
Hospital
Capricorn
Hospital - Central
New Dental Unit
and Clinical
Psychology Unit
0
0
6 000
9 500
Mankweng
Hospital
Capricorn
Hospital - Central
New Spinal Unit
0
0
6 000
15 500
Seshego
Hospital
Capricorn
Hospital - District
New Hospital M2
Mortuary and
Theatre Chiller
Plant
0
0
4 000
3 000
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS
Page 42
MUNICIPALITY /
REGION
TYPE OF
INFRASTRUCTURE
PROJECT
DESCRIPTION
Capricorn
Accommodation
Hospital Staff
Accommodation
(10 single rooms)
Zebediela
Hospital
Capricorn
Accommodation
Zebediela
Hospital
Capricorn
PROJECT NAME
WF Knobel
Hospital
Letaba
Hospital
Mopani
2013/2014
R,000
2014/2015
R,000
4 720
800
0
0
Hospital Staff
Accommodation
(10 single rooms)
5 165
800
0
0
Hospital - District
Zebediela Hospital
Roof Renovation
1 480
226
0
0
Hospital - Regional
A2. Construction
of Gynaecology
ward and orthotic
& prosthetic
workshop,
extension to
nursing college,
renovations to
nursing residence,
and staff housing
37 595
1 912
500
0
15 000
41 598
1 000
0
22 000
0
20 000
0
24 000
0
2 000
0
42 000
0
23 000
19 000
Letaba
Hospital
Mopani
Hospital - Regional
Letaba
Hospital
Mopani
Hospital - Regional
Upgrading of
Existing
Administration and
Psychiatric Ward
Letaba
Hospital
Maphuta
Malatjie
Hospital
Maphuta
Malatjie
Hospital
Maphuta
Malatjie
Hospital
Maphuta
Malatjie
Hospital
MTEF FORWARD ESTIMATES
2012/2013
R,000
A3. Demolish
existing maternity
and construct new
maternity and
external covered
walkways new
victim
empowerment
centre
Letaba
Hospital
TOTAL
PROJECT
COST
R,000
Workshop, 48
hours Water
Standby Storage
& Mechanical
Works
Upgrading of
medical records
room and linen
store
Mopani
Hospital - Regional
Mopani
Hospital - Regional
Mopani
Hospital - District
Demolition of
existing buildings
and stores
34 415
417
0
0
Mopani
Hospital - District
Construction of
OPD, Casualty, XRay
63 400
0
25 000
25 000
24 275
1 715
745
0
29 061
3 665
200
0
Mopani
Hospital - District
Mopani
Hospital - District
Final Account for
Construction of
Administration,
Gateway Clinic
and external works
Construction of
Transport Control,
Workshop,
Recreational
facility, Kitchen
upgrade.
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS
Page 43
PROJECT NAME
Maphuta
Malatjie
Hospital
Dr CN Phatudi
Hospita Enablingl
Nkhensani
Hospital
Letaba
hospital
Ga-Kgapane
Hospital
TYPE OF
INFRASTRUCTURE
PROJECT
DESCRIPTION
Hospital - District
Construction of
Resource Center
Mopani
Hospital - District
Dr C N Phatudi
OPD, X-ray and
Pharmacy Enabling Works
Program
Mopani
Hospital - District
Mopani
Hospital - Regional
MUNICIPALITY /
REGION
Mopani
Mopani
Hospital - District
Ga-Kgapane
Hospital
Mopani
Hospital - District
Sekororo
Hospital
Mopani
Hospital - District
Mopani
Hospital - District
Kgapane
Hospital
Mopani
Accommodation
Old Nkhensani
Hospital
Mopani
Accommodation
Letaba
Hospital
Mopani
Accommodation
Van Velden
Hospital
Sekororo
Hospital
Mecklenburg
Hospital Enabling
St Ritas
Hospita –
Enablingl
Matlala
Hospital Enabling
Philadelphia
Hospital –
Enabling
Mopani
Sekhukhune
Sekhukhune
MTEF FORWARD ESTIMATES
TOTAL
PROJECT
COST
R,000
2012/2013
R,000
2013/2014
R,000
2014/2015
R,000
1 000
0
1 000
0
16 273
10 360
12 000
0
Standby
Generator
0
0
900
0
Theatre Chiller
Plant
0
0
500
0
0
0
6 000
20 000
0
0
2 700
0
0
0
6 000
17 500
0
0
6 000
17 500
4 786
800
0
0
4 771
800
0
0
4 795
800
0
0
9 043
5 434
0
0
New Gate
House/PatientVisitors'
Center/Kiosk,
OPD/Casualty/
Xray Complex,
Stanby Generator
and Theatre
Chiller Plant
New Maternity
Complex; Medical
Gas Plant Room
New Maternity
Complex; Hospital
Compliant with
Disabled
Requirements
Hospital Staff
Accommodation
(10 single rooms)
Hospital Staff
Accommodation
(10 single rooms)
Hospital Staff
Accommodation
(10 single rooms)
Accommodation
Hospital Staff
Accommodation
(20 single rooms)
Hospital - District
Mecklenburg
OPD, X-Ray,
Casualty &
