A Programme to improve health services in rural South Africa: Perceptions from participating hospital managers, health science students and graduates

Abstract Background: The shortage of HCPs negatively affects health services in rural areas in many parts of the world, as is the case in South Africa. A NPO, the UYDF, initiated a programme designed to improve the health system in a rural area. It consisted of a scholarship and mentorship programme in 1999 for youth from the area to study for health science degrees on condition that they would take up a post at the hospital in their community once qualified.Aims: This paper reports the perceptions and experiences of the students and graduates sponsored by the foundation, and those of managers from the facilities where the students were ultimately placed, in order to gauge whether such a programme can make a sustainable contribution to address the shortage of health personnel in rural areas and to what extent this is happening.Methods: The study used qualitative methods. Students and senior health managers were interviewed using a semi-structured in-depth format, and graduates took part in focus group discussions at three hospitals, in different districts. The data were analyzed thematically.Results: The students interviewed appreciated the financial and socio-emotional support that they received, and the graduates were appreciative that posts awaited them in their home community on completion of their studies. The managers reported the success of the programme in increasing the number of healthcare personnel at the hospitals, and the range of available medical services. Since the graduates are familiar with the language and culture of their patients the managers considered that they are better able to assist them.Conclusion: The system was well thought-out and achieved its goal of improving health services in an underdeveloped rural area of South Africa. More could be achieved if other government services in the area were simultaneously improved and if the system were replicated elsewhere.