Original Research

Retention of medical officers in the district health services of the Western Cape, South Africa: An exploratory descriptive qualitative study

Robert J. Mash, Werner Viljoen, Steve Swartz, Mumtaz Abbas, Leigh Wagner, Herma Steyn, Gavin Hendricks, Dusica Stapar, Andrew Williams, Adeloye Adeniji, Johan Schoevers, Paul Kapp
South African Family Practice | Vol 64, No 1 : Part 2| a5467 | DOI: https://doi.org/10.4102/safp.v64i1.5467 | © 2022 Bob J. Mash | This work is licensed under CC Attribution 4.0
Submitted: 03 December 2021 | Published: 10 May 2022

About the author(s)

Robert J. Mash, Division of Family Medicine and Primary Care, Stellenbosch University, Cape Town, South Africa
Werner Viljoen, Division of Family Medicine and Primary Care, Stellenbosch University, Cape Town, South Africa; and, Metro Health Services, Western Cape Government, Cape Town, South Africa
Steve Swartz, Division of Family Medicine and Primary Care, Stellenbosch University, Cape Town, South Africa; and, Metro Health Services, Western Cape Government, Cape Town, South Africa
Mumtaz Abbas, Division of Family Medicine and Primary Care, Stellenbosch University, Cape Town, South Africa; and, Metro Health Services, Western Cape Government, Cape Town, South Africa
Leigh Wagner, Division of Family Medicine and Primary Care, Stellenbosch University, Cape Town, South Africa; and, Metro Health Services, Western Cape Government, Cape Town, South Africa
Herma Steyn, Division of Family Medicine and Primary Care, Stellenbosch University, Cape Town, South Africa; and, Rural Health Services, Western Cape Government, Cape Town, South Africa
Gavin Hendricks, Division of Family Medicine and Primary Care, Stellenbosch University, Cape Town, South Africa; and, Rural Health Services, Western Cape Government, Cape Town, South Africa
Dusica Stapar, Division of Family Medicine and Primary Care, Stellenbosch University, Cape Town, South Africa; and, Metro Health Services, Western Cape Government, Cape Town, South Africa
Andrew Williams, Division of Family Medicine and Primary Care, Stellenbosch University, Cape Town, South Africa; and, Rural Health Services, Western Cape Government, Cape Town, South Africa
Adeloye Adeniji, Division of Family Medicine and Primary Care, Stellenbosch University, Cape Town, South Africa; and, Rural Health Services, Western Cape Government, Cape Town, South Africa
Johan Schoevers, Division of Family Medicine and Primary Care, Stellenbosch University, Cape Town, South Africa; and, Rural Health Services, Western Cape Government, Cape Town, South Africa
Paul Kapp, Division of Family Medicine and Primary Care, Stellenbosch University, Cape Town, South Africa; and, Rural Health Services, Western Cape Government, Cape Town, South Africa

Abstract

Background: An adequate health workforce is an essential building block of effective health systems. In South Africa, medical officers (MOs) are a key component of service delivery in district health services. The Stellenbosch University Family Physician Research Network in the Western Cape identified that retention of MOs was a key issue. The aim of this study was to explore the factors that influence the retention of MOs in public sector district health services in the Western Cape, South Africa.

Methods: This is a descriptive exploratory qualitative study. Medical officers were purposefully selected in terms of districts, facility types, gender, seniority and perceived likelihood of leaving in the next four years. Semi-structured interviews were performed by family physicians, and the qualitative data were analysed using the framework method.

Results: Fourteen MOs were interviewed, and four major themes were identified: career intentions; experience of clinical work; experience of the organisation; and personal, family and community issues. Key issues that influenced retention were: ensure that the foundational elements are in place (e.g. adequate salary and good infrastructure), nurture cohesive team dynamics and relationships, have a family physician, continue the shift towards more collaborative and appreciative management styles, create stronger career pathways and opportunities for professional development in the district health services, be open to flexible working hours and overtime, and ensure workload is manageable.

Conclusion: A number of important factors influencing retention were identified. Leaders and managers of the healthcare services could intervene across these multiple factors to enhance the conditions needed to retain MOs.


Keywords

district health services; district hospitals; primary healthcare; primary care; retention; workforce; medical officers; family physicians; staff satisfaction

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