recruitment and retention strategy for health professionals

RECRUITMENT AND RETENTION STRATEGY FOR HEALTH PROFESSIONALS

NO ITEMS PAGE NO1 External and Internal Stakeholders and their

responsibilities 4-5

2 Introduction 52.1 Background 6-9

2.2 Vision 102.3 Mission 10

2.4 Legal Mandates and Other Policy Mandates 10-112.6 Departmental Programmes 12-16

3. Departmental Strategic Goals 16-19

4. Strategic Objectives of the Recruitment and Retention Strategy

19

5. Environmental Scan (External & Internal Scan) 20-27

Factors that contribute to Staff Turnover 28-29

Examples of what some Health Professionals say on Exit Interviews.

30

6. Best Practises as Recommended by World Health Organisation (WHO)Relevance of the WHO recommendations to the Departmental Recruitment and Retention Strategy

31

7. Intervention Strategies 33-36

8.1.1 Recruitment Plan 388.1.2 Bursary Projections and Costs 39-40

8.2 Infrastructures Development 41-449. Monitoring and evaluation 45

10. Implementation Plan 46-5111. Financial Implications 52

12. Impact of Strategy on Service Delivery 53

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


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

Head of Department

Is accountable for the overall management

of Recruitment and Retention Strategy.

Executive Management

Providing strategic direction and

monitoring the implementation of the

Recruitment and Retention Strategy.

Senior Management Service

Ensuring compliance with Recruitment and

Retention Strategic within their respective

Divisions.

Districts and Institutions

Management Services

Ensuring compliance with Recruitment and

Retention Strategy within the District

Offices and Institutions.

Managers

Are individually and collectively

responsible for the implementation,

management, monitoring and evaluation of

the Recruitment and Retention Strategy in

their respective Business Units.

Labour

Employee representatives in the form of

organised labour. They play a role in the

process of consultation, monitoring and

evaluation of the Recruitment and

Retention Strategy.


External Stakeholders:

STAKEHOLDERS RESPONSIBILITIES

Department of Public Service and

Administration

• Provide technical advice and support on

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.


2.1 BACKGROUND

a) Population ProfileFIGURE 1

-8.00 -6.00 -4.00 -2.00 0.00 2.00 4.00 6.00 8.00

0-4

5-9

10-14

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-69

70-74

75-79

80+

Male Female

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.


Estimated population for Limpopo by district and GENDER, 2009

District Male Female Total population estimate

Percentage share of the provincial

populationCapricorn 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%).


Malaria Cases & Cfr per Financial Year: Limpopo: 1999/2000 to 2010/11

0

2000

4000

6000

8000

10000

12000

1999/00

2000/01

2001/02

2002/03

2003/04

2004/05

2005/06

2006/07

2007/08

2008/09

2009/10

2010/11

Financial Year

# of

cas

es

0

0.2

0.4

0.6

0.8

1

1.2

1.4

1.6

1.8

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 15th 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.

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

0

5

10

15

20

25

30

35

Districts

% P

reva

lenc

e

2007 2008 2009

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

Capricorn Mopani Sekhukhune Vhembe Waterberg Limpopo Province

FIGURE 3: Limpopo HIV prevalence among antenatal women by district, 2006-2010.

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).


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

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 2010/11-2014/15 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.

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.

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.

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.

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.

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

corporate

governance system

Support the

implementation of

the Departmental

Improve quality of

health services

by 2014.


by 2014. plans and

programs to

improve service

delivery.


2. Appropriate human

resources

management and

development provided.

Ensure appropriate

HRM and

development

services by 2014.

A need to

optimise the

realisation of the

strategic

objectives of the

Department

through human

resource

management and

development

services.

Improve

realisation of the

Department’s

objectives.

3. Sound financial

management practice

promoted.

Ensure efficient and

effective financial

and supply chain

management by

2014.

A need to ensure

fiscal discipline

and optimisation

of resource

allocation.

Improved

accountability on

financial

resources

resulting in well-

funded and

managed health

services.

