“Harvest the students before they hatch”

By Dr Anna- Marie Radloff & Dr Gustaaf Wolvaardt

In survey after survey South African companies bewail the shortage of skilled professionals and its detrimental effect on the growth of the economy.

Attracting and retaining highly skilled professionals in a global market is notoriously difficult and if this is a challenge in the private sector it is even more so in the public sector and NGO sector. The ramification of this inability to retain the brightest and the best, for service delivery in the health sector, was amply demonstrated in the recently leaked Development Bank of South Africa survey of the competency of public sector hospital managers. The shocking lack of managerial competency demonstrated in this survey has served as a wakeup call for policy makers to rethink managerial recruitment. This editorial will argue that innovative approaches to recruiting young high potential graduates can help alleviate the scarce skill shortage in the public and not for profit sector.

The PEPFAR Fellowship Programme is an example of an innovative approach that has shown that it is able to recruit and retain highly skilled young professionals in the not-for-profit sector. Established in late 2006 this programme set out to attract master’s degree students and graduates to the HIV/AIDS care sector in South Africa through a one-year structured practical exposure programme. The main focus areas of scarce skills development in this programme is monitoring and evaluation (M&E), project management and therapeutic-related support / clinical mentoring.  The programme recruited newly qualified master’s degree students, employed them on a stipend for a one year period and seconded them to AIDS service programmes. During this period the fellows were exposed to training on project management and M&E, were encouraged to work on specific projects at their employer and were mentored during this period.

The four main objectives of this approach are:
1. to create a gateway to developing operational skills;
2. to facilitate exposure to a network of health care organizations for career opportunities;
3. to provide host organizations access to scarce skills in technical assistance;
4. to facilitate the retention of such developed scarce skills within the South African health care sector.

The “Harvest before Hatch” capacity building method can be defined as directive career path modeling where students and graduates from diverse academic backgrounds are “harvested” from South African universities and developed according to identified areas of scarce skills needs within the South African health care sector. This type of fellowship programme approach is a well-known internationally practiced method for capacity development in newly formed specialized fields of need. It is an ideal method to apply within the South African context where newly qualified master’s graduates are not optimally utilized in the midst of a scarce skills crisis within our health care system^1,2,3,5.

METHODOLOGY

Four years after its inception the programme was reviewed in order to identify the scarce-skills retention rates as an indicator of success. This retrospective, descriptive survey investigated the fellows’ initial career expectations and compared these with their expectations post-exposure^1,3,4. Longer-term career-path-tracking trends were also included in the evaluation profile.

Longer-term career path trends: The majority (64%) of employed alumni have continued their career path development within the monitoring & evaluation health care service provision field.  The remainder of employed alumni have either developed career paths within the research field or advanced to management positions.  Ten percent of alumni chose to remain within a clinical service provision environment where both clinical mentoring and monitoring and evaluation support form part of their work scope.

Table 1: Long term career path trends 2007 to 2010

Pre-Fellowship Career Expectations

• The majority (87%) of placements chose to participate in the programme in order to apply their knowledge gained within the academic environment in the HIV/AIDS sector and to obtain practical skills in project management and monitoring & evaluation.
• The majority of placements (75%) had no or very little operational experience within the HIV/AIDS field related to monitoring and evaluation, project management and basic management of such services.

Post-Fellowship Career Expectations

• The fellowship experience was rated favorably for career fixing and path building towards becoming monitoring & evaluation practitioners in 75% of cases.
• 90% of the respondents indicated that the fellowship placement program did open up career doors for them. Specific comments included that fellows received more job opportunities; the programme exposed fellows to professionals who served as role models and mentors; fellows gained more knowledge, practical skills and capabilities and allowed fellows to compete for job openings.

CONCLUSION

This editorial has often argued that lack of innovation stifles management development in the South African health sector. This study clearly shows that a novel structured one-year postgraduate service-learning experience is a powerful tool for re-directing career paths of newly qualified professionals to scarce-skills work environment within a sector which usually struggles to attract such graduates.  This model can be expanded to any part of the health care sector.  This approach also creates an effective conduit to expose previously disadvantaged students to appropriate potential employers where their skills will be optimally used.

Dr Anna-Marie Radloff, HOD: PEPFAR Fellowship Programme, Foundation for Professional Development

Dr Gustaaf Wolvaardt, Managing Director, Foundation for Professional Development

REFERENCES

1. Corvington PA, Pankaj V. September 2004.  National Hunger Fellows Program Evaluation Report

2. Patrick CL.  Educational Researcher, October 1991; vol 20,7:pp. 29-32. Spencer Postdoc Fellowships Give Young Scholars “A Chance to Look at the Taller Mountains.

3. Brown DJ, DeCorse-Johnson AL.  Policy, Politics, & Nursing Practice, November 2005; vol 6, 4:pp. 331-334. Performance Evaluation for Diversity Programs.

4. Bierer SB, Fishleder AJ.  Evaluation & the Health Professions, December 2004; vol. 27. 4: pp.410-424. Psychometric Properties of an Instrument Designed to Measure the Educational Quality of Graduate Training Programs.

5. Christina A.  American Journal of Evaluation, February 2011. Promoting Diversity in the Field of Evaluation: Reflections on the First Year of the Robert Wood Johnson Foundation Evaluation Fellowship Program.