Posted by: davidjolson | 08/03/2011

Addressing the isolation of African doctors in rural areas

“It’s about addressing the professional isolation of rural practice and greasing the wheels of the machine so that ultimately rural doctors are happier and can get on with what they’re trained to do in an environment that works for them.” – Dr. Tim Wilson 

This is a guest blog by Lindsay Harris, Jeanette Strydom and Kate Thiers of Africa Health Placements, a member organization of the Global Health Council based in South Africa.

JOHANNESBURG, South Africa — In Europe, rural health workers enjoy a high status in their own communities but a low one among their peers, according to the European Charter for Rural Practice. This is related to isolation, limited resources and a high workload.

In Australia, “recruitment and retention in rural areas may be improved in the future through strategies to reduce perceived professional isolation, improve management support, access to continuing education and the development of career pathways,” according to the Department of Rural Health at the Australian University of North South Wales.

This trend is also evident in the rural public health sector in South Africa, which is facing huge challenges in the recruitment and retention of medical officers. The South African Department of Health (1998) has noted the difficulties in attracting and retaining doctors in rural communities because of professional isolation from their peers, lack of continued medical opportunities, low patient volume and loss of continuity when patients are referred to hospitals in larger urban centers.

Eastern Cape Rural Doctors Support Programme

In response to the chronic lack of support for medical officers in the Eastern Cape, Africa Health Placements (AHP), with the support of Dr. Tim Wilson (an expert in rural healthcare in South Africa) launched the Eastern Cape Rural Doctors Support Programme (ECRDSP) in January 2011. The aim of this project is to reduce professional isolation and increase retention rates of doctors in underserved rural facilities in the Eastern Cape.

At this early stage, the project is targeting three rural districts in the Eastern Cape with a dedicated practice manager in each. The practice managers have been tasked with key responsibilities that include making regular visits to all district hospitals in their districts, providing support for the doctors and managers in those facilities, facilitating Continuing Professional Development (CPD) sessions, assisting with administrative problems and orienting new foreign doctors.

CPD sessions: Are they helping?

Since January, the achievements of the ECRDSP have been phenomenal, largely due to dedication and hard work by the practice managers. The achievements include conducting over 14 CPD sessions since February, with an average of two sessions per district per month. These sessions have proven to be a vital means of reducing the feeling of professional isolation and providing much needed support for medical officers based in these rural districts.

Of the attendees who returned CPD-feedback forms (88% response rate): 98% found the relevant CPD session useful, 97% agreed the CPD session helped reduce their feeling of isolation and 99% would like to attend more sessions in future. Additionally, the sessions attracted over 250 students from 35 facilities throughout the three districts, which offered valuable chances for networking and social interaction among peers.

Clearly, even though the programme is only six months old, results are already being shown. AHP and the Eastern Cape Rural Doctors Support Programme will continue to monitor CPD-feedback forms as the programme extends into the second half of 2011, and are very encouraged by the success so far in actively addressing a key issue which deters so many medical officers from accepting posts at rural healthcare facilities in South Africa.

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