Challenges facing the Cuban-South African medical collaboration for medical capacity building in KwaZulu-Natal.

Abstract

The South African public healthcare system faces significant disparity between the demand for healthcare services and the availability of skilled medical professionals. To address this, the government collaborated with Cuba to train South African students from disadvantaged backgrounds, with the intention that they would return to serve in underserved areas upon qualification. The aim of the study was to identify challenges at macro, meso, and micro levels of the Cuban-South African medical collaboration. The overarching question was whether the exploration and resolution of the challenges within this collaboration could contribute to optimising the effectiveness of the programme aligned with the WHO’s SDGs for UHC and health care reforms, emphasizing primary health care in South Africa. Drawing on theoretical perspectives including Migration Theory, Resource-Based Theory, and Human Capital Theory, a conceptual model was developed to highlight the importance of investing in human resources for competitive advantage. An exploratory, qualitative study was conducted by reviewing relevant human resources for health policy documents, and through interviews with University of KwaZulu-Natal programme administrators, programme managers and South African students in Cuban cohorts, providing a holistic investigation into the challenges facing the collaboration. Document analysis and purposive snowball sampling methods were utilised to choose pertinent policies, records, and participants for this study. This combined approach aimed to gather comprehensive insights by examining documented policies and capturing the first-hand experiences and perspectives of individuals actively engaged in the Cuban-South African medical collaboration. Thematic analysis of relevant policies revealed misalignment with South Africa's healthcare objectives. Interviews highlighted challenges such as adapting to the institutional and cultural differences, technical, social and psychological hurdles. Despite training in Cuba, students' primary healthcare skills are often under utilised upon their return, emphasizing the need to recognize and preserve these skills for use in underserved areas. Therefore, a model was developed from these findings to guide stakeholders in enhancing the programme experience. The study recommends acknowledging and utilising primary healthcare skills acquired in Cuba to improve healthcare delivery in rural and underserved areas. This could lead to sustained quality healthcare for marginalized communities and contribute to a transformation in healthcare culture.