Date Published: July 27, 2017
Author(s): Dumisani M. Gumede, Andrew J. Ross, Laura M. Campbell, Richard G. MacGregor.
Staffing of rural healthcare facilities is a challenge, with literature supporting the selection and training of rural-origin students. The Umthombo Youth Development Foundation (UYDF) scholarship scheme supports rural students to train as healthcare professionals and offers a unique support programme. This programme has not been evaluated, and this study sought UYDF-supported students’ perceptions of the programme.
The aim of the study was to assess students’ perceptions of the UYDF support programme.
This was an observational descriptive study. Participants were students supported by UYDF and data were collected by a questionnaire with a Likert scale to assess perceptions of various aspects of the support programme.
Students’ perceptions about the UYDF support programme were generally positive, with initial orientation and information sharing perceived as useful. Some respondents did not perceive value in holding discussions around English proficiency. The support required appeared to diminish with increasing years of study.
A comprehensive, proactive compulsory support system that provides both academic and social support was perceived as useful by the UYDF students. Further research is required around aspects such as encouraging English proficiency. In future, the support programme could prioritise students in the early years of their study.
Staffing of rural healthcare facilities constitutes an ongoing challenge globally, with many rural areas experiencing greater shortages of staff than urban areas.1,2,3 International and local evidence has shown that rural-origin graduate students are more likely to provide long-term services in rural healthcare facilities than urban-origin students.4,5 Despite the evidence, it is of concern that South African Health Science Institutes of Higher Learning (IHL) do not currently prioritise the selection of rural-origin students, and in fact some policies (e.g. the National Bench Mark Examination) discriminate against increasing access for rural-origin students.6
This was an observational, descriptive study. Inclusion criteria were all UYDF students who had participated in the support programme for at least one year. A total of 201 students were supported by the UYDF in 2014, of whom 138 met the inclusion criteria.
Of the 138 eligible students, 109 completed the questionnaire, giving a response rate of 79%. Of the participants, 55% were female, aged between 18 and 30 years, with a mean age of 21.3 years. The participants attended a variety of universities, with the majority attending the Nelson R. Mandela School of Medicine at UKZN. The universities attended are summarised in Table 2.
The data showed that students studying a wide range of disciplines are supported by the UYDF, with a large number of different universities attended. This reflects the large number of services provided at rural district-level hospitals and the importance the hospitals attach to the training of staff to provide these services. Those 11 universities being attended also present challenges for UYDF in providing a support service that is spread across South Africa.
Although every effort was made to ensure that responses were anonymous, students may have perceived that their responses could become known and this might have affected their responses to the questionnaire. There may have been potential bias in that participants may have responded in an overly positive manner to please the researcher. The questionnaire adopted a deductive methodology in which the researcher set the variables according to his knowledge and experience of the support programme. A more inductive method may facilitate students speaking about their own experiences, and thus data should be triangulated by further study including methods such as interviews with students and focus group discussions. The questionnaire did not permit for disaggregation and focus on specific aspects of the UYDF programme (e.g. the role of comprehensive financial support, the selection process and the student Life Skills Imbizo), which may be key in facilitating student success at IHLs. In addition, utilising the term ‘useful’ in all of the questions was a non-specific term with an interpretation on what it means that may have varied from one student to another.
UYDF-supported students hail from deep rural areas, do not speak English as a first language and may never have travelled outside their local area prior to attending an IHL. They may be more disadvantaged than their urban colleagues, as rural schools generally prepare learners poorly for tertiary education. The UYDF team can be assured that the multifaceted student support strategy was perceived as generally useful by students. The potential link between a high-quality support programme and high graduation success rates requires further study. This study reported on one specific support programme and the lessons learnt around integration, being proactive and responsive, which may be useful to other support programmes offered to disadvantaged students attending IHLs.