Human resources for health planning and national health insurance : the urgency and the opportunity
CITATION: Smith, A., et al. 2018. Human resources for health planning and National Health Insurance : the urgency and the opportunity. South African Health Review, 2018(1):23-31.
The original publication is available at https://www.hst.org.za
The implementation of National Health Insurance (NHI) amplifies the urgent need for coordinated, comprehensive health workforce planning in South Africa. Planning for and estimating the cost of adequate human resources for health (HRH) is of paramount importance to a well-functioning health system. Planning is also a central requirement for a strategic purchaser of health services tasked with matching healthcare needs with the supply of services. The NHI is likely to alter health staffing requirements in South Africa as it strives to improve quality of and equitable access to health care. Increased healthseeking behaviour anticipated under NHI implies increased need for all cadres of healthcare workers, particularly specialists and general practitioners (GPs), who are underrepresented in the public sector. The creation of the NHI Fund also provides the opportunity for much-needed HRH planning on a more systematic and regular basis. At present there is no ongoing process for HRH planning and no single, high-quality, integrated data source in South Africa to enable such planning. A review of the available data, together with the limitations of these data, is presented. There are no publicly available, audited and regularly updated statistics on the number and mix of health workers available and required for South Africa’s population. This chapter considers both global best practice in health workforce planning and the South African context of critical shortages in order to recommend a way forward. The creation of a timely, accurate and integrated repository of human resources data is an essential first step. We recommend the creation of a multi-stakeholder structure tasked with the development of integrated plans that consider the health system as a whole, based on models that account for both supply-side dynamics and the need for services, and that explicitly model the interactions between cadres of healthcare workers.