Healthcare professional training centres
Healthcare professional training centres
Business Model Description
Deliver private health care training centres for mid-level health workers, such as radiographers, social workers, emergency service workers, community health workers and nurses.
Expected Impact
Help address the need for healthcare practitioners in the country, contributing to a better healthcare situation.
How is this information gathered?
Investment opportunities with potential to contribute to sustainable development are based on country-level SDG Investor Maps.
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Country & Regions
- South Africa: Gauteng
- South Africa: Western Cape
- South Africa: KwaZulu-Natal
Sector Classification
Health Care
Development need
South Africa has made notable progress on multiple aspects of SDG 3 - Good Health and Wellbeing, but major challenges still remain to achieve the goal by 2030.(2)
Policy priority
The National Development Plan (NDP) aims to achieve healthcare so everyone has access to an equal standard of care regardless of income.(4) The government has committed to increasing health expenditure.(3) The NDP also outlines a national health insurance system that ensures all citizens have access essential healthcare, improves the quality of public healthcare and lowers the relative cost of private healthcare.(3) Other key areas include recruiting more professionals in the public and private sectors, improving healthcare systems and providing HIV/AIDS healthcare.
Gender inequalities and marginalization issues
COVID-19 lockdowns and restricted access to health services have directly affect women's health, particularly maternal health, unintended pregnancies, and women with chronic illnesses especially HIV/AIDS.(31)
Investment opportunities introduction
Despite progress towards achieving SDG 3, there is a significant need for private sector investment to achieve equitable access to healthcare in South Africa. This need has been illuminated by COVID-19.
Key bottlenecks introduction
Progress is still overshadowed by the inequities caused by the previous regime. Universal health coverage, value for money and funding requirements remain significant challenges.(3)
Health Care Providers
Development need
There is a very high degree of inequality in the South African healthcare sector, where 16% of the population access private healthcare and 84% are served by the public sector.(1) By 2030, the health system should provide quality care for all, but the public health system cannot meet demand.(2)
Gender inequalities and marginalization issues
COVID-19 has disrupted access to healthcare for contraception and maternal care, routine programs (HIV, tuberculosis) and sanitary dignity programs for teenage girls. Constraints in medicine supply and immunization services disproportionately affect women.(31)
Investment opportunities introduction
Increasing the contributions of mid-level health workers to healthcare will require significant new investment in their training, including trainers and facilities.(21),(24)
Health Care Delivery
Pipeline Opportunity
Healthcare professional training centres
Deliver private health care training centres for mid-level health workers, such as radiographers, social workers, emergency service workers, community health workers and nurses.
Business Case
Market Size and Environment
Shortage of 2,000 doctors and 11,000 nurses; additional 12,000 healthcare workers needed due to COVID-19.
South Africa recorded a shortage of 2,000 doctors and 11,000 nurses in 2020.(8) And an additional 12,000 healthcare workers are needed due to the pandemic.(20) There is a major gap in private healthcare (colleges) that train healthcare workers (such as radiographers, social workers, emergency service workers, nurses etc.) in South Africa.(7)
South Africa will have a shortage of more than 2,000 doctors and 11,000 nurses in 2020.(8) An additional 12,000 healthcare workers are needed to fight coronavirus.(20)
Indicative Return
> 25%
Analysis shows training facilities for healthcare professionals in South Africa are expected to generate an internal rate of return (IRR) of 63%.(10)
Investment Timeframe
Medium Term (5–10 years)
The investment timeframe is expected to be 5-10 years, based on studied benchmark projects.
Ticket Size
USD 1 million - USD 10 million
Market Risks & Scale Obstacles
Market - Highly Regulated
Impact Case
Sustainable Development Need
South Africa has a critical shortage of healthcare professionals (nurses, doctors, emergency service workers and social workers.(9),(11) Getting access to medical training in South Africa is nearly impossible for many South Africans.(9)
South Africa has a major gap for private healthcare colleges that train mid-level health workers such as radiographers, social workers, emergency service workers, community health workers and nurses.(7)
Increasing the contributions of mid-level health workers to healthcare will require significant new investment in their training, including trainers and facilities.(21),(24)
Gender & Marginalisation
COVID-19 lockdowns and restricted access to health services have directly affect women's health, particularly maternal health, unintended pregnancies, and women with chronic illnesses especially HIV/AIDS.(31)
Expected Development Outcome
Decreased human resource shortages and improved health care access and equity; reduced healthcare disparities (more trained staff to work in rural clinics); increased access to healthcare training (for radiographers, social workers, emergency service workers, nurses etc.) in South Africa
Increased opportunities for training and support of healthcare workers to improve the quality of care; increased job creation; improved skills development; increased empowerment opportunities for women; contributions to regional health education; public-private partnerships established with government hospitals and clinics to improve customer care delivery through affordable quality training
Investing in healthcare training initiatives (private healthcare colleges) can directly address the need for healthcare practitioners in the country.
