Embedding inclusive health management practices requires a multiskilled workforce

This year’s winter school theme, “Health workforce development for inclusive health management and universal health coverage in Africa”, recognises that the increasing complexity of the health landscape is transforming the demands on the health workforce. A multifaceted health landscape – where social, economic, political and commercial factors all play a role in health outcomes – requires a multiskilled workforce that understands the diverse determinants of health.

To equip our PgDip students with practical insights and case studies that extend their thinking beyond the health sphere and that encourage a well-considered, strategic approach to inclusive health management, guest speakers from both the public and private sectors shared their real-world experiences across various aspects of health workforce development

Health and employee wellbeing for universal health coverage

Universal health coverage (UHC), which at its core is about ensuring that everyone can obtain the health services they need without financial hardship, is a major priority for most African countries. The PgDip winter school keynote speaker, Dr Jameson Malemela, senior vice-president of health and employee wellbeing at mining multinational Sibanye Stillwater, explored what health and employee wellbeing for UHC looks like.

Looking through a local lens, with a focus on South Africa’s mining sector, he explained how demographic transitions are changing health systems and models, affecting the provision of support services, district health capacity, public health financing and disease burdens. For a global perspective, Malemela highlighted how public and workplace health converge in international workplace health policies, using the example of the Occupational Safety and Health (OSH) Conventions established by the ⁠ILO.

The OSH conventions set binding standards for governments, employers and workers to prevent workplace injuries, diseases and deaths. Together, these local and global factors provide the foundation for a public health policy framework that supports UHC. Insights from Sibanye Stillwater’s 2024 report on occupational health and wellbeing helped students to see the practical application of these principles.

The role of business in developing health workers

Dr Nothando Moyo, an occupational health medical practitioner with more than 20 years’ experience in occupational health and policy formulation and current deputy head for occupational health at the Minerals Council South Africa (MCSA), also brought a private sector lens to the winter school agenda. In discussing the role of business in developing health workers, Moyo argued that business is a strategic partner, not just a donor, in building Africa’s health workforce: “Large employers bring financial muscle, infrastructure, reach and innovation (for example, telemedicine, digital health and data-driven decisions) that public systems can’t mobilise alone.”

Moyo used the MCSA’s Masoyise programme, an initiative that aims to reduce the impact of TB, HIV/Aids, non-communicable diseases and occupational lung diseases to protect and improve mineworkers’ wellbeing, as a model of expanding healthcare access, upskilling workers and advancing universal health coverage. Masoyise includes workplace-based training, skill transfer to community health workers, continuous professional development and data-driven performance monitoring.

According to Moyo, the key lesson from Masoyise is that the power of scale, service integration and multi-sector partnerships can balance the challenges of structural barriers, resource constraints and long-term sustainability. She believes that, going forward, there will be a shift from corporate social responsibility to a shared-value approach where health is embedded in core business strategies:

“Investing in health isn’t charity, it’s a strategic investment in workforce resilience, economic productivity and national development.”

The role of private-public partnerships in expanding and transforming the health workforce

Persistent gaps in health workforce capacity, distribution and capability play a key role in limiting progress toward universal health coverage (UHC). Dr Gloria Maimela, CEO of the Foundation for Professional Development, argued that public-private partnerships can help address these challenges, which include weak workforce planning, poor distribution, skills mismatch and limited absorption into the system. She pointed out that Africa’s severe health workforce gap requires a whole-of-society response: “A [workforce] shortage is not simply a lack of training — it reflects failures in system design and management.”

According to Maimela, public-private partnerships (PPPs) act as multi-actor ecosystems that bring together complementary actors (higher education institutions, training colleges, government, NGOs etc.) around the shared goal of ensuring that the workforce is able to provide UHC. She stated that effective PPPs – underpinned by governance, alignment and accountability – can:

• Expand the workforce via co-investments in infrastructure, access to clinical platforms and expansion into underserved regions
• Support workforce transformation through in-service training, including curriculum innovation, practice-oriented learning, continuous professional development and digital education
• Bridge the gap between what is taught academically and what is needed in practice

Ultimately, the future workforce must be systems-aware, practice-ready and leadership-capable. Maimela argued that PPPs can play a strategic role in achieving this objective through multi-sector collaboration and by extending workforce development beyond clinical training to leadership, management and systems capacity.