4. Implementation of

comprehensive care

and management of

HIV and AIDS, TB,

STIs and other

communicable

Develop and

implement plans for

the provincial

priority programs by

2014.

A need to reduce

morbidity and

mortality related

to the burden of

diseases.

Reduce morbidity

and mortality.


diseases accelerated.

5. Decreasing Maternal

and Child mortality.

Ensure

implementation of

programmes

targeting women

and children.

A need to reduce

morbidity and

mortality in

pregnant women

and children.

Reduced

morbidity and

mortality.


6. Strengthen District

health and hospital

services.

Implement 80% of

DHS components in

all districts and

sustainable

outreach

programme at all

levels of care by

2014.

A need to ensure

equitable access

to health care

services.

Improved access

to health

services.

7. Improve quality of

health care.

Implement quality

improvement plans

in the districts and

hospitals by 2014.

Improve client

satisfaction and

clinical outcomes.

Reduced

morbidity and

mortality in the

province.

Improved client

satisfaction and

patient safety.

8. Improve Emergency

Medical Services.

Ensure that 90% of

EMS calls are

responded to within

nation norm of 15

minutes in rural

areas and 40

minutes in urban

areas by 2014.

A need to

respond to calls

within the norm in

order to save

lives.

Reduce morbidity

and mortality in

the province.

9. Tertiary services

development.

Tertiary/academic

services increased

Improved and

increased access

Increased access

to tertiary


from 22 to 37 in line

with the

Modernisation of

Tertiary Services

Document.

to tertiary

services in the

province.

Developed

teaching platform

in the province.

Reduced referrals

to other

provinces.

services.


10 Improve

infrastructure

development

and

maintenance

Implement a

reviewed 5 year

infrastructure

development and

maintenance plan

by 2014.

Health services

delivery needs for

additional

infrastructure

expansion.

Improved access

and quality of

health services.

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.

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

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:

BENEFITS OF TELEMEDICINE

BENEFITS ELABORATION

1. Advancements in delivery of services. 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 can enhance educational

opportunities for health care providers,

patients, and families, improving clinical

outcomes and reducing hospitalizations.

Source: http://www.atsp.org/business/otalink/homepage.asp

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.


http://www.atsp.org/business/otalink/homepage.asp

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

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

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.

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.

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

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

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.

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 ELABORATIONS

1. Advertising positions with poor

responses

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.

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

Remunerated Work outside Public

Service

Some of the Departmental Health

Professionals practice work outside

Public Service, and this is not

properly managed.

11.Non-Implementation of Cellphone

Allowance for Health Professionals

on call and standby.

No cellphones at the institutions for

Health Professionals (such as

Medical Officers) on duty or

standby.

12. Inadequate support from HR

Personnel

Delays in addressing issues such

as payment of acting allowance.

13.Discrepancy in the Implementation Due to the fact that Limpopo is


of Rural Allowance in the

Department.

considered to be 80% Rural, and

20% Urban.

5.2.8.2 EXAMPLES OF WHAT SOME HEALTH PROFESSIONALS SAY ON EXIT INTERVIEWS.

QUESTIONS RESPONSES

1. What was most satisfying about your

job?

I enjoy to be working in theatre, more especially in the operating room. I

love to be next to the patient.

2. Was your workload fair? Yes / No. If No what can be done to improve the

situation?

The supervisor must learn to improve the delegation of Job, because

they want us to do each and JOB coming our way. This puts us under

extremely pressure to deliver quality work.

3. Were your Key Results Areas, Key

Results Indicators and Targets in your

Performance instrument / Performance

Agreement addressed? Yes / No, please

explain why below.

Yes, but our supervisors want us to do the jobs above our scope of

practice and they don’t cover us.

4. Were quarterly reviews with your

supervisor conducted as agreed in the

performance instrument / Performance

Agreement? Yes / No. If No, please

explain why?

Yes, but the problem is that they don’t want to assist us with were we

are failing to comply. But yet they want to rate us at the end of the

quarter.

