Research Focus Areas

A health labour market is a dynamic system that consists of two independent, yet related economic forces: the supply of health workers and the demand for such workers. A health labour market is influenced by a country¡¯s institutions, regulations and socio-economic circumstances (McPake et al. 2013): p 842. 

There is a dearth of research on the health labour market in low- and middle-income countries, particularly in sub-Saharan Africa. 

The health labour market research aims to:

• Investigate the career choices and job location decisions of several cohorts of Wits health professional graduates over a period of time (WiSDOM).
• Analyse the factors that cause or contribute to the mal-distribution of health workers between: rural and urban areas, the public and private health sectors; and primary health care and hospital services.
• Examine migration of health professionals, and the determinants of such movement.
• Conduct a comparative analysis of the compensation (salaries and benefits) of health professionals in South Africa, and between South Africa and countries with a similar level of income.

Around the world, there is increasing scholarly attention on the relationships among universal health coverage, leadership, management and governance, and the health workforce (Milicevic, Vasic and Edwards 2015; National Department of Health. 2013; WHO. 2006; WHO. 2012). The World Health Organization (WHO) defines governance as “the existence of strategic policy frameworks combined with effective oversight, coalition building, regulation, attention to systems design, and accountability” (World Health Organisation 2007):p 8. However, governance means different things to different people, and more empirical research is needed to contribute to conceptual clarity and evidence on the impact of governance on the performance of the health system and/or population health outcomes. 

The research on health workforce governance aims to:

• Investigate the relationships among primary health care facility management and governance, health worker practice environment, health workforce outcomes, and the quality of patient care.
• Examine the factors that influence the accountability of health professionals in psychiatric hospitals in Gauteng.
  
• Explore the leadership and governance of community health workers.
• Evaluate the implementation of South Africa’s 2030 Human Resources for Health Strategy.

Universal health coverage cannot be achieved without a well- performing health workforce. The 2006 World Health Report defines performance in terms of availability, competence, responsiveness, and productivity (WHO 2006). There are many potential negative consequences of poor or sub-optimal performance of health professionals. These include lack of or poor access to health care services, inappropriate or sub-optimal quality of care and lack of responsiveness to community needs. 

Worldwide, research on the performance of the health workforce has received insufficient priority, but is critical in order to address patient and population health priorities and to improve health system performance (Global Health Workforce Alliance and WHO 2013). 

The aims of the research on health workforce performance and accountability are to:

• Explore ethical dilemmas and moral distress of frontline health professionals during the COVID-19 pandemic. 
• Examine multiple jobholding among doctors, professional nurses and rehabilitation therapists in Gauteng and Mpumalanga provinces.
• Investigate the professional quality of life of health professionals in the public sector.
• Determine the extent of, and factors that influence, absenteeism among health professionals in South Africa’s public health sector.
• Examine general practitioner contracting in the proposed National Health Insurance System.