The Role of Communities in the Recruitment and Retention Process of Medical Doctors for Rural South Africa

Abstract

The purpose of this research study is to explore the variables that contribute to improving the process of recruiting and retaining rural doctors within the South African context. The aim is to explore rural doctors’ perceptions of the role which the rural community can and ought to play in respect of the latter process. A basic recognition is that the emphasis on the Mainstream Approach (which elevates health workforce planning and management as well as market-related interventions and solutions) cannot exclusively achieve the desired result of effective and efficient recruitment and retention of rural doctors. The ‘active’ role which communities can and ought to play in the recruitment/ retention process, is an overlooked and neglected aspect within the South African research and healthcare service-delivery context. Even though the notion of collaborative management and governance of human resources within the health sector is generally mandated from a policy and legislative perspective, the practical manifestation and implementation thereof remain limited or at best piece-meal. An alternative governance model with reference to the humanresources-in-health system outlines the Partnership Approach advocating the need for the establishment of practical working relationships, amongst an identified range of multiple-stakeholders. This study examines the notions of ‘passive’ vis-à-vis ‘active’ community participation equated to the Utilitarian and Community Empowerment/ Development Perspectives continuum. The study introduces the ‘Principle of Balancing Model’ as well as the notion of a ‘hybrid perspective’ as key underpinnings of an efficacious rural-doctor recruitment and retention process