BackgroundStaffing of rural healthcare facilities is a challenge, with literature supporting the selection and training of rural-origin students. The Umthombo Youth Development Foundation (UYDF) scholarship scheme supports rural students to train as healthcare professionals and offers a unique support programme. This programme has not been evaluated, and this study sought UYDF-supported students’ perceptions of the programme.AimThe aim of the study was to assess students’ perceptions of the UYDF support programme.MethodsThis was an observational descriptive study. Participants were students supported by UYDF and data were collected by a questionnaire with a Likert scale to assess perceptions of various aspects of the support programme.ResultsStudents’ perceptions about the UYDF support programme were generally positive, with initial orientation and information sharing perceived as useful. Some respondents did not perceive value in holding discussions around English proficiency. The support required appeared to diminish with increasing years of study.ConclusionA comprehensive, proactive compulsory support system that provides both academic and social support was perceived as useful by the UYDF students. Further research is required around aspects such as encouraging English proficiency. In future, the support programme could prioritise students in the early years of their study.

Background. Internationally, the development of partnerships between institutions of higher learning and the communities they serve is stressed as a priority. The Umthombo Youth Development Foundation (UYDF) is an educational model developed in rural KwaZulu-Natal, South Africa as a response to the scarcity of medical personnel in hospitals. Community involvement in health professional education has become a key strategy in the model, and review of the model may provide lessons for other educators towards implementing community involvement in health professional education. Objective. To review the UYDF, with emphasis on aspects of community involvement. Methods. This qualitative study used a social accountability theoretical framework. Data were collected using the Appreciative Inquiry method and participants who were involved in the UYDF model were interviewed. Themes arising around community involvement were generated inductively. Results. Community involvement in health professional education grew from a funding requirement and has strengthened over time to become an integral component of the UYDF model. Community involvement occurred mainly at the student selection process, but continued during education and after graduation. Participants suggested means by which community involvement could be strengthened. Conclusion. The UYDF successfully presents a model that facilitates community involvement in health professional education. Lessons learnt could guide other models, and the UYDF model could be strengthened by further research.

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Many South Africans living in rural areas do not have access to affordable, quality, comprehensive healthcare, despite considerable government investments in programmes to strengthen the healthcare system. In their study, Pillay et al. [1] found that the burden of poverty and disease in South Africa (SA) is highest in rural areas, while Benatar et al. [2] confirmed that public and private health resources are skewed towards urban areas. Within the context of free primary health services, substantial barriers to receiving care remain, as accessing health services can be a challenge [3] owing to high transport costs. More than 15% of poor rural households live >1 hour away from the closest clinic, and 20% >1 hour away from the nearest hospital. [4] Compounding these challenges, is a critical shortage of health workers in SA, as cited by Moyimane et al. [5] In 2013, it was estimated that SA had 60 doctors per 100 000 population compared with a global average of 152/100 000. [4] Large inequalities also exist in the distribution of healthcare resources between rural and urban areas, which exacerbate the challenge of accessing quality healthcare. In 2004, a study conducted by Hamilton and Yau [6] estimated that only 12% of doctors and 18% of nurses were serving 46% of the national population who lived in rural areas. These challenges are acknowledged in many government strategies, and are the focus of the proposed National Health Insurance (NHI) and Human Resources for Health strategy, which aim to provide a comprehensive and equitable health service to all South Africans. [7] However, there can be no healthcare without a health workforce, and the dream of universal health coverage cannot be achieved without a considerable injection of resources into the training of healthcare professionals (HCPs). [8] A few studies have investigated the cost of educating HCPs in SA, and have tracked the resources and efforts required to maintain an adequate supply nationally. [9-11] The aim of this article was to assess the financial return on investment of HCP education using data from the Umthombo Youth Development Foundation (UYDF) scholarship scheme to determine whether the costs associated with their education should be viewed as an expense or as an investment. The UYDF has been supporting rural youth to train as HCPs since 1999, and by the end of 2017, had produced 337 graduates across 16 health disciplines, with an annual pass rate of >90% for the past 10 years. [12,13] The aim of the scheme is to address the shortages of qualified HCPs at rural hospitals by identifying, training and supporting rural youth to graduate in various disciplines. The UYDF education and training process involves an integrated model of recruitment at school level, selection at rural hospitals, support during education and training, and employment support and retention on return to the local rural workplace (Fig. 1), the details of which have been previously described by MacGregor et al. [14] Methods A desk-top economic analysis was undertaken to calcu...

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