The perception of primary health care nurses regarding the role of clinical associates

Abstract

Shortage of human resources is a major problem which has become an international emergency that in recent years has caused substantial international attention and concern. Mid-level medical workers were introduced internationally, in Africa and recently in South Africa as a strategy to overcome health workforce challenges and improve access to essential health services, as well as achieve the health related targets of the Millennium Development Goals. Mid-level workers in South Africa are called Clinical Associates. The aim of the study was to explore and describe the PHC nurses’ perception of the Clinical Associate role. A qualitative, contextual, exploratory and descriptive design was used to explore and describe the PHC nurses’ opinions and thoughts concerning the role the clinical associates would play in the health care system; and to obtain an understanding of how the PHCNs see the feasibility of working with these newly introduced health workers. A purposive convenient sampling was used to select participants who were most likely to offer information required in the study. The study findings show that PHC nurses had insufficient knowledge regarding who Clinical Associates are and what their role is. Although to some extend the PHC nurses acknowledged the important role the Clinical Associates would play, the PHC nurses expressed more concern related to their professional status. The concerns included matters like: who would be senior between the Clinical Associate and the PHC nurses taking into consideration the level of education and training of Clinical Associates versus that of nurses; who would take orders from whom between Clinical Associates and PHC nurses. Another worry was the possibility of clinical associates taking over the PHC nurses roles.