Goal 2
Retention
The new National Health Insurance plan as the country’s health system requires a concerted drive towards Primary Health Care. Whilst both government and the UKZN-MEPI programmes work towards this realisation, a key issue is the retention of doctors in resource constrained environments which are mainly rural. MEPI has therefore developed a number of programmes to encourage health professionals to work in these areas, which include:
MEPI Learning Centres
Two urban and eleven rural sites were chosen in collaboration with the various disciplines at UKZN and DOH, to be developed as decentralised teaching sites, known as MEPI Learning Centres (MLCs) as follows:
Rural Sites:
- Murchison
- St Andrews
- Harding
- Emmaus
- Church of Scotland Hospital
- Eshowe
- Manguzi
- Mseleni
- Mosvold
- Bethesda
- St Mary’s KwaMagwaza.
Urban Sites:
Wentworth Hospital
Northdale Hospital
Objective of the MLC
The idea is to provide medical, nursing and pharmacy students with a positive academic and rural experience through mentorship and support, thereby encouraging their return to these areas after graduation. The rural sites are selected by a joint team comprising officials from the Department of Health and MEPI.
The establishment of MLCs is also being proposed as academic centres of enrichment as they are equipped with a resource centre comprising an electronic document repository, video conferencing facility and links, seminar room, internet access, accommodation, etc.
Pholela - World’s First Community Health Care Site
One of the rural sites, the Pholela Community Health centre was chosen as one of the MLCs following discussions with the KZN Minister of the Executive Committee (MEC) for Health, Dr Sibongiseni Dhlomo. Pholela is considered the birthplace of the world’s first Community Oriented Primary Health Care (COPC) model but due to its location, size and patient profile and rich history, is being mooted as a heritage site with a museum. MEPI has committed to the renovations of the rondavels on site to showcase the history of COPC in Pholela and have also partnered with other stakeholders to revive the historical market place and establish a community garden with produce being in the area - thus contributing to community upliftment.
Around 254 first year students were taken on a visit to this historical site as part of their orientation program. Following on the success of this visit, future student visits to the site will be incorporated into the curriculum, as from 2016.
Postgraduate students in Family Medicine, Public Health and Rural Health are also set to benefit from similar visits as COPC forms part of the new health care system in South Africa.
Infrastructure
Students at MLCs have access to several network platforms, including video conferencing facilities as outlined above. This enables students to learn online, engage with fellow students, receive faculty support where needed and participate in special training workshops, amongst others.
The MLC Model
A structured teaching programme with specialist supervision has been developed as part of the formal teaching curriculum for undergraduate medical students from fourth to sixth year of the MBChB curriculum as part of the MLC model. This will be extended to pharmacy, allied health sciences and nursing students.
REMETH
As retention of health workers in academic institutions is a key challenge, the Research Methodology (REMETH) PhD support programme is specifically aimed at meeting this need. This is done by identifying and building capacity of successful PhD candidates within the University to join the faculty.
ESMOE
The Essential Steps in Managing Obstetric Emergencies (ESMOE) programme plays a pivotal role in skills building in handling pregnancy related emergencies. To ensure minimal disruption of the work force and retain health workers at their facilities, ESMOE training facilities are initially being rolled out at the MEPI Learning Centres.
Master Trainers
The MEPI funded ESMOE programme provides training in the Master Trainers workshop for up to two health professionals from each public health facility in KZN with a maternity unit.
Certified Master Trainers then provide training to all other staff in their maternity wards, including interns and community service officers. Master Trainers are then appointed internally at the relevant facilities to ensure ongoing training at the site, thus providing an incentive towards career path and encouraging retention.