The importance of spirituality in effective, sustainable healthcare

The role of spirituality and religion in healthcare provision and outcomes is highly relevant for Africa’s healthcare sector, in which indigenous health knowledge systems and traditional healers have historically often been disregarded. With the tide changing, two of the PgDip winter school guest speakers spoke about the role of spirituality and religion in developing Africa’s health workforce.

Dr Annemarie Oberholzer, CEO of HospiVision, explained that spirituality is an essential, yet often neglected, dimension of holistic healthcare. “While modern Western healthcare has achieved remarkable advances in diagnosing and treating disease, less emphasis is placed on the spiritual dimension of health, which includes the meaning of suffering, hope and sources of strength.” Yet these beliefs are often inseparable from physical health. In fact, during Oberholzer’s doctoral research, the children who participated in her research study identified participation in religious activities as one of their most important sources of support while in hospital.

The field is not without its challenges. Oberholzer pointed out that spirituality means different things to different people and is difficult to assess, compare and evaluate. Despite these challenges, research on spirituality and religion in healthcare continues to grow and the practical benefits are evident: “By respecting and responding sensitively to the diverse spiritual beliefs and worldviews of patients, healthcare professionals can provide more compassionate, person-centred care.” It’s not about imposing personal beliefs on patients but rather about recognising religious and cultural differences and the importance of spiritual and religious support.

Dr Raksha Balbadhur (a medical doctor with over two decades of experience and founder of the Values in Healthcare Association of South Africa) looked at spirituality from the inside out, emphasising the importance of health workers’ mental wellbeing in achieving universal health coverage and sustainable healthcare. “Universal health coverage is not only about reaching more people. It is about delivering care that preserves human dignity for both patients and healthcare workers,” she said. Yet burnout, compassion fatigue, moral distress and workforce attrition continue to challenge health systems across the continent.

According to Balbadhur, a spiritual approach to health workforce development that nurtures healthcare professionals’ inner capacities for, for example, self-awareness, resilience and compassion, enables them to provide more sustainable, person-centred and values-driven care. This approach complements technical and professional development and contributes to more inclusive and humane health management. It is about a shift in focus: from focusing on fixing problems, workforce numbers, technical competence, managing stress and service delivery to focusing on building inner capacity, workforce wellbeing, human flourishing, cultivating resilience and meaningful service. For the PgDip students, the key lesson is that long-term success in healthcare management requires reflective practitioners who understand the relationship between wellbeing, values, resilience and effective leadership.

Challenges and opportunities for health worker skills development and training

One of the key paradoxes facing Africa’s health sector is that despite the severe shortage of health workers across the continent, hundreds of thousands of trained health professionals remain unemployed. Alexio Musindo, director of the ILO Decent Work Team for Eastern and Southern Africa, shared his insights on how Africa can transform this challenge into an opportunity for improved healthcare outcomes and large-scale job creation. “Africa’s health workforce crisis is not simply a health-sector issue but also a jobs, skills and economic development challenge,” he said.

Drawing on labour market, skills development and health workforce perspectives, Musindo highlighted the critical role that labour market systems play in connecting trained health workers to employment opportunities, while ensuring that health and care jobs are decent, productive and sustainable. Emerging trends such as digital health and AI are also reshaping the future of healthcare work and creating new demands for skills and workforce adaptation.

He furthermore explained the role of the ILO in supporting countries to address these challenges, with a particular focus on skills development, workforce planning, social dialogue, collective bargaining and decent work principles. “These are essential building blocks for strengthening health systems, improving workforce retention and advancing universal health coverage across Africa.”

• Would you like to see more of the PgDip winter school? View the photos and videos that capture the spirit of the week.
• If you are interested in applying for the PgDip, have a look at the programme information here and find out more about studying with the Africa Centre here.