5. Were your duties clearly defined? Yes / No. Was the job description accurate?

Yes / No, if No, please explain why?

No, if there is a problem in other sections, supervisors want us to go

and do that particular job.

6. Did your duties turn out to be as

expected? Yes / No. If No, please

No, the issue is that our supervisors want to give us with lot of work

which is stressing. These days we do lot of paper work than patient


explain why? care.

7. Did you receive enough training /

adequate support (both on the job and

specialised) to perform your job

effectively? Yes / No, if No, please

explain why?

Yes, but the problem is that at the in-service training at our institution,

they allocate professional nurses to go and attend in-service training. We are not given equal opportunity to attend in-service training.

8. Were you satisfied with the department‘s

performance review system? If No what

can be done to improve the situation?

Not at all, our department should hire the appropriate people to do the

job e.g. washing of instrument.

9. Any other things you need us to know

about the institution including the

management?

The problem is that people are getting old without proper training to

deliver quality health services. Other employees have potential to teach,

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.

6. BEST PRACTICES AS RECOMMENDED BY WORLD HEALTH ORGANISATION (WHO REPORT 2006):

QUESTIONS RESPONSES

6.1 Workforce: Enhancing performance 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 HIV-

positive 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)

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.

7. STRATEGIC INTERVENTIONS TO CLOSE IDENTIFIED GAPS

7.1 GOAL: STRENGTHEN RECRUITMENT OF HEALTH PROFESSIONALS

Output Indicator Activity Outcomes7.1.1 Strengthened

Recruitment of

Health professionals

in the Department.

Number of health

professionals recruited in

the Department.

Advertisement of posts The advertisement of posts

will be posted in the media

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

Improved health

service delivery in

the Province.


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 Health professionals

recruited through

Government to

Government contract

Number of health

professionals recruited in

the Department.

Medical Doctors are recruited

through Government to

Government contract from

Cuba, Tunisia and Iran.

This is done through the

National Department of

Health.

Improved health

service delivery in

the Province.

7.1.3 Facilitate the return

of Health

professionals

Number of returns of

health professionals

recruited and retained in

the department

This can be achieved through

the utilization of South African

Embassies of the host

countries.

For Health professionals

returning from local and

outside the country

remuneration could be based

on the recognition of current

and previous experience.

Improved health

service delivery in

the Province.

Output Indicator Activity Outcomes

7.1.4 Health professionals

recruited through

United Nations

Volunteer

Programme (UNV)

UNV medical doctors;

UNV clinical

engineers

UNV pharmacists;

and

UNV specialist Nurses

recruited and placed

within the health

facilities

The UNDP assist the

Department through

recruitment and placement of

United Nations Volunteer

health professionals to

accelerate transfer of skills

and development of local

practitioners to improve the

delivery of service in the

Province.

Improved health

service delivery in

the Province.

7.1.5 Awarding of

bursaries to study in

Number of bursaries

awarded

Review the Departmental

Bursary Policy, to bind the

Bursary Holders

Retained


health related

professional fields.

bursary holders.

Improved health

service delivery in

the Province.

7.1.6 Awarding of

Learnerships

Number of learnerships

awarded

The Department, as a

recruitment measure awards

learnerships in various health

related training fields

whereupon completion the

learners are absorbed in the

system

Improved health

service delivery in

the Province.

7.1.7 Marketing of

hospitals

Hospital profiles

developed

Development of Marketing

Strategy.

Updating of the Departmental

website.

All hospital profiles to be

posted on the Departmental

website.

Hospital newspapers and

video/DVD clips to be played

on hospital TV’s.

Improved health

service delivery in

the Province.

7.2 GOAL: RETENTION OF HEALTH PROFESSIONALS


7.2.1 Rural Allowances Rural Allowances

implemented equally to all

Medical Officers, Medical

Specialists, Dentists,

Registrars and

Pharmacists.

Implement Rural Allowances

equally to all Medical

Officers, Medical Specialists,

Dentists, Registrars and

Pharmacists.

