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. 2024 May 9;16(1):e1-e11.
doi: 10.4102/phcfm.v16i1.4421.

The role of clinical associates in South Africa as a health workforce: A scoping review

Sanele Ngcobo  1 , Lynn Bust, Ian Couper, Kathryn Chu
Affiliations

The role of clinical associates in South Africa as a health workforce: A scoping review

Sanele Ngcobo et al. Afr J Prim Health Care Fam Med. .

Abstract

Background: 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.

Aim: This study mapped Clin-As' history and practice in South Africa, assessing their roles in the health workforce and offering recommendations.

Methods: 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.

Results: 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.

Conclusion: 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.

Keywords: bachelor of clinical medical practice; clinical associates; clinical officers; district hospitals; human resources for health; mid-level health workers; mid-level medical workers.; physician assistants; physician associates.

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Conflict of interest statement

The authors declare that they have no financial or personal relationship(s) that may have inappropriately influenced them in writing this article.

Figures

FIGURE 1
FIGURE 1
Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flow diagram for the scoping review process.
See this image and copyright information in PMC

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