Conceptualizing the impacts of dual practice on the retention of public sector specialists - evidence from South Africa

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dc.contributor.authorAshmore, John
dc.contributor.authorGilson, Lucy
dc.date.accessioned2015-07-30T04:02:07Z
dc.date.available2015-07-30T04:02:07Z
dc.date.issued2015-01-19
dc.date.updated2015-05-05T18:01:07Z
dc.description.abstractAbstract Background ‘Dual practice’, or multiple job holding, generally involves public sector-based health workers taking additional work in the private sector. This form of the practice is purported to help retain public health care workers in low and middle-income countries’ public sectors through additional wage incentives. There has been little conceptual or empirical development of the relationship between dual practice and retention. Methods This article helps begin to fill this gap, drawing on empirical evidence from a qualitative study focusing on South African specialists. Fifty-one repeat, in-depth interviews were carried out with 28 doctors (predominantly specialists) with more than one job, in one public and one private urban hospital. Results Findings suggest dual practice can impact both positively and negatively on specialists’ intention to stay in the public sector. This is through multiple conceptual channels including those previously identified in the literature such as dual practice acting as a ‘stepping stone’ to private practice by reducing migration costs. Dual practice can also lead specialists to re-evaluate how they compare public and private jobs, and to overworking which can expedite decisions on whether to stay in the public sector or leave. Numerous respondents undertook dual practice without official permission. Conclusions The idea that dual practice helps retain public specialists in South Africa may be overstated. Yet banning the practice may be ineffective, given many undertake it without permission in any case. Regulation should be better enforced to ensure dual practice is not abused. The conceptual framework developed in this article could form a basis for further qualitative and quantitative inquiry.
dc.identifier.apacitationAshmore, J., & Gilson, L. (2015). Conceptualizing the impacts of dual practice on the retention of public sector specialists - evidence from South Africa. <i>Human Resources for Health</i>, http://hdl.handle.net/11427/13617en_ZA
dc.identifier.chicagocitationAshmore, John, and Lucy Gilson "Conceptualizing the impacts of dual practice on the retention of public sector specialists - evidence from South Africa." <i>Human Resources for Health</i> (2015) http://hdl.handle.net/11427/13617en_ZA
dc.identifier.citationAshmore, J., & Gilson, L. (2015). Conceptualizing the impacts of dual practice on the retention of public sector specialists-evidence from South Africa. Human resources for health, 13(1), 3.
dc.identifier.ris TY - Journal Article AU - Ashmore, John AU - Gilson, Lucy AB - Abstract Background ‘Dual practice’, or multiple job holding, generally involves public sector-based health workers taking additional work in the private sector. This form of the practice is purported to help retain public health care workers in low and middle-income countries’ public sectors through additional wage incentives. There has been little conceptual or empirical development of the relationship between dual practice and retention. Methods This article helps begin to fill this gap, drawing on empirical evidence from a qualitative study focusing on South African specialists. Fifty-one repeat, in-depth interviews were carried out with 28 doctors (predominantly specialists) with more than one job, in one public and one private urban hospital. Results Findings suggest dual practice can impact both positively and negatively on specialists’ intention to stay in the public sector. This is through multiple conceptual channels including those previously identified in the literature such as dual practice acting as a ‘stepping stone’ to private practice by reducing migration costs. Dual practice can also lead specialists to re-evaluate how they compare public and private jobs, and to overworking which can expedite decisions on whether to stay in the public sector or leave. Numerous respondents undertook dual practice without official permission. Conclusions The idea that dual practice helps retain public specialists in South Africa may be overstated. Yet banning the practice may be ineffective, given many undertake it without permission in any case. Regulation should be better enforced to ensure dual practice is not abused. The conceptual framework developed in this article could form a basis for further qualitative and quantitative inquiry. DA - 2015-01-19 DB - OpenUCT DO - 10.1186/1478-4491-13-3 DP - University of Cape Town J1 - Human Resources for Health LK - https://open.uct.ac.za PB - University of Cape Town PY - 2015 T1 - Conceptualizing the impacts of dual practice on the retention of public sector specialists - evidence from South Africa TI - Conceptualizing the impacts of dual practice on the retention of public sector specialists - evidence from South Africa UR - http://hdl.handle.net/11427/13617 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/13617
dc.identifier.urihttp://dx.doi.org/10.1186/1478-4491-13-3
dc.identifier.vancouvercitationAshmore J, Gilson L. Conceptualizing the impacts of dual practice on the retention of public sector specialists - evidence from South Africa. Human Resources for Health. 2015; http://hdl.handle.net/11427/13617.en_ZA
dc.language.rfc3066en
dc.publisher.departmentHealth Economics Uniten_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an Open Access article distributed under the terms of the Creative Commons Attribution License*
dc.rights.holderAshmore and Gilson; licensee BioMed Central.
dc.rights.urihttp://creativecommons.org/licenses/by/4.0*
dc.sourceHuman Resources for Healthen_ZA
dc.source.urihttp://www.human-resources-health.com
dc.subject.otherHealth Economicsen_ZA
dc.subject.otherMultiple job holdingen_ZA
dc.subject.otherPublic private mixen_ZA
dc.subject.otherRetentionen_ZA
dc.subject.otherMigrationen_ZA
dc.subject.otherLoyaltyen_ZA
dc.subject.otherHealth worker distributionen_ZA
dc.titleConceptualizing the impacts of dual practice on the retention of public sector specialists - evidence from South Africa
dc.typeJournal Articleen_ZA
uct.type.filetype
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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