Retention of medical officers in district health services, South Africa: a descriptive survey

Abstract

BackgroundThe health workforce is critical to strengthening district health services (DHS). In the public sector of South Africa medical officers (MO) are essential. Family physicians, responsible for clinical governance, identified their retention as a key issue.AimTo evaluate factors that influence retention of MOs in public sector DHS.Design & settingA descriptive survey of MOs working in DHS, Western Cape, South Africa.MethodAll 125 MOs working in facilities associated with the Stellenbosch University Family Physician Research Network were included in the survey. A questionnaire measured the prevalence of key factors that might be associated with retention (staying >4 years) and included the Satisfaction of Employees in Health Care tool and Short Warwick-Edinburgh Mental Well-being Scale. Data was collected in REDCap and analysed in the Statistical Package for Social Sciences.ResultsNinety-five MOs completed the survey. The overall rating of the facility (P=0.001), age (P=0.004), seniority (P=0.015), career plans (<0.001) and intention to stay in the public sector (P<0.001) were associated with retention. More personal factors such as social support (P=0.007), educational opportunities for children (P=0.002) and staying with one’s partner (P=0.036) were also associated. Gender, rural vs urban location, district hospital vs primary care facility, overtime, remuneration and additional rural allowance, were not associated.ConclusionsThe overall rating of the facility was important and subsequent qualitative work has explored the underlying issues. These findings can guide strategies in the Western Cape and similar settings to retain MOs in the DHS.

The career pathways of new family physicians in South Africa from 2008 to 2022

“… 14 Medical officers, already working in the public sector, did not regard this as a significant factor in retention. 15 …”

“…14 Medical officers, already working in the public sector, did not regard this as a significant factor in retention. 15 Being part of a cohesive team with strong supportive relationships was also seen as important in the retention of medical officers. 13,15 The public sector may be more predisposed towards working in multidisciplinary teams with a mix of specialist, nonspecialist and nonprofessional colleagues.…”

“…15 Being part of a cohesive team with strong supportive relationships was also seen as important in the retention of medical officers. 13,15 The public sector may be more predisposed towards working in multidisciplinary teams with a mix of specialist, nonspecialist and nonprofessional colleagues. The private sector regulations and remuneration model make it difficult for practices to register in this way and reduce opportunities for such teamwork in general practice.…”