Analysing approved incapacity leave among health professionals in the Gauteng Department of Health
Background: In South Africa, a well-performing health workforce is critical to the successful implementation of the National Health Insurance system. Sickness absenteeism influences health worker performance, with potentially negative consequences for quality of patient care and staff morale. Within the South African public sector, temporary incapacity leave is additional sick leave which is granted at the discretion of the employer once the allocated sick leave has been exhausted. Incapacity leave may only be accessed once the allocated 36 days of sick leave have been exhausted and the year 2016 marked the beginning of a new sick leave cycle. Objectives: The aim of this study was to examine approved incapacity leave of health professionals in the Gauteng Department of Health (GDoH) with the objectives of describing the demographic and occupational characteristics of health professionals with approved incapacity leave, the medical reasons for this type of leave and to determine whether there was an association between demographic characteristics, occupational characteristics and medical reasons (independent variables) and approved incapacity leave (outcome). Methodology: This descriptive study used official government statistics obtained from the Personnel Salary Administration System. Electronic records of approved incapacity leave absences of health professionals employed in the GDoH were obtained for the period from 1 January 2016 until 31 December 2016. A structured record review form was used to extract information. STATA ® 15 was used for descriptive and multivariate statistical analysis. Results: In 2016, the GDoH approved the incapacity leave of 518 health professionals, who accounted for 1155 leave episodes. The mean age of health professionals with incapacity leave was 46 years (SD ± 10.2 years). Professional nurses accounted for 41.5% of incapacity leave. The main medical reasons for incapacity leave were mental disorders (12.8%) and musculoskeletal disorders (12.0%). The risk factors for incapacity leave among health professionals were: female, 35 years and older, from district hospitals and working in the Sedibeng health district (p<0.05). The odds of incapacity leave was three times higher for health professionals who were older than 45 years (45 to 54 years – adjusted odds ratio (AOR) 3.0 95% CI 2.3-4.0) (≥ 55 years - AOR 3.1 95% CI 2.3-4.3). The odds of incapacity leave among health professionals was highest for those working in the Sedibeng health district (AOR 2.2 95% CI 1.5-3.3). Conclusions: Sickness absenteeism is complex and influenced by individual, workplace and health system factors. The study findings suggest the need to improve the management of incapacity leave in the GDoH, through inter alia, improved information systems, monitoring of sickness absenteeism and the creation of positive practice environments.
A research report submitted in partial fulfilment of the requirements for the degree of Master of Public Health (MPH) in the School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2019
Ramsamy, Roshnee (2019) Analysing approved incapacity leave among health professionals in the Gauteng Department of Health, University of the Witwatersrand, Johannesburg, <http://hdl.handle.net/10539/229852>