Department of Family Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria.
Afr J Prim Health Care Fam Med. 2024 May 9;16(1):e1-e11. doi: 10.4102/phcfm.v16i1.4421.
South Africa's health care system grapples with persistent challenges, including health care provider shortages and disparities in distribution. In response, the government introduced clinical associates (Clin-As) as a novel category of health care providers.
This study mapped Clin-As' history and practice in South Africa, assessing their roles in the health workforce and offering recommendations.
Following the framework outlined by Arksey and O'Malley, we conducted a comprehensive literature search from January 2001 to November 2021, utilising PubMed, Scopus and EBSCOhost databases. One thousand six hundred and seventy-two articles were identified and then refined to 36 through title, abstract and full-text screening.
Strengths of the Clin-A cadre included addressing rural workforce shortages and offering cost-effective health care in rural areas. Challenges to the success of the cadre included stakeholder resistance, rapid implementation, scope of practice ambiguity, inadequate supervision, unclear roles, limited Department of Health (NDoH) support, funding deficits, Clin-As' perceived underpayment and overwork, degree recognition issues, inadequate medical student training on Clin-A roles, vague career paths and uneven provincial participation.
As a health care provider cadre, Clin-As have been welcomed by multiple stakeholders and could potentially be a valuable resource for South Africa's health care system, but they face substantial challenges. Realising their full potential necessitates enhanced engagement, improved implementation strategies and precise scope definition.Contribution: This study acknowledges Clin-As in SA as a promising solution to health care workforce shortages but highlights challenges such as stakeholder resistance, insufficient NDoH support and unclear policies, emphasising the need for comprehensive efforts to maximise their potential.
南非的医疗保健系统面临着持续存在的挑战，包括医疗保健提供者短缺和分布不均。为了解决这些问题，政府引入了临床助理（Clin-As）作为一种新型医疗保健提供者。
本研究绘制了南非 Clin-As 的历史和实践情况，评估了他们在卫生劳动力中的角色，并提出了建议。
根据 Arksey 和 O'Malley 概述的框架，我们从 2001 年 1 月到 2021 年 11 月进行了全面的文献搜索，使用了 PubMed、Scopus 和 EBSCOhost 数据库。确定了 1672 篇文章，然后通过标题、摘要和全文筛选将其精炼至 36 篇。
Clin-A 干部的优势包括解决农村劳动力短缺问题，并在农村地区提供具有成本效益的医疗保健。该干部面临的挑战包括利益相关者的抵制、快速实施、实践范围不明确、监督不足、角色不明确、卫生部门（NDoH）支持不足、资金短缺、Clin-As 认为报酬过低和工作过度、学位认可问题、临床助理学生培训不足、职业道路模糊以及省级参与不均等。
作为医疗保健提供者干部，Clin-As 受到了多方利益相关者的欢迎，有可能成为南非医疗保健系统的宝贵资源，但他们面临着巨大的挑战。要充分发挥他们的潜力，需要加强参与、改进实施策略和精确界定范围。
本研究承认 Clin-As 在南非是解决医疗保健劳动力短缺的有希望的解决方案，但强调了利益相关者的抵制、NDoH 支持不足和政策不明确等挑战，强调需要做出全面努力，以最大限度地发挥其潜力。
