Quality Health Care For Africa's Rural Poor
Recruitment of foreign qualified doctors from developed countries to address the critical shortage of doctors in rural South African hospitals.
About Your Organization
Africa Health Placements
South Africa, GT, Johannesburg
Country where this project is creating social impact
Is your organization a
Non‐profit/NGO/citizen sector organization
How long has your organization been operating?
More than 5 years
Has the organization received awards or honors? Please tell us about them
ABSA Healthcare Initiative Award in 2007 -
Nominee Award; Silver Loerie in 2008
References - Please provide two references with a two-sentence biography, email address, and phone number for each
Prof. Jannie Hugo (MB ChB, M Fam Med) is a family physician and associate professor in the Department of Family Medicine at the University of Pretoria responsible for Community Engagement for the Faculty of Health Sciences. 082 372 2435 / Jannie.email@example.com
Dr Wolvaardt, CEO of the Foundation for Professional Development (Pty), serves on the board of directors of the South African Institute for Health Care Managers, Dira Sengwe Conferences, Right to Care and Aids Accountability International. 083 300 8271 / firstname.lastname@example.org
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Select the stage that best applies to your solution
Scaling (the next step will be growing impact on a regional or even global scale)
How long have you been in operation?
Operating for more than 5 years
Which of the following best describes the barrier(s) your innovation addresses? Choose up to two
The Need: What problem are you trying to solve?
Worldwide the shortage of medical staff is a massive health care challenge. This is most profound in Africa which, in addition to having 20% of the world’s population but only 2% of the world’s physicians, faces high levels of HIV/Aid, TB and diabetes. In South Africa medical staff shortages are no better than the worst affected African countries, with rural areas (home to approximately 24,000,000 people) being the most severely affected. In contrast to the USA, which has 550 doctors per 100,000 people, health care in South Africa’s rural hospitals rests on the shoulders of 2 to 3 doctors per 100,000 people.
The Solution: What is your solution? Be specific!
AHP’s solution lies in their proven recruitment, orientation and retention model which promotes the recruitment and retention of foreign medical skills from developed countries to address immediate human resources in health needs in rural South African hospitals. Once a contingent of foreign qualified doctors (FQDs) are in place at the hospital, local health workers are more easily attracted and retained as a result of having a professional team to work with and hospital management can move out of crisis mode and focus on promoting the improved capacity and more attractive work offering at the hospital thus maintaining its clinical team and provide improved and sustainable access to healthcare in rural areas of the country.
The Model: Walk us through a specific example of how your solution makes a difference; include your primary activities
In 2009 AHP established a working relationship with Isilimela Hospital - a rural hospital in the Eastern Cape province which was critically understaffed with only 3 doctors. In addition to being unable to attend to the large volume of patients seeking medical care daily, the hospital was unable to use its fully equipped surgical unit, its peri-natal mortality rate was as high at 6.4%, it had relatively few patients on ARV’s, and bed utilisation rate was extremely low at 28%.
Through AHP’s Foreign Recruitment Programme which incorporates pre and post arrival orientation and ongoing support and professional development opportunities, AHP recruited and placed 5 FQDs at Isilimela Hospital, increasing the number of doctors at the facility to 7. The increased staff compliment had an enormous impact on Isilimela’s performance. Where assisted deliveries were non-existent in 2009, the hospital now performs in excess of 2 per month. Peri-natal mortality has dropped from 6.4% to 2%. The number of patients receiving ARV treatment has more than doubled to 468 per month. Theatre cases have increased 7 fold to 30 per month, and bed utilisation has gone from 28% to 60%.
The Marketplace: Who are your peers and competitors? Identify others also working to address the needs you are and what differentiates you from them. What challenges could these players pose to your success or growth?
AHP is the only organisation recruiting foreign and local health workers for South Africa’s public hospitals. The only other organisation whose work is close to that done by AHP is MSF (Doctors Without Borders) which focus on emergency situations, whereas AHP offers more sustainable long-term solutions. The emergency nature of the work done by MSF could potentially be viewed by doctors as a more exciting option than working in public hospitals.
This Entry is about (Issues)
Founding Story: We want to hear about your "Aha!" moment. Share the story of where and when the founder(s) saw this solution's potential to change the world.
Madwaleni Hospital in the Eastern Cape was the facility that first grabbed the attention of AHP’s CEO and co-founder, Saul Kornik. In 2005, Kornik and a friend took a trip to Madwaleni Hospital with Steve Reid’s proposed idea of recruiting foreign doctors for rural hospitals in mind. This visit was critical for Saul in formulating his own ideas around the formation of AHP as he experienced first-hand the serve impact that staff shortages in hospitals have on communities in rural areas. The visit left little question in his mind that more doctors were desperately needed to improve the quality of healthcare in rural hospitals like Madwaleni and that recruiting foreign doctors could provide the answer. With this idea in mind, AHP was born.
