School of Health Systems and Public Health (SHSPH), Faculty of Health Sciences, University of Pretoria, Pretoria.
S Afr Fam Pract (2004). 2022 Oct 28;64(1):e1-e10. doi: 10.4102/safp.v64i1.5598.
Clinical associates (ClinAs) were introduced into the South African healthcare system to increase the numbers of skilled health professionals. Little is known on how they are viewed. This study explored stakeholder views on the utility and employment strategies of ClinAs in the public sector.
A mixed-methods design was used. An online survey was used to collect data from operational stakeholders, while online interviews explored strategic stakeholders' views.
Forty-five operational stakeholders participated. The view of ClinAs' contribution to the joint management of four common health conditions was strong (91% - 96%). The poorest agreement was their perceived contribution to maternal health (38%). There was a strong agreement (mean = 6.13, s.d.: 0.94) that conditions of ClinAs practice are met. Clinical associates were viewed as being able to work with others (mean = 6.11, s.d.: 0.98) and contribute to service improvement (mean = 6.47, s.d.: 0.62). There was a low agreement regarding the positive impact of recruitment (mean = 2.93, s.d.: 1.99) and retention strategies on ClinAs (mean = 2.75, s.d.: 1.51). The six key strategic stakeholders ascribed the slow progress made in career development, career progression, post creation and professional autonomy to the uncertainty regarding the scope of practice and perceived lack of support.
The utility of ClinAs to provide health services in the public sector is clear, and their contribution is valued. The lack of progress around many of the human resource issues is a constraint that needs a champion if this cadre is to fully realise their potential.Contribution: Clinical associates are valued at service delivery level, but appear overlooked higher up.
临床助理员（ClinAs）被引入南非医疗保健系统，以增加熟练卫生专业人员的数量。目前还不太清楚人们对他们的看法。本研究探讨了利益攸关方对公共部门 ClinAs 的效用和就业策略的看法。
采用混合方法设计。在线调查用于收集运营利益攸关方的数据，而在线访谈则探讨了战略利益攸关方的观点。
有 45 名运营利益攸关方参与。他们认为 ClinAs 对管理四种常见健康状况的共同管理做出了重要贡献（91%-96%）。他们对孕产妇健康的贡献的看法最差（38%）。他们强烈认为（平均值=6.13，标准差：0.94）ClinAs 的实践条件得到了满足。临床助理员被认为能够与他人合作（平均值=6.11，标准差：0.98）并为服务改进做出贡献（平均值=6.47，标准差：0.62）。对于招聘（平均值=2.93，标准差：1.99）和留用策略对 ClinAs 的积极影响（平均值=2.75，标准差：1.51），人们的看法较低。六位主要战略利益攸关方将职业发展、职业晋升、职位创建和专业自主权方面进展缓慢归因于实践范围的不确定性和感知到的缺乏支持。
ClinAs 在公共部门提供卫生服务的效用是明确的，其贡献是有价值的。在许多人力资源问题上缺乏进展是一个限制因素，如果要充分发挥这一干部的潜力，就需要一个拥护者。贡献：临床助理员在服务提供层面上受到重视，但在更高层面上似乎被忽视了。
