Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Human Resources for Health
Published in: Human Resources for Health 1/2021

Open Access 01-12-2021 | Research

Reflecting on the current scenario and forecasting the future demand for medical doctors in South Africa up to 2030: towards equal representation of women

Authors: Ritika Tiwari, Angelique Wildschut-February, Lungiswa Nkonki, René English, Innocent Karangwa, Usuf Chikte

Published in: Human Resources for Health | Issue 1/2021

Login to get access

Abstract

Background

Increasing feminization of medical professions is well-acknowledged. However, this does not always equate to equitable representation of women within medicine, regarding their socio-demographic indicators, regions, sectors and fields of practice. Thus, this paper quantifies the gap in supply of female medical doctors in relation to demand, towards reaching different gender equity scenarios.

Methods

A retrospective review of the Health Professions Council of South Africa’s (HPCSA) database on registered medical doctors (medical practitioners and medical specialists) from 2002 until 2019 was utilized as an indicator of supply. Descriptive statistics were used to summarize data, and inferential statistics (considering a significance level of 0.05) were utilized to determine the association between the number of male and female doctors, disaggregated by demographic variables. We forecasted future gaps of South African male and female doctors up to 2030, based on maintaining the current male-to-female ratio and attaining an equitable ratio of 1:1.

Results

While the ratio of female doctors per 10 000 population has increased between 2000 and 2019, from 1.2 to 3.2, it remains substantially lower than the comparative rate for male doctors per 10 000 population which increased from 3.5 in 2000 to 4.7 in 2019. Men continue to dominate the medical profession in 2019, representing 59.4% (27,579) of medical doctors registered with the HPCSA with females representing 40.6% (18,841), resulting in a male-to-female ratio of 1:0.7. Female doctors from the Black population group have constantly grown in the medical workforce from 4.4% (2000), to 12.5% (2019). There would be a deficit of 2242 female doctors by 2030 to achieve a 1:1 ratio between male and female medical doctors. An independent-samples t-test revealed that there was a significant difference in the number of male and female doctors. The Kruskal–Wallis test indicated that there was a sustained significant difference in terms of the number of male and female doctors by population groups and geographical distribution.

Conclusions

Based on the investigation, we propose that HRH planning incorporate forecasting methodologies towards reaching gender equity targets to inform planning for production of healthcare workers.
Appendix
Available only for authorised users
Footnotes
1
As noted in the introduction to the African National Congress’ (ANC) 1994 National Health Plan (ANC, 1994): “the South African government, through its apartheid policies, developed a health-care system which was sustained through the years by the promulgation of racist legislation and the creation of institutions such as political and statutory bodies for the control of the health-care professions and facilities. These institutions and facilities were built and managed with the specific aim of sustaining racial segregation and discrimination in health care”.
 
2
The paper uses both the terms gender equity and equality as both are relevant to the discussion. Gender equity refers to “fairness of treatment for women and men, according to their respective needs. This may include equal treatment or treatment that is different but which is considered equivalent in terms of rights, benefits, obligations and opportunities”, while gender equality would refer to equal outcomes for men and women.
 
3
In this paper, we have used the term population along the lines of the Population Registration Act (Act No. 30 of 1950) which classified South African citizens into four major population groups namely ‘White’, ‘Coloured’ ‘Indian’, ‘Chinese’ and ‘Black’ based on the colour of their skin (14). Although the legislation on race was repealed in 1991, in some instances it is still required to report along these categories in different sectors across government.
 
4
The limitation of this approach is the difficulties in an exact quantification of the attrition of medical doctors between graduation and practice.
 
5
Intersectionality suggests that various socially and culturally constructed categories of discrimination
interact on multiple and often simultaneous levels, contributing to varying degrees of social inequality. For example, although women as a group may be discriminated against and have less power than men
within a specific context, within a group of women, Black women are likely to be more disadvantaged and
have less power within that context.
 
