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Stakeholders’ perspectives on Public Health Medicine in South Africa

South Africa (SA) is reforming its health system in preparation for an anticipated national health insurance (NHI) scheme that aims to improve the delivery of affordable, equitable, accessible health care. Public health (PH) language is explicit in the policy and skilled PH professionals would be ex...

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Detalles Bibliográficos
Autores principales: Zweigenthal, Virginia E. M., Pick, William M., London, Leslie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6713439/
https://www.ncbi.nlm.nih.gov/pubmed/31461481
http://dx.doi.org/10.1371/journal.pone.0221447
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author Zweigenthal, Virginia E. M.
Pick, William M.
London, Leslie
author_facet Zweigenthal, Virginia E. M.
Pick, William M.
London, Leslie
author_sort Zweigenthal, Virginia E. M.
collection PubMed
description South Africa (SA) is reforming its health system in preparation for an anticipated national health insurance (NHI) scheme that aims to improve the delivery of affordable, equitable, accessible health care. Public health (PH) language is explicit in the policy and skilled PH professionals would be expected to play a key role in its implementation. In South Africa, training of doctors as Public Health Medicine (PHM) specialists is funded by the state, yet there are few positions for PHM specialists in the health services. We explored stakeholders’ perspectives about this absence, and their views on PHM specialist’ roles and contribution in an era of health reform. A qualitative study was conducted in 2012–13, using in-depth interviews with thematic analysis, which elicited perspectives of 31 key stakeholders nationally reflecting diverse employer and institutional backgrounds. While some were surprised by the absence of PH professionals in SA’s health system, most agreed the reason was due to factors internal to the profession, such as its low profile and uncertain identity. External factors such as legislation and political preferences for health managers impacted on the employment of PH professionals. However, given the competencies required to implement an ambitious restructuring of the health sector, all believed that PH and PHM personnel were vital. In view of the health system’s dominant curative orientation, embedding PH personnel in the services should ensure that health protection, promotion and prevention strategies will inform health priorities. This study, the first known from a low and middle-income country, contributes to the international literature about the identity and roles of PHM physicians, who are versatile professionals with broad skills-sets. In SA, through consultation with health sector employers about potential roles, curricular redesign and trainee recruitment, PHM can graduate fit-for-purpose specialists to work in a range of institutions to address health system reform.
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spelling pubmed-67134392019-09-04 Stakeholders’ perspectives on Public Health Medicine in South Africa Zweigenthal, Virginia E. M. Pick, William M. London, Leslie PLoS One Research Article South Africa (SA) is reforming its health system in preparation for an anticipated national health insurance (NHI) scheme that aims to improve the delivery of affordable, equitable, accessible health care. Public health (PH) language is explicit in the policy and skilled PH professionals would be expected to play a key role in its implementation. In South Africa, training of doctors as Public Health Medicine (PHM) specialists is funded by the state, yet there are few positions for PHM specialists in the health services. We explored stakeholders’ perspectives about this absence, and their views on PHM specialist’ roles and contribution in an era of health reform. A qualitative study was conducted in 2012–13, using in-depth interviews with thematic analysis, which elicited perspectives of 31 key stakeholders nationally reflecting diverse employer and institutional backgrounds. While some were surprised by the absence of PH professionals in SA’s health system, most agreed the reason was due to factors internal to the profession, such as its low profile and uncertain identity. External factors such as legislation and political preferences for health managers impacted on the employment of PH professionals. However, given the competencies required to implement an ambitious restructuring of the health sector, all believed that PH and PHM personnel were vital. In view of the health system’s dominant curative orientation, embedding PH personnel in the services should ensure that health protection, promotion and prevention strategies will inform health priorities. This study, the first known from a low and middle-income country, contributes to the international literature about the identity and roles of PHM physicians, who are versatile professionals with broad skills-sets. In SA, through consultation with health sector employers about potential roles, curricular redesign and trainee recruitment, PHM can graduate fit-for-purpose specialists to work in a range of institutions to address health system reform. Public Library of Science 2019-08-28 /pmc/articles/PMC6713439/ /pubmed/31461481 http://dx.doi.org/10.1371/journal.pone.0221447 Text en © 2019 Zweigenthal et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Zweigenthal, Virginia E. M.
Pick, William M.
London, Leslie
Stakeholders’ perspectives on Public Health Medicine in South Africa
title Stakeholders’ perspectives on Public Health Medicine in South Africa
title_full Stakeholders’ perspectives on Public Health Medicine in South Africa
title_fullStr Stakeholders’ perspectives on Public Health Medicine in South Africa
title_full_unstemmed Stakeholders’ perspectives on Public Health Medicine in South Africa
title_short Stakeholders’ perspectives on Public Health Medicine in South Africa
title_sort stakeholders’ perspectives on public health medicine in south africa
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6713439/
https://www.ncbi.nlm.nih.gov/pubmed/31461481
http://dx.doi.org/10.1371/journal.pone.0221447
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