Pharmacy Enabling Works
Program
36 035
14 651
6 000
0
Hospital - Regional
St Ritas Pharmacy
Upgrade Enabling Works
Program
10 247
6 612
6 000
0
21 241
3 223
1 874
0
37 798
10 819
12 000
0
Sekhukhune
Hospital - District
Sekhukhune
Hospital - Regional
Matlala OPD, XRay, Casualty &
Pharmacy Enabling Works
Program
Philadelphia OPD,
X-Ray, Casualty Enabling Works
Program
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS
Page 44
MUNICIPALITY /
REGION
TYPE OF
INFRASTRUCTURE
PROJECT
DESCRIPTION
Dilokong
Hospital
Sekhukhune
Accommodation
Hospital Staff
Accommodation
(10 single rooms)
Jane Furse
Hospital
Sekhukhune
Accommodation
Philadelphia
Hospital
Sekhukhune
PROJECT NAME
MTEF FORWARD ESTIMATES
TOTAL
PROJECT
COST
R,000
2012/2013
R,000
2013/2014
R,000
2014/2015
R,000
4 797
800
0
0
Hospital Staff
Accommodation
(10 single rooms)
4 720
800
0
0
Accommodation
Hospital Staff
Accommodation
(10 single rooms)
4 747
800
0
0
Sekhukhune
Community Health
Centre
New Community
Health Centre
65 155
400
0
0
Sekhukhune
Ambulance base
New Emergency
Medical Service
Station
5 700
4 200
0
0
Philadelphia
Hospital
Sekhukhune
Hospital - Regional
Renovation of
Staff
Accommodation
0
0
4 000
7 000
Mecklenburg
Hospital
Sekhukhune
Hospital - District
Concrete Palisade
Fence
0
0
2 900
0
Elim Hospital Enabling
Vhembe
Hospital – District
5 281
547
0
0
Tshilidzini
Hospital
Vhembe
Hospital - Regional
0
0
4 000
9 480
Louis Trichardt
Hospital
Vhembe
Hospital - District
New Theatre
Block and
Upgrade Casualty
0
0
2 000
18 000
Malamulele
Hospital
Vhembe
Accommodation
Hospital Staff
Accommodation
(10 single rooms)
4 876
800
0
0
Louis Trichardt
Hospital
Vhembe
Accommodation
Hospital Staff
Accommodation
(10 single rooms)
5 036
800
0
0
Donald Fraser
Hospital
Vhembe
Accommodation
Hospital Staff
Accommodation
(10 single rooms)
4 772
800
0
0
Vhembe
Hospital - District
Boilers Upgrade
16 624
4 207
0
0
57 500
11 225
0
0
160 000
60 372
50 473
32 527
25 385
14 587
5 000
0
HC Boshoff
New Health
Centre
Bosele EMS
Elim Hospital
Boilers
Thabazimbi
Hospital
Waterberg
Hospital - District
Waterberg
Hospital - District
Waterberg
Hospital - District
Thabazimbi
Hospital
George
Masebe
Hospital Enabling
Elim Hospital
Theatre - Enabling
Works Program
Replacement of
Psychiatric Ward
gutted by fire
OPD, Casualty, Xray, Pharmacy and
ARV Clinic and
administration
block
Construction of
maternity, wards
and theatre, linen
bank ,kitchen,
medical waste
and ring road
George Masebe
Maternity
&Theatre Enabling Works
Program
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS
Page 45
MTEF FORWARD ESTIMATES
PROJECT NAME
Voortrekker
Hospital –
Enabling
MUNICIPALITY /
REGION
PROJECT
DESCRIPTION
Hospital - District
Voortrekker OPD,
X-Ray, Casualty &
Pharmacy Enabling Works
Program
2012/2013
R,000
2013/2014
R,000
2014/2015
R,000
32 524
14 615
5 000
0
Hospital - Regional
Mokopane
Theatre Complex Enabling Works
Program
37 500
9 158
2 000
0
Waterberg
Hospital - District
New Health
Support, New
Admin Block, New
Gateway Clinic;
Re-organization of
Casualty/OPD
0
0
6 000
20 000
Waterberg
Hospital - District
New Wards, New
Gateway Clinic,
Upgrade Casualty
0
0
6 000
22 313
Waterberg
Hospital - Regional
New Psychiatric
Ward
0
0
6 000
7 000
Waterberg
Hospital - District
Replacement of Xray Building at an
optimal location
according to
health flow
0
0
4 000
3 400
Waterberg
Hospital - District
Standby
Generator
0
0
400
0
Waterberg
Accommodation
Hospital Staff
Accommodation
(10 single rooms)
5 085
800
0
0
Waterberg
Accommodation
Hospital Staff
Accommodation
(10 single rooms)
4 720
800
0
0
Waterberg
Hospital - Specialised
FH Odendaal
Hospital TB MDR
Units
44 201
6 000
0
0
Waterberg
Hospital - District
Upgrade
Casualty/OPD,
New Laboratory,
0
0
6 000
15 000
-
-
-
1,068,397
261,945
258,887
262,720
Waterberg
Mokopane
Hospital –
Enabling
TYPE OF
INFRASTRUCTURE
Waterberg
F.H.