Literature
1.
Walker L. ‘Since male doctors were pushing us aside, we had to elbow our way through’’. A history of the South African Society of Medical Women.’ South Afr Med J. 1997;87(11):1505–7.
2.
African National Congress. A national health plan for South Africa. 1994.
3.
Department of Health SA. White paper for the transformation of the health system in South Africa. 1997.
4.
Hall E, Erasmus J. Medical practitioners and nurses. 2015.
5.
Mayosi BM. The first black doctors and their influence in South Africa. South Afr Med J. 2015;105(8):635–6.CrossRef
6.
7.
Birch S, Kephart G, Tomblin-Murphy G, O’Brien-Pallas L, Alder R, MacKenzie A. Health human resources planning and the production of health: development of an extended analytical framework for needs-based health human resources planning. A program for research on social and economic dimensions of an aging population. Ontario: SEDAP Research Paper No. 168; 2007. Hamilton; 2007.
8.
Scheffler RM, Liu JX, Kinfu Y, Dal Poz MR. Forecasting the global shortage of physicians: an economic-and needs-based approach. Bull World Health Organ. 2008;86:516–23.CrossRef
9.
IBM Corp. IBM SPSS Statistics for Windows, Version 22.0 Armonk, NY: IBM Corp; Released 2013.
10.
11.
Tiwari R, Negandhi H, Zodpey S. Forecasting the future need and gaps in requirements for public health professionals in India up to 2026. WHO South-East Asia J Public Health. 2019;8(1):56.CrossRef
12.
13.
Ostertagova E, Ostertag O. Forecasting using simple exponential smoothing method. Acta Electrotechnica et Informatica. 2012;12(3):62.CrossRef
14.
Johnson LF, May MT, Dorrington RE, Cornell M, Boulle A, Egger M, et al. Estimating the impact of antiretroviral treatment on adult mortality trends in South Africa: A mathematical modelling study. PLoS medicine. 2017;14(12).
15.
16.
The Labour Court of South Africa, in Johannesburg Judgment, (2014).
17.
Wildschut AC. A feminist investigation into the reasons for attrition of women doctors from the South African medical profession and practice: Exploring the case of UCT medical school between 1996 and 2005: Stellenbosch: University of Stellenbosch; 2011.
18.
19.
Africa SS. Quarterly Labour Force Survey Quarter. 2016;4:2015.
20.
Reporter S. Mythbusting: Are South Africans hard workers? Business Tech. 2016;2016:15.
21.
Colleges AoAM. Physician specialty data report. 2016.
22.
23.
Karan A, Negandhi H, Nair R, Sharma A, Tiwari R, Zodpey S. Size, composition and distribution of human resource for health in India: new estimates using National Sample Survey and Registry data. BMJ open. 2019;9(4):e025979.CrossRef
24.
Roter DL, Hall JA, Aoki Y. Physician gender effects in medical communication: a meta-analytic review. JAMA. 2002;288(6):756–64.CrossRef
25.
Frank E, Zhao Z, Sen S, Guille C. Gender disparities in work and parental status among early career physicians. JAMA Netw Open. 2019;2(8):e198340.CrossRef
26.
Talib Z, Barry M. Women leaders in global health. Lancet Global Health. 2017;5(6):e565–6.CrossRef
27.
Beaman L, Duflo E, Pande R, Topalova P. Female leadership raises aspirations and educational attainment for girls: a policy experiment in India. Science. 2012;335(6068):582–6.CrossRef
28.
World Health Organization. The World Health Report 2006: working together for health: World Health Organization; 2006.
29.
Scheffler RM, Campbell J, Cometto G, Maeda A, Liu J, Bruckner TA, et al. Forecasting imbalances in the global health labor market and devising policy responses. Human resources for health. 2018;16(1):5.CrossRef
30.
United Nations. The Sustainable Development Goals Report 2019. New York. 2019.
Metadata
Title
Reflecting on the current scenario and forecasting the future demand for medical doctors in South Africa up to 2030: towards equal representation of women
Authors
Ritika Tiwari
Angelique Wildschut-February
Lungiswa Nkonki
René English
Innocent Karangwa
Usuf Chikte
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Human Resources for Health / Issue 1/2021
Electronic ISSN: 1478-4491
DOI
https://doi.org/10.1186/s12960-021-00567-2

Other articles of this Issue 1/2021

Human Resources for Health 1/2021 Go to the issue

Research

Diversifying the health workforce: a mixed methods analysis of an employment integration strategy

Research

Variations in regulations to control standards for training and licensing of physicians: a multi-country comparison

Research

Evaluating the association of state regulation of community health workers on adoption of standard roles, skills, and qualities by employers in select states: a mixed methods study

Research

Increasing doctors working in specific rural regions through selection from and training in the same region: national evidence from Australia

Review

Educational needs of medical practitioners about medical billing: a scoping review of the literature

Case study

Development of accreditation standards for interprofessional education: a Canadian Case Study