Gender & Marginalisation
Improve women's access to healthcare services and create new employment for women in the industry (female nurses and community healthcare staff represent 77% of health workers)
Primary SDGs addressed
3.c.1 Health worker density and distribution
While the government has increased the subsidized training of health professionals, it is difficult to retain trained staff in the public sector health services, especially at senior levels.(3)
South Africa introduced Occupational Specific Dispensation (OSD) for health professionals in the public sector to overcome this challenge. The government is also devoting resources to developing improved healthcare practices.(3)
Secondary SDGs addressed
Directly impacted stakeholders
People
Indirectly impacted stakeholders
People
Outcome Risks
Potential differences in quality of training (especially practical) between private streams (that are trained in better equipped hospitals and typically feed private sector needs) and public streams (less well equipped) may reinforce observed inequality regarding quality of care between private and public sector healthcare.(5)
Impact Risks
Unexpected impact risk through different levels of quality in training provision
Impact Classification
What
Training and skills development for healthcare practitioners
Risk
Low risk
Impact Thesis
Help address the need for healthcare practitioners in the country, contributing to a better healthcare situation.
Enabling Environment
Policy Environment
The South African government has a constitutional mandate to provide quality healthcare services to its citizens.(17)
Human Resource Strategy for the Health Sector (2012/13 – 2016/17): This strategy deals with the supply of health professionals and equity of access to education and training. It also deals with increasing human resources in the health system (including increasing the capacity of training facilities for various health professionals).(12)
Health Professions Council of South Africa: This council guides and regulates the health professions in terms of registration, education and training, professional conduct and ethical behaviour, ensuring continuing professional development, and fostering compliance with healthcare standards.(19)
Financial Environment
Financial incentives: The Infrastructure and Efficiency Grant could address infrastructural needs. The Clinical Training Grant should continue to advance quality clinical training, specifically human resources and operational aspects. The imminent allocation of the Health Professional Training and Development Grant to universities provides an opportunity to renegotiate joint health education and services agreements with their teaching platforms and staff establishments.(25)
Regulatory Environment
National Health Act of 2003: The Department of Health (DoH) derives its mandate from the National Health Act of 2003, which requires the department to provide a framework for a structured and uniform health system for South Africa.(23)
Section 61 (1) of the Health Professions Act 1974 (Act No.56 of 1974): This Act, in consultation with the Health Professions Council of South Africa, sets the regulations relating to registration, education and training, professional conduct and ethical behaviour of South African healthcare workers.
Health Professions Act Regulations: These regulations relate to registration and training of medical interns.(23)
South African Nursing Council: This body sets and maintains standards of nursing education and practice in South Africa.(22)
Marketplace Participants
Private Sector
Netcare, Life Healthcare, Netcare Education, RH Bophelo, Technical and Vocational Education and Training (TVET) colleges
Government
Sector Education and Training Authorities (SETAs)
Non-Profit
Umthombo Youth Development Foundation (UYDF), Youth Employment Service (YES) initiative
Target Locations
South Africa: Gauteng
South Africa: Western Cape
South Africa: KwaZulu-Natal
References
- (1) Statistics South Africa (2019). Sustainable Development Goals: Country Report 2019 - South Africa. http://www.statssa.gov.za/MDG/SDGs_Country_Report_2019_South_Africa.pdf
- (2) Sachs, J., Schmidt-Traub, G., Kroll, C., Lafortune, G., Fuller, G. and Woelm, F. (2020). The Sustainable Development Goals and Covid-19. Sustainable Development Report. Cambridge University Press. https://dashboards.sdgindex.org/#/ZAF
- (3) South African Government (2019). South Africa Voluntary National Review: Empowering people and ensuring inclusiveness and equality. https://sustainabledevelopment.un.org/content/documents/23402RSA_Voluntary_National_Review_Report___The_Final_24_July_2019.pdf
- (4) National Planning Commission (2011). National Development Plan 2030; Our future - make it work. https://www.gov.za/sites/default/files/gcis_document/201409/ndp-2030-our-future-make-it-workr.pdf
- (5) Africa Health (2020). Industry Insights: South Africa Healthcare Market Overview. https://www.africahealthexhibition.com/content/dam/Informa/africahealthexhibition/en/2020/pdf/AFH19_Industry_Insights-SA_MARKET_REPORT.pdf
- (6) Mapham, W. (2020). Interview with UCT GSB Bertha Centre for Social Innovation and Entrepreneurship.
- (7) Interview with Lee Wallis, Western Cape Government, 28 July 2020.