Health

Professionals

attracted, recruited

and retained

7.2.2 Cell Phone Allowance One cell phone at each

institution for Health

Professionals on call or

standby.

Review current cell phone

policy.

Implement reviewed cell

phone policy.

Health

professionals


and retained

7.2.3 Strengthening

Implementation of

OSDs

OSDs implemented

across all Health

Categories.

Implement reviewed salary

packages aligned to OSDs

across all Health Categories.

Health

Professionals


and retained.


7.2.4 Infrastructures

Improvement

Improved infrastructures Implement hospitals

revitalisation programmes.

Purchase required

equipment in the hospitals.

Health

Professionals


and retained.

7.2.5 Staff Accommodation Fully furnished staff

accommodation for Health

Professionals.

Conduct assessment on the

existing staff

accommodation.

Compile a report with

recommendations.

Implementation of the

recommendations.

Health

Professionals


and retained.

7.2.6 Recreational facilities Increased number of

recreational facilities at

the hospitals.

Conduct an audit on the

existing recreational facilities

at the hospitals.


recommendations.


recommendations.

Health

Professionals


and retained.

7.2.7 Hospital resource

centres

Fully equipped hospital

resource centres.

Establish fully equipped

hospital resource centres

with computers and clinical

reference material.

Health

Professionals


and retained.


7.2.8 Strengthening Security

measures at the health

facilities.

Increased number of safe

health facilities.

Provide 24 hours of effective

security and effective

coverage of the facilities and

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

Safety of personnel

and property

ensured.


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.

8. RECRUITMENT PLAN

8.1.1 HR PROJECTIONS AND COSTS

Job Title Approved posts

Filled Vacant Target2012/13

Estimated Costs(2012/2013)

R

Target2013/14


R

Target2014/15


R

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, 615 630 154,681,350 720 178,050,670

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).


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

CostPer

Student

Expenditure to be

incurred(2013/2014)

Target 2014/15

CostPer

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/prosthetic

22 0 R40,517 0 10 R40,517 R405,170 10 R40,517 R405,170

Clinical Engineering

20 0 R43,859 0 10 R43,859 R438,590 10 R43,859 R438,590

Dental Therapy 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


Study field Baseline 2011/12

Target 2012/13

CostPer

Student

Expenditure to be

incurred(2012/2013)

Target 2013/2014

CostPer

Student

Expenditure to be

incurred(2013/2014)

Target 2014/15

CostPer

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

TOTAL 2309 325 - R18,126,462 340 - 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.


8.1.3 INFRASTRUCTURE DEVELOPMENT / AND OR IMPROVEMENTS:

PROJECT NAME MUNICIPALITY / REGION

TYPE OF INFRASTRUCTURE

PROJECT DESCRIPTION

TOTAL PROJECT

COSTR,000

MTEF FORWARD ESTIMATES

2012/2013R,000

2013/2014R,000

2014/2015R,000

Thabamoopo Hospital Capricorn Hospital Specialised

Construction water supply lines and Reservoir, parking areas, and related works

1 500 500 0 0

Thabamoopo Hospital Capricorn Hospital - Specialised Security ward 3 086 182 0 0

Thabamoopo Hospital Capricorn Hospital - Specialised

Staff accommodation, Kiosk, Pharmacy, Halfway House

3 840 361 0 0


Construction of medical and geriatric ward

17 024 1 280 300 0


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


Construction of the female acute ward

9 731 1 000 0 0


Construction Substance abuse and Adolescent ward

5 206 1 347 395 0

WF Knobel Hospital - Enabling

Capricorn Hospital - District

WF Knobel Theatre Complex - Enabling Works Program

28 517 9 008 0 0

Zebediela Hospital Capricorn Mortuary New Hospital M2

Mortuary 5 900 1 090 0 0

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

MUNICIPALITY / REGION


PROJECT DESCRIPTION

TOTAL PROJECT MTEF FORWARD ESTIMATES


PROJECT NAME COST R,000

2012/2013R,000

2013/2014R,000

2014/2015R,000

WF Knobel Hospital Capricorn Accommodation

Hospital Staff Accommodation (10 single rooms)

