Developing a human resource profile for the nutrition workforce in the public health sector in the Western Cape province, South Africa

[摘要] Background:The crisis and study of health workforce has become more important in developed anddeveloping countries. The relationship between human resource issues and health systemeffectiveness has been acknowledged. Human resources are seen to be one of the mainconstraints in achieving the millennium development goals. A number of changes have takenplace within health services since 2003, including the promulgation of the new health Act 63of 2003, restructuring processes in the Western Cape province and the development of aComprehensive Service Plan (CSP) to implement Health Care 2010. Nationally andprovincially nutrition is declared a priority, due to the documented beneficial impact ofnutrition support on preventable diseases, disease of life-style, as well as the treatment ofhigh priority disease groups, namely TB and HIV/AIDS. For appropriate planning of nutritionservices, the Integrated Nutrition Programme (INP) in the Western Cape needed to reviewthe status of the nutrition workforce in the province, towards developing a human resourceplan to meet the nutrition service needs, in the provincial context, its service platforms andapproved service implementation plan for public health sector.ObjectivesThe study aimed to describe the current status of the nutrition workforce (staffing profile) inthe Western Cape province in terms of staffing levels, personnel categories, location,placement, qualifications, skills, and personnel expenditure at all levels of the public healthsector. Provincial maps were developed to indicate the density of personnel per categorypictorially.MethodsIn this descriptive observational study, a targeted sampling approach was applied bydeveloping master lists of the respective nutrition/dietetic/food service units and personnelwithin the geographical districts and hospitals at all levels of care. All nutrition personnelemployed by the Western Cape Department of Health were included in the study.Quantitative data collection methods including coding sheets (per facility), self administeredquestionnaires and the official personnel database (Persal) of the Department of Health wasused. Questionnaires were constructed according to the variability of services, settings, andjob outputs. The respective personnel were grouped into 5 categories. Descriptive statisticalmethods were used to analyse data. Comparisons in terms of urban and rural distributionswere also completed. ResultsA response rate of 86% was achieved (N = 647) with food service workers being the largestproportion of staff (N = 509), followed by dietitians (N = 64), managers (N = 31), auxiliaryworkers (N = 28) and administrative personnel (N= 15). Significant differences (p=0.0001-0.05) were found amongst the respective personnel categories in terms of demographics,qualifications, training, experience, skills, competencies, time spent on the INP, and generalhuman resource management areas. Training needs and areas of low skills were identifiedfor the respective categories and key challenges and solutions in the nutrition workforce werehighlighted.ConclusionThe study indicates that the processes used to develop the workforce need to receive thesame intensity as all other interventions. The results can be applied in providing evidencebased information for the development of the Department of Health, Western Cape humanresource plan and the integration of nutrition therein.

[发布机构] Stellenbosch University