Evaluation of the alignment of policies and practices for state-sponsored educational initiatives for sustainable health workforce solutions in selected Southern African countries: a protocol, multimethods study
Introduction Health systems across the world are facing challenges with shortages and maldistribution of skilled health professionals. Return-of-service (ROS) initiatives are government-funded strategies used to educate health professionals by contracting beneficiaries to undertake government work o...
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BMJ Publishing Group
2021-04-01
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| Series: | BMJ Open |
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| author | Blake Angell Rohina Joshi Sikhumbuzo Mabunda Andrea Durbach |
| author_facet | Blake Angell Rohina Joshi Sikhumbuzo Mabunda Andrea Durbach |
| author_sort | Blake Angell |
| collection | DOAJ |
| description | Introduction Health systems across the world are facing challenges with shortages and maldistribution of skilled health professionals. Return-of-service (ROS) initiatives are government-funded strategies used to educate health professionals by contracting beneficiaries to undertake government work on a year-for-year basis after their qualification. It is envisaged that once they have served their contract, they will be attracted to serve in the same area or government establishment beyond the duration of their obligatory period. Little is known about the processes that led to the development and implementation of ROS policies. Furthermore, there is no systematic evaluation of the strategies that demonstrate their utility. This research aims to evaluate the ROS initiatives, explore their efficacy and sustainability in five Southern African countries.Methods and analysis This study will be conducted in South Africa, Eswatini, Lesotho, Botswana and Namibia in a phased approach through a multimethods approach of policy reviews, quantitative and qualitative research. First, a review will be conducted to explore current ROS schemes. Second, a quantitative retrospective cohort study of ROS scheme recipients for the period 2000–2010 will be undertaken. Information will be sourced from multiple provincial or national information systems and/or databases. Third, we will conduct semistructured group or individual interviews with senior health, education, ROS managing agency managers (where appropriate) and finance managers and/policy makers in each country to determine managers’ perceptions, challenges and the costs and benefits of these schemes. Fourth, we will interview or conduct group discussions with health professional regulatory bodies to assess their willingness to collaborate with ROS initiative funders.Ethics and dissemination Ethics approval for this study was obtained through the Human Research Ethics Committees of the University of New South Wales (HC200519), Australia; South Africa and Lesotho (065/2020); Eswatini (SHR302/2020); Namibia (SK001); and Botswana (HPDME 13/18/1). Relevant findings will be shared through presentations to participating governments, publications in peer-reviewed journals and presentations at relevant conferences. |
| format | Article |
| id | doaj-art-cf8b93a18b0f43c38a832a176b485060 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2021-04-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-cf8b93a18b0f43c38a832a176b4850602024-11-18T01:50:07ZengBMJ Publishing GroupBMJ Open2044-60552021-04-0111410.1136/bmjopen-2020-046379Evaluation of the alignment of policies and practices for state-sponsored educational initiatives for sustainable health workforce solutions in selected Southern African countries: a protocol, multimethods studyBlake Angell0Rohina Joshi1Sikhumbuzo Mabunda2Andrea Durbach3The George Institute for Global Health, Sydney, New South Wales, AustraliaThe George Institute for Global Health India, New Delhi, IndiaThe George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia3 Law, University of New South Wales—Kensington Campus, Sydney, New South Wales, AustraliaIntroduction Health systems across the world are facing challenges with shortages and maldistribution of skilled health professionals. Return-of-service (ROS) initiatives are government-funded strategies used to educate health professionals by contracting beneficiaries to undertake government work on a year-for-year basis after their qualification. It is envisaged that once they have served their contract, they will be attracted to serve in the same area or government establishment beyond the duration of their obligatory period. Little is known about the processes that led to the development and implementation of ROS policies. Furthermore, there is no systematic evaluation of the strategies that demonstrate their utility. This research aims to evaluate the ROS initiatives, explore their efficacy and sustainability in five Southern African countries.Methods and analysis This study will be conducted in South Africa, Eswatini, Lesotho, Botswana and Namibia in a phased approach through a multimethods approach of policy reviews, quantitative and qualitative research. First, a review will be conducted to explore current ROS schemes. Second, a quantitative retrospective cohort study of ROS scheme recipients for the period 2000–2010 will be undertaken. Information will be sourced from multiple provincial or national information systems and/or databases. Third, we will conduct semistructured group or individual interviews with senior health, education, ROS managing agency managers (where appropriate) and finance managers and/policy makers in each country to determine managers’ perceptions, challenges and the costs and benefits of these schemes. Fourth, we will interview or conduct group discussions with health professional regulatory bodies to assess their willingness to collaborate with ROS initiative funders.Ethics and dissemination Ethics approval for this study was obtained through the Human Research Ethics Committees of the University of New South Wales (HC200519), Australia; South Africa and Lesotho (065/2020); Eswatini (SHR302/2020); Namibia (SK001); and Botswana (HPDME 13/18/1). Relevant findings will be shared through presentations to participating governments, publications in peer-reviewed journals and presentations at relevant conferences.https://bmjopen.bmj.com/content/11/4/e046379.full |
| spellingShingle | Blake Angell Rohina Joshi Sikhumbuzo Mabunda Andrea Durbach Evaluation of the alignment of policies and practices for state-sponsored educational initiatives for sustainable health workforce solutions in selected Southern African countries: a protocol, multimethods study BMJ Open |
| title | Evaluation of the alignment of policies and practices for state-sponsored educational initiatives for sustainable health workforce solutions in selected Southern African countries: a protocol, multimethods study |
| title_full | Evaluation of the alignment of policies and practices for state-sponsored educational initiatives for sustainable health workforce solutions in selected Southern African countries: a protocol, multimethods study |
| title_fullStr | Evaluation of the alignment of policies and practices for state-sponsored educational initiatives for sustainable health workforce solutions in selected Southern African countries: a protocol, multimethods study |
| title_full_unstemmed | Evaluation of the alignment of policies and practices for state-sponsored educational initiatives for sustainable health workforce solutions in selected Southern African countries: a protocol, multimethods study |
| title_short | Evaluation of the alignment of policies and practices for state-sponsored educational initiatives for sustainable health workforce solutions in selected Southern African countries: a protocol, multimethods study |
| title_sort | evaluation of the alignment of policies and practices for state sponsored educational initiatives for sustainable health workforce solutions in selected southern african countries a protocol multimethods study |
| url | https://bmjopen.bmj.com/content/11/4/e046379.full |
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