4 720 800 0 0

Zebediela Hospital Capricorn Accommodation


5 165 800 0 0

Zebediela Hospital Capricorn Hospital - District Zebediela Hospital

Roof Renovation 1 480 226 0 0

Letaba Hospital

Mopani 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

Letaba Hospital Mopani Hospital - Regional

A3. Demolish existing maternity and construct new maternity and external covered walkways new victim empowerment centre

15 000 41 598 1 000 0

Letaba Hospital Mopani Hospital - Regional

Upgrading of Existing Administration and Psychiatric Ward

22 000 0 20 000 0

Letaba Hospital


Workshop, 48 hours Water Standby Storage & Mechanical Works

24 000 0 2 000 0

Letaba Hospital


Upgrading of medical records room and linen store

42 000 0 23 000 19 000

Maphuta Malatjie Hospital

Mopani Hospital - DistrictDemolition of existing buildings and stores

34 415 417 0 0

Maphuta Malatjie Hospital

Mopani Hospital - DistrictConstruction of OPD, Casualty, X-Ray

63 400 0 25 000 25 000

Maphuta Malatjie Hospital Mopani Hospital - District

Final Account for Construction of Administration, Gateway Clinic and external works

24 275 1 715 745 0

Maphuta Malatjie Hospital Mopani Hospital - District

Construction of Transport Control, Workshop, Recreational facility, Kitchen upgrade.

29 061 3 665 200 0

PROJECT NAME MUNICIPALITY / REGION


PROJECT DESCRIPTION

TOTAL PROJECT COST


2012/2013 2013/2014 2014/2015


R,000 R,000 R,000 R,000Maphuta Malatjie Hospital

Mopani Hospital - District Construction of Resource Center 1 000 0 1 000 0

Dr CN Phatudi Hospita - Enablingl Mopani Hospital - District

Dr C N Phatudi OPD, X-ray and Pharmacy - Enabling Works Program

16 273 10 360 12 000 0

Nkhensani Hospital

Mopani Hospital - District Standby Generator 0 0 900 0

Letaba hospital

Mopani Hospital - Regional Theatre Chiller Plant 0 0 500 0

Ga-Kgapane Hospital

Mopani Hospital - District

New Gate House/Patient-Visitors' Center/Kiosk, OPD/Casualty/Xray Complex,

0 0 6 000 20 000

Ga-Kgapane Hospital Mopani Hospital - District

Stanby Generator and Theatre Chiller Plant

0 0 2 700 0

Sekororo Hospital Mopani Hospital - District

New Maternity Complex; Medical Gas Plant Room

0 0 6 000 17 500

Van Velden Hospital

Mopani Hospital - District

New Maternity Complex; Hospital Compliant with Disabled Requirements

0 0 6 000 17 500

Kgapane Hospital Mopani Accommodation


4 786 800 0 0

Old Nkhensani Hospital Mopani Accommodation


4 771 800 0 0

Letaba Hospital Mopani Accommodation


4 795 800 0 0

Sekororo Hospital

Mopani

AccommodationHospital Staff Accommodation (20 single rooms)