- (8) Boitekanelo College (2020). Our history. http://www.boitekanelo.ac.bw/OurHistory.aspx
- (9) Democratic Alliance (2018). South Africa must prioritise medical skills development. https://www.da.org.za/2018/03/south-africa-must-prioritise-medical-skills-development/
- (10) MacGregor, R.G., Zihindula, G., Chola, L. and Ross, A.J. (2020). 'The training of healthcare professionals: An expense or an investment?', South African Medical Journal, 110(5):369-373. http://www.samj.org.za/index.php/samj/article/view/12923
- (11) Business Day (2020). Private hospitals appeal to nursing council to let them train more nurses. https://www.businesslive.co.za/bd/national/health/2019-10-23-private-hospitals-appeal-to-nursing-council-to-let-them-train-more-nurses/
- (12) Western Cape Department of Health (2014). Healthcare 2030 Strategic Plan. https://www.westerncape.gov.za/news/healthcare-2030-future-health-service-western-cape
- (13) Department of Health. Green Paper on the National Health Insurance (NHI). https://static.pmg.org.za/docs/110812nhi_0.pdf
- (14) Interview with Peter Benjamin, HealthEnabled 21 July 2020.
- (15) van Niekark, L. and Bonnici, F. (2014). Insights 2014: How healthcare in Africa can be re-imagined. https://www.gsb.uct.ac.za/Downloads/Bertha_IHI_Insights_Report.pdf
- (16) Africa Health (2020). Healthcare Market Insights for South Africa. https://www.africahealthexhibition.com/content/dam/Informa/africahealthexhibition/en/2020/pdf/AFH20_Industry_Insights_Healthcare_Market_South-Africa.pdf
- (17) RH Bophelo (2017). A glimpse into the South African healthcare industry. https://www.rhbophelo.co.za/understand-the-south-african-healthcare-industry/
- (18) Department of Health. National Digital Health Strategy for South Africa 2019 - 2024. https://www.bhfglobal.com/wp-content/uploads/downloads/news/national%20digital%20health%20strategy%20for%20south%20africa%202019-2024a.pdf
- (19) Health Professions Council of South Africa (2020). Health Professions Council of South Africa. https://www.hpcsa.co.za/
- (20) Mahlati, Z. (2020). An additional 12 000 healthcare workers needed to fight coronavirus - Ramaphosa. https://www.iol.co.za/news/politics/an-additional-12-000-healthcare-workers-needed-to-fight-coronavirus-ramaphosa-50892758
- (21) Couper, I., Sunanda, R., Blaauw, D. et al (2018). 'Curriculum and training needs of mid-level health workers in Africa: a situational review from Kenya, Nigeria, South Africa and Uganda', BMC Health Services Research, 18. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-018-3362-9
- (22) South African Nursing Council (2020). South African Nursing Council. https://www.sanc.co.za/
- (23) Department of Health (2020). Department of Health. Government of South Africa. https://www.gov.za/about-sa/health
- (24) Dovlo D. (2004). 'Using mid-level cadres as substitutes for internationally mobile health professionals in Africa', Human Resources for Health, 2(1):7. https://pubmed.ncbi.nlm.nih.gov/15207010/
- (25) Essack, S.Y. (2012). 'Models for increasing the health workforce', South African Medical Journal, 102(11). http://www.samj.org.za/index.php/samj/article/view/5779/4757
- (26) South African Medical Research Council (2018). Investment case for community health workers in South Africa. https://www.samrc.ac.za/sites/default/files/files/2017-10-30/SavingLivesSavingCosts.pdf
- (27) Council on Higher Education and South African Nursing Council (2019). Notice to all nursing education institutions on collaboration between the CHE and SANC. https://www.sanc.co.za/wp-content/uploads/2020/08/Collaboration-between-the-Council-on-Higher-Education-and-the-South-African-Nursing-Council.pdf
- (28) Kgosana, R. (2019). South African Nursing Council, health department need to align to resolve training crisis. https://citizen.co.za/news/south-africa/health/2125633/south-african-nursing-council-health-department-need-to-align-to-resolve-training-crisis-solidarity/
- (29) Business Day (2019). Private hospitals appeal to nursing council to let them train more nurses. https://www.businesslive.co.za/bd/national/health/2019-10-23-private-hospitals-appeal-to-nursing-council-to-let-them-train-more-nurses/
- (30) Educonnect (2018). Nursing in South Africa. https://educonnect.co.za/nursing-in-south-africa/
- (31) United Nations Development Programme (2020). South Africa Report 2020: Covid-19 Rapid Emergency Needs Assessment for the Most Vulnerable Groups. https://www.za.undp.org/content/south_africa/en/home/library/rapid-emergency-needs-assessment.html