Odendaal:
George
Masebe
Hospital
Mokopane
Hospital
W.F. Knobel
Hospital
Voortrekker
Hospital
George
Masebe
Hospital
Voortrekker
Hospital
FH Odendaal
Hospital TB
MDR
Ellisras
Hospital
TOTAL
TOTAL
PROJECT
COST
R,000
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS
Page 46
9.
MONITORING AND EVALUATION
9.1 The Recruitment and Retention Strategy will be monitored and evaluated
by all stakeholders listed below:
DESIGNATION
BRANCH / DIVISION
1. Senior General Manager
Corporate Services
2. Senior General Manager
Health Branch
3. Chief Financial Officer
Finance
4. General Manager
Human Resource Management
and Development
5. General Manger
Budget
6. Senior Manager
Human Resource Development
7. Senior Manager
Human Resource Management
8. Senior Manager
Human Resource Planning,
Research & Product
Development
9. Senior Manager
Security
10.
Infrastructure Development
Senior Manager
11. Senior Manager
OD & Efficiency
12. Senior Manager
Labour Relations
13. Senior Manager
Risk Management
14. Senior Manager
Strategic Planning
15. Head of Monitoring and
Monitoring and Evaluation
Evaluation
9.2. Quarterly and Annual Reports will serve as a means of verification.
Additionally, efforts to address any deviations will be identified, and
where necessary actions for rectification will need to be taken.
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 47
10. IMPLEMENTATION PLAN
NUMBER OF POSTS TO BE FILLED
PRIORITY
KEY
EXPECTED
INERVENTIONS
ACTIVITIES
OUTCOMES
1. To Strengthen
Recruitment Of Health
Professionals in the
Department.
A dvertisement of posts in
Improved
the:
-Print
media, such as
newspapers, medical
journals,
Health
-Electronic media such
as online recruitment and
radios
INDICATORS
Y1
Y2
Y3
Y4
2011/2012
2012/2013
2013/2014
2014/2015
RESPONSIBILITY
Number of
Care
posts advertised
-
563
630
720
SENIOR MANAGER:
Service Delivery
in print and
Human Resource
in the Province.
electronic
Management
media, and
filled.
-Open advertisement for
recruitment of qualifying
Health Professionals.
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 48
REQUIRED BUDGET
PRIORITY
KEY
INERVENTIONS
2. To Award Bursaries
to students, to
ACTIVITIES
Review the Departmental
Bursary Policy to bind
Bursary Holders
study Health related
Careers.
3. To Market Hospitals
EXPECTED
OUTCOMES
Improved
Health
Y1
Y2
Y3
Y4
2011/2012
2012/2013
2013/2014
2014/2015
Care
bursaries
Service Delivery
awarded.
in the Province.
website.
Health
Improved
-
18 126 462
19 175 905
19 175 905
SENIOR MANAGER:
Human Resource
Development
Updated
Care
Service Delivery
Departmental
-
0
Website.
in the Province.
profiles on the
Hospital Profiles
Departmental website.
posted on the
Departmental
Playing Hospitals
RESPONSIBILITY
Number of
Implementation of the
reviewed Policy.
Updating of Departmental
Posting all Hospital
INDICATORS
website.
newspapers and video /
DVD clips on Hospital’s
Video / DVD
TVs.
clips played on
Hospitals.
