Questions/Answers

Many rural health care institutions struggle to find professional staff to provide services to the indigent population. Umthombo Youth Development Foundation (UYDF) aims to improve rural health care services at rural district hospitals through the identification and support of young people from around these rural district hospital. School outreach programs and open days at the hospital help raise awareness of career opportunities at the hospital. Selection of students for support is based on provincial priorities and local needs and is done by senior hospital staff members. UYDF provides comprehensive funding at university and a proactive mentoring program. The initiative has expanded from Mosvold hospital to 15 other rural district hospitals. To date over 500 rural students have been supported across 16 health disciplines. 304 + 34 (graduating 2017) health care professionals have graduated and in 2017 we were supporting 243 rural origin students. Graduates have a work back obligation at the hospital where they were chosen. More than 97% of students supported have honored their work back obligation and 57% of those who no longer have a work back obligation continue to work in rural areas

The aim of the initiative is to achieve health for all by the provision of quality health services to rural communities by addressing the shortages of qualified staff at rural hospitals through the identification of youth with interest and potential to study a health science degree who are able to provide transformational leadership and service excellence

This initiative is an innovative partnership between government institutions (hospitals and Provincial Department of Health) to identify and train rural youth who are then able to provide health care services in rural and under served areas. It is an innovation HR initiative. It also improves access to health care to the indigent population, provides training and long term job opportunities to rural students who train as health care professionals, it promotes education and opportunity for women (57% of our students / graduates are women), it contributes to economic transformation for graduates and their families

This initiate improves the delivery of public services by training local staff who come back to rural district hospitals to provide services. Staffing rural hospitals is challenging - in this initiate students who are willing to come back and work (year for year) are supported to obtain a professional qualification. Graduates have also contributed to the development of services (clinical psychology, optometry, dentistry) around the hospitals where they have worked

The focus of this initiate is on improving health care delivery in rural areas. The vehicle for achieving this is the identification and support of rural youth who can be trained to become health care professionals committed to returning to the hospital where they were selected and providing a service to the population around the hospital where they were selected. 304 + 34 (graduating in 2017) graduates have returned to rural hospitals over the last 18 years and have been able to provide services across 16 health professions. In addition a number of new services have been initiated (or strengthened) - such as optometry, clinical psychology and dentistry) as trained staff are now available to provide these services

This initiative has had a positive impact on rural youth who live around the hospitals - these chosen and supported are able to provide role models to others in their community and encourage other young people to work towards the marks that they need to be accepted into training program. In addition the initiative has enable rural hospitals associated with the program to fill posts which are often difficult to fill (pharmacy, radiographer, medical technologist, doctor) and thereby provide services to the communities around the hospital

The initiates identifies rural youth from the hospitals where we are working, allows senior hospital staff to decide who UYDF should support (based on the priorities identified by the Department of Health), provides proactive compulsory mentoring to all students, ensures that all students supported do 3 weeks at the hospital where they were chosen each year. Students supported by UYDF have a 93% pass rate, over 97% of students have met their work back obligation and 57% of graduates continue to work in rural areas after they have completed any work back obligation that they had.

The original idea of supporting rural youth to train to become health care professionals was based on the experiences from Australia and Canada where it has been shown that rural youth are more likely to work in rural areas than urban origin youth. However the package of what we do has been is our innovation.

Currently UYDF employs - a director, a mentor coordinator, a bookkeeper, admin officer and school outreach worker. In addition local mentors are identified at each university where we have students. These local mentors are expected to meet monthly with the students studying at those institutions and to send reports to the mentor supervisor (local mentors receive a stipend). The cost of supporting 243 students in 2018 is anticipated to be R 31 106158 (currently it is anticipated that the government fee support program will contribute R 15 853 513 and the director will raise the balance of the funds needed). However there is uncertainly in SA about the cost of tertiary education as the President Zuma recently announced no fees for students from families earning less than R 350000 / year

Si

The initiative initially started at Mosvold Hospital, Ingwavuma. We now operate in 15 rural district hospitals throughout KwaZulu Natal

This initiative has been in existence since 1999. We have built partnerships with the department of Health to ensure participation of senior hospital staff in the open days to promote careers in health sciences, the selection of students, holiday work at the hospitals and in the filling of posts with students who graduate. In addition significant relationships have been built with the Department of Higher Education to ensure that government funding (NSFAS) is available to partially cover university costs. The director has developed long term relationships with private funders who have supported the initiative over many years.

the initiative has been running over the last 18 years and has grown from supporting 3 students to the 243 students who were supported in 2017

Si

The initiative has been evaluated on a number of occasions 2009 - A review and record of the end-to-end process that constitutes the “coaching infra-structure” at the Friends of Mosvold Scholarship Scheme (FoMSS) 2012 - DG Murray Trust-supported Bursary Programmes: A Comparative Review of Models and Impacts. 2016 - The economic implications of the Umthombo scholarship scheme A PhD based on interviews with graduates resulted in 5 publications relating to this initiative A masters research project led to a publication in 2017 And and publication based on community involvement

All of these reports will be attached Economic benefit of UYDF: A total of 254 graduates were supported by the Umthombo scheme. The total cost of training these graduates was estimated to be R186 million (Table 2). These graduates are expected to generate an estimated R15 billion in lifetime earnings, which would be equal to R4 billion at current prices. The IRR is 63%, much higher than the interest rates on commercial loans, showing that Umthombo is a highly efficient programme. For example, the types of IRR’s that would be considered satisfactory in commercial settings might be 10% for acquisition of a stabilized asset, 15% for acquisition and repositioning of an ailing asset, 20% for development in established area and 35% for development in an unproven area. Umthombo’s IRR is outstanding.

Mentoring processes Comparison between UYDF and other scholarship models Economic benefit

The Provincial department of Health and the management of local hospitals are key stakeholders The local hospital is responsible for promoting careers in health sciences by holding open days at the hospital. In addition the local hospital is involved in selecting students, allowing them to do holiday work at the hospital and in appointing graduates into posts at the hospital when they graduate. The provincial department of health is involved in setting priorities with regards to human resource needs and allowing the hospitals to employ graduates without having to be interviewed. Private stakeholders have funded the initiative and have been involved in aspects of evaluating the initiative

Lessons learnt; Local students can be identified Local students can succeed at university and can qualify as health care professionals Graduates who originated from rural areas will return and work in rural areas Graduates who complete their work back obligations will continue to work in rural areas