Health Promotion Workforce in South Africa: Direction from the Australian Health Promotion Association

Abstract

Background: South Africa's progress towards forming a health promotion workforce lags behind the health promotion career opportunities and professional standards guided by the Australian Health Promotion Association (AHPA), from which South Africa can learn valuable lessons.

Problem statement: Despite the existence of a national health promotion strategy, inconsistencies in health promotion workforce standards are a national reality. In one of the 10 National Health Insurance pilot districts in South Africa, researchers investigated health care workers' experiences of the barriers and enablers for the health promotion workforce.

Methodology: A qualitative explorative descriptive design was used. Health care workers (health promoters, n = 8; operational managers, n = 6; senior managers, n = 3) in Dr Kenneth Kaunda District's public health sector were sampled using purposive proportional quota sampling. Data were gathered through semi-structured individual interviews until data saturation was reached (N = 17). Transcribed interviews were thematically analysed, supported by ATLAS.ti 8.

Results: Five themes and thirteen sub-themes emerged, and barriers to the health promotion workforce exceeded enablers. Health promotion workforce structure and policies were deficient. Managerial supervision and monitoring were lacking. The health promotion workforce received insufficient resources with limited implementation of health promotion programs. Formal and informal health promotion training was necessary.

Recommendations: The AHPA's proposed Health Promotion Workforce model is considered, focusing on a clear workforce structure, strengthened by managerial buy-in and efficient monitoring and evaluation. Formal and informal health promotion training and advocacy of the health promotion workforce industry are highlighted. Countries with emerging economies and similar health systems to South Africa might find this article useful.

Keywords: AHPA; Australian Health Promotion Association; barriers; enablers; health promotion workforce.