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 49
0
0
SENIOR MANAGER:
Communications
PRIORITY
KEY
EXPECTED
INERVENTIONS
ACTIVITIES
OUTCOMES
4. Infrastructures
INDICATORS
Implement Hospital
Improved
Development
Revitalisation project in
Health
(Funded by
six Hospitals
Service Delivery
revitalisation
National)
(Jane Furse,
in the Province.
projects
REQUIRED BUDGET
Y1
Y2
Y3
Y4
2011/2012
2012/2013
2013/2014
2014/2015
R310, 211,000
R399, 286,000
RESPONSIBILITY
Number of
Care
Nkhensani,Letaba,
Hospital
-
R1, 193,000
SENIOR MANAGER:
Revitalisation Programme
implemented.
Maphutha
Malatji,Thabamoopo &
Thabazimbi).
5. Staff
Accommodation
Conduct assessment on
Improved
the
Health
existing
staff
accommodation.
Assessment on
Care
the existing staff
Service Delivery
accommodation
in the Province.
conducted, and
Compile a report with
recommendatio
recommendations.
ns
-
R261,945,000
R258,887,000
Implemented.
Implementation
of
recommendations.
the
Number of staff
accommodation
s built.
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 50
R262,720,000
SENIOR
MANAGER:
Physical Facilities
PRIORITY
KEY
EXPECTED
INERVENTIONS
ACTIVITIES
OUTCOMES
24
hours
6. Strengthen Security
Provide
Measures at the
effective
Health facilities.
effective coverage of the
Service Delivery
security and
facilities and premises
in the Province.
effective
security
of
and
Improved
INDICATORS
Health
REQUIRED BUDGET
Y1
Y2
Y3
Y4
2011/2012
2012/2013
2013/2014
2014/2015
24 hours of
Care
effective
-
R235, 244,000
R242,301,320
coverage of the
Maintain and record all
facilities and
occurrences
the
premises
occurrence register and
provided.
in
pocket books.
All occurrences
Conduct regular checks /
maintained and
patrolling duties around
recorded in the
the premises as required.
occurrence
register and
Guarding the premises
against
intrusion
pocket books.
on
unauthorised entries.
Regular checks
/ patrolling
Maintain a high standard
RESPONSIBILITY
duties around
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 51
R249,570,360
SENIOR MANAGER:
Security Services
of
disciplines
and
the premises
smartness in appearance
conducted as
at all times.
required.
Palisade fence at all
Premises
Health facilities.
guarded against
intrusion on
Installation of surveillance
unauthorised
cameras
entries.
at
sensitive
points.
Palisade fence
built at all
Health facilities.
Surveillance
cameras
installed at
sensitive points.
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS Page 52
11. FINACIAL IMPLICATIONS
This strategy will not be fully implemented due to financial constraints, and
cost cutting measures which must be implemented by the Department to curb
spending as required by the National and Provincial Treasury. In addition,
amendments to this strategy will be made as and when national and provincial
policies are reviewed or when new policies are developed.
The Department needs the funds (estimates) indicated in the table below to
fully implement this strategy:
Appointments for
Awarding of Bursaries
Infrastructure
Health Professionals
2011/12-2013/14
Development
2011/12-2013/14
R4,624,012,000
2011/12-2013/14
R447,320,502
R668,860,000
Additionally, the Department anticipates spending the budget reflected in the
table below for partial implementation of this strategy:
Appointments for
Awarding of Bursaries
Infrastructure
Health Professionals
2011/12-2013/14
Development
2011/12-2013/14
R469,018,635
2011/12-2013/14
R56,478,272
R547,104,000
GAP (DEFICIT) TO FULLY IMPLEMNT THE STRATEGY:
Appointments for
Awarding of Bursaries
Infrastructure
Health Professionals
2011/12-2013/14
Development
2011/12-2013/14
R4,154,993,365
2011/12-2013/14
R390,842,230
R121,756,000
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS
Page 53
12. IMPACT OF THE RECRUITMENT AND RETENTION STRATEGY ON
SERVICE DELIVERY.
The revised strategy due to financial constraints will have the following impact:
12.1 Transformation and modernisation of infrastructure and equipment at
health institutions may not be achieved;
12.2 Management systems, structures and processes may be affected;
12.3 Inadequate staff accommodation at health institutions which may result
in high staff turnover;
12.4 Health Professionals’ skills / competencies may not be achieved as
planned in terms of the Human Resource Development Strategy;
12.5 Number of posts to be filled in terms of Human Resource Plan may not
be achieved, this might result into workload, eventually into burnouts and
employee stress;
12.6 Patients waiting time at the health institutions will remain a challenge;
and
12.7 High staff turnover rate will remain a challenge.
RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS
Page 54