9 043 5 434 0 0

Mecklenburg Hospital - Enabling Sekhukhune Hospital - District

Mecklenburg OPD, X-Ray, Casualty & Pharmacy - Enabling Works Program

36 035 14 651 6 000 0

St Ritas Hospita – Enablingl

Sekhukhune Hospital - Regional

St Ritas Pharmacy Upgrade - Enabling Works Program

10 247 6 612 6 000 0

Matlala Hospital - Enabling

Sekhukhune Hospital - District

Matlala OPD, X-Ray, Casualty & Pharmacy - Enabling Works Program

21 241 3 223 1 874 0

Philadelphia Hospital – Enabling

Sekhukhune Hospital - Regional

Philadelphia OPD, X-Ray, Casualty - Enabling Works Program

37 798 10 819 12 000 0

MUNICIPALITY / REGION


PROJECT DESCRIPTION

TOTAL PROJECT



PROJECT NAME COSTR,000

2012/2013R,000

2013/2014R,000

2014/2015R,000

Dilokong Hospital Sekhukhune Accommodation


4 797 800 0 0

Jane Furse Hospital Sekhukhune Accommodation


4 720 800 0 0

Philadelphia Hospital Sekhukhune Accommodation


4 747 800 0 0

HC Boshoff New Health Centre

Sekhukhune Community Health Centre

New Community Health Centre 65 155 400 0 0

Bosele EMSSekhukhune 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 Elim Hospital Theatre - Enabling Works Program

5 281 547 0 0

Tshilidzini Hospital Vhembe Hospital - Regional

Replacement of Psychiatric Ward gutted by fire

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


4 876 800 0 0

Louis Trichardt Hospital Vhembe Accommodation


5 036 800 0 0

Donald Fraser Hospital Vhembe Accommodation


4 772 800 0 0

Elim Hospital Boilers

Vhembe Hospital - District Boilers Upgrade 16 624 4 207 0 0

Thabazimbi Hospital Waterberg Hospital - District

OPD, Casualty, X-ray, Pharmacy and ARV Clinic and administration block

57 500 11 225 0 0

Thabazimbi Hospital

Waterberg Hospital - District

Construction of maternity, wards and theatre, linen bank ,kitchen, medical waste and ring road

160 000 60 372 50 473 32 527

George Masebe Hospital - Enabling


George Masebe Maternity &Theatre - Enabling Works Program

25 385 14 587 5 000 0

PROJECT NAME MUNICIPALITY / TYPE OF INFRASTRUCTURE

PROJECT DESCRIPTION

TOTAL PROJECT



REGION COST R,000

2012/2013R,000

2013/2014R,000

2014/2015R,000

Voortrekker Hospital – Enabling Waterberg Hospital - District

Voortrekker OPD, X-Ray, Casualty & Pharmacy - Enabling Works Program

32 524 14 615 5 000 0

Mokopane Hospital – Enabling Waterberg Hospital - Regional

Mokopane Theatre Complex - Enabling Works Program

37 500 9 158 2 000 0

F.H. Odendaal:


New Health Support, New Admin Block, New Gateway Clinic; Re-organization of Casualty/OPD

0 0 6 000 20 000

George Masebe Hospital

Waterberg Hospital - DistrictNew Wards, New Gateway Clinic, Upgrade Casualty

0 0 6 000 22 313

Mokopane Hospital

Waterberg Hospital - Regional New Psychiatric Ward 0 0 6 000 7 000

W.F. Knobel Hospital Waterberg Hospital - District

Replacement of X-ray Building at an optimal location according to health flow

0 0 4 000 3 400

Voortrekker Hospital

Waterberg Hospital - District Standby Generator 0 0 400 0

George Masebe Hospital

Waterberg AccommodationHospital Staff Accommodation (10 single rooms)

5 085 800 0 0

Voortrekker Hospital Waterberg Accommodation


4 720 800 0 0

FH Odendaal Hospital TB MDR

Waterberg Hospital - SpecialisedFH Odendaal Hospital TB MDR Units

44 201 6 000 0 0

Ellisras Hospital Waterberg Hospital - District

Upgrade Casualty/OPD, New Laboratory,

0 0 6 000 15 000

TOTAL - - - 1,068,397 261,945 258,887 262,720


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. Senior Manager Infrastructure Development

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

Evaluation

Monitoring and 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.


10. IMPLEMENTATION PLAN

PRIORITY INERVENTIONS

KEYACTIVITIES

EXPECTEDOUTCOMES

INDICATORSNUMBER OF POSTS TO BE FILLED

RESPONSIBILITYY12011/2012

Y22012/2013

Y32013/2014

Y42014/2015

1.To Strengthen Recruitment Of Health Professionals in the Department.

Advertisement of posts in the: -Print media, such as newspapers, medical journals,

-Electronic media such as online recruitment and radios

-O pen advertisement for

recruitment of qualifying

Health Professionals.