Please describe the goal of your initiative; outline what you are trying to achieve
The goal is to enhance the health care delivery system in Africa through the provision of human resource solutions and services. These extend beyond the recruitment and retention of health care professionals and management staff to include services directed towards building sustainability, such as consulting, information services, advocacy and marketing. AHP’s proven model for recruiting and retaining foreign health workers for rural hospitals, coupled with extensive experience on the ground and strong working partnerships with key stakeholders enables the organization to communicate human resource issues from the ground up and utilize close working relationships to influence and inform policy from the top down.
What has been the impact of your solution to date?
Since 2005 AHP has placed 1,297 FQDs in rural South African hospitals - providing improved access to health care to an estimated 18 million of the country’s rural population. The recruitment programme has also had an immeasurable impact on retaining local qualified doctors in rural facilities. The introduction of the Rural Doctor Support Programme which places Practice Managers in rural areas to improve the working and management conditions faced by health workers has strengthened retention efforts, with an estimated 40% of rural health workers extending their time in rural practice in 2011. AHP has regularly consulted to the National DOH and HPCSA on matters of foreign recruitment policy and process and assisted with the drafting of the recruitment policy in the government's Draft HRH Strategic Plan.
What is your projected impact over the next five years?
In line with AHP’s vision “Health for Africa, powered by people”, the organisation plans to increase its operations in South Africa and expand into the rest of Africa in the next five years.
AHP’s aim is to be the default organisation for human resources in health on the African continent, specifically for rural areas. Together with working partners AHP will provide professional service - from sourcing candidates to retaining health workers - in underserved areas across Africa.
What barriers might hinder the success of your project? How do you plan to overcome them?
Policy amendments making it more challenging for foreign qualified health professionals to work in South Africa would restrict or hamper AHP’s ability to fill public sector vacancies. Further additions to the already bureaucratic application and registration processes would also increase applicant dropout rates. AHP is, and will continue to work with the various bodies to speed up the process and guide optimal policy decisions. It is imperative that AHP maintains excellent working relationships with the Department of Health and Health Professionals Council of South Africa and ultimately succeed in integrating AHP operations into Department of Health systems.
Winning entries present a strong plan for how they will achieve and track growth. Identify your six-month milestone for growing your impact
AHP has the staff, systems and processes to effectively and efficiently implement, manage and track growth.
Identify three major tasks you will have to complete to reach your six-month milestone
Build and maintain the human capital necessary for AHP to maximise impact with regards to its mission and vision.
Create and maintain repositories of internal and external information and M&E systems to improve the impact of AHP and partners
Create and maintain systems and processes to support customer service and internal human resource needs to maximise impact.
Now think bigger! Identify your 12-month impact milestone
400 foreign qualified doctors recruited for rural hospitals providing improved access to health care to 7,872,503 people
Identify three major tasks you will have to complete to reach your 12-month milestone
Expand online presence to identify and target new sources of foreign health workers for rural hospitals.
Maintain and expand twinning projects to increase foreign qualified doctor placements.
Maximise the use of AHP alumni social networks to source candidates for rural hospitals.
Tell us about your partnerships
FPD provide operational support, assist with strategic decisions and facilitates linkages to donors.
RHI provide insight into the challenges faced by rural hospitals and doctors.
Homecoming Revolution directs health professionals wishing to return to South Africa to AHP.
RuDASA provide strategic guidance and ad hoc support for our doctors.
The Rural Health Advocacy Project serves as a voice to discuss essential rural health issues.
The International Organisation for Migration partner on research and strategic-level initiatives.
Are you currently targeting other specific populations, locations, or markets for your innovation? If so, where and why?
During 2012, AHP plans to expand the Recruitment Programme into Lesotho and Swaziland. AHP assisted with foreign recruitment for these countries in 2010 and both governments have expressed an interest in working with AHP again. The need for nurses and other health workers remains critical in these countries and it is for this reason that AHP plans to re-expand into these regions in 2012.
What type of operating environment and internal organizational factors make your innovation successful?
AHP offers a professional and innovative service to address the shortage of health workers. Our work is characterised by integrity, passion and unity in the delivery of pragmatic solutions to staffing gaps.
Please elaborate on any needs or offers you have mentioned above and/or suggest categories of support that aren't specified within the list
AHP is a non-profit organisation and depends on funding from donors. The organisation bases its work on evidence and places great value on conducting research and sharing information with other organisations. Innovative ideas drive AHP’s operations and as the organisation grows innovation will continue to play an important role.