Identifying the strengths, weaknesses, opportunities and threats (SWOT) of return-of-service bursary schemes for health workforce capacity: a qualitative study of Botswana, Lesotho and Eswatini
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Summary
This summary is machine-generated.Return-of-service (RoS) schemes in Botswana, Eswatini, and Lesotho aim to strengthen health workforces but face challenges. Poor planning, outdated policies, and lack of evaluation threaten their sustainability and effectiveness.
Area Of Science
- Health Workforce Development
- Public Policy Analysis
- International Health
Background
- Return-of-service (RoS) schemes are utilized by Botswana, Eswatini, and Lesotho to bolster their health workforces.
- These programs offer bursaries in exchange for future service commitments.
Purpose Of The Study
- To conduct a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis of RoS schemes in these three Southern African nations.
- To inform policy discussions regarding the efficacy and value of these health workforce strategies.
Main Methods
- Qualitative semistructured interviews were conducted with 9 policymakers involved in administering RoS schemes.
- Thematic analysis was applied to interview data, followed by an internal and external SWOT analysis of emergent themes.
- Data collection occurred over a 17-month period (November 2020 - April 2022).
Main Results
- The organizational structure was identified as a strength, contrasted with 17 weaknesses, 4 opportunities, and 3 threats.
- Key weaknesses include outdated policies, rigid conditions, non-renewed agreements, mismatched training, high defaulter rates, poor coordination, monitoring, and evaluation.
- Lack of funding threatens sustainability, while opportunities exist for improved information systems.
Conclusions
- Despite intentions to educate citizens and build the health workforce, RoS schemes suffer from poor planning and coordination.
- A critical lack of evaluation, weak information systems, and failure to employ beneficiaries undermine scheme sustainability.
- Addressing these systemic issues is crucial for the future success of return-of-service programs.
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