Improved

Health Care

Service Delivery

in the Province.

Number of

posts advertised

in print and

electronic

media, and

filled.

- 563 630 720 SENIOR MANAGER: Human Resource

Management

REQUIRED BUDGET



KEYACTIVITIES

EXPECTEDOUTCOMES

INDICATORS RESPONSIBILITYY12011/2012

Y22012/2013

Y32013/2014

Y42014/2015

2. To Award Bursaries to students, to study Health related Careers.

Review the Departmental Bursary Policy to bind Bursary Holders

Implementation of the reviewed Policy.

Improved

Health Care

Service Delivery

in the Province.

Number of

bursaries

awarded.- 18 126 462 19 175 905 19 175 905 SENIOR MANAGER:

Human Resource Development

3. To Market Hospitals Updating of Departmental

website.

Posting all Hospital

profiles on the

Departmental website.

Playing Hospitals

newspapers and video /

DVD clips on Hospital’s

TVs.

Improved

Health Care

Service Delivery

in the Province.

Updated

Departmental

Website.

Hospital Profiles

posted on the

Departmental

website.

Video / DVD

clips played on

Hospitals.

- 0 0 0 SENIOR MANAGER: Communications


KEYACTIVITIES

EXPECTEDOUTCOMES

INDICATORS REQUIRED BUDGETRESPONSIBILITYY1 Y2 Y3 Y4


2011/2012 2012/2013 2013/2014 2014/2015

4. Infrastructures Development (Funded by National)

Implement Hospital Revitalisation project in six Hospitals (Jane Furse, Nkhensani,Letaba,Maphutha Malatji,Thabamoopo & Thabazimbi).

Improved

Health Care

Service Delivery

in the Province.

Number of

Hospital

revitalisation

projects

implemented.

- R1, 193,000 R310, 211,000 R399, 286,000 SENIOR MANAGER:Revitalisation Programme

5. Staff Accommodation

Conduct assessment on

the existing staff

accommodation.


recommendations.


recommendations.

Improved

Health Care

Service Delivery

in the Province.

Assessment on

the existing staff

accommodation

conducted, and

recommendatio

ns

Implemented.

Number of staff

accommodation

s built.

- R261,945,000 R258,887,000 R262,720,000 SENIOR MANAGER: Physical Facilities


KEYACTIVITIES

EXPECTEDOUTCOMES

INDICATORS REQUIRED BUDGETRESPONSIBILITYY1

2011/2012Y2

2012/2013Y3

2013/2014Y4

2014/2015


6. Strengthen Security Measures at the Health facilities.

Provide 24 hours of

effective security and

effective coverage of the

facilities and premises

Maintain and record all

occurrences in the

occurrence register and

pocket books.

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

Improved

Health Care

Service Delivery

in the Province.

24 hours of

effective

security and

effective

coverage of the

facilities and

premises

provided.

All occurrences

maintained and

recorded in the

occurrence

register and

pocket books.

Regular

checks /

patrolling duties

around the

premises

conducted as

required.

- R235, 244,000 R242,301,320 R249,570,360 SENIOR MANAGER: Security Services


Health facilities.

Installation of surveillance

cameras at sensitive

points.

Premises

guarded against

intrusion on

unauthorised

entries.

Palisade fence

built at all

Health facilities.

Surveillance

cameras

installed at

sensitive points.


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 Health Professionals

2011/12-2013/14

Awarding of Bursaries2011/12-2013/14

Infrastructure Development

2011/12-2013/14

R4,624,012,000 R447,320,502 R668,860,000

Additionally, the Department anticipates spending the budget reflected in the

table below for partial implementation of this strategy:


2011/12-2013/14



2011/12-2013/14

R469,018,635 R56,478,272 R547,104,000

GAP (DEFICIT) TO FULLY IMPLEMNT THE STRATEGY:


2011/12-2013/14



2011/12-2013/14

R4,154,993,365 R390,842,230 R121,756,000


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

Documents