Hift, the Dean and Head of School and staff of the School of Clinical Medicine, KwaZulu-Natal. South Africa is not unique in that the supply of doctors is far below the demand required to service the country's population, resulting in high doctor-to-patient ratios.
Introduction
Background to the Study
In order to respond to the needs of countries for a more equitable health care system, increasing the number of students who will be trained in this profession was a reasonable option to remedy this problem in the future. In 2013, the Minister of Health announced that they would increase the number of students studying medicine in Cuba.
Problem Statement
Second, as a crisis management intervention program that aimed to meet the needs of the South African health sector given the limited number of universities producing doctors. The program is said to increase tenfold in the next five years, increasing the number of undergraduate students by 1000 annually to be absorbed by the existing universities in South Africa from 2018 (Bateman, 2013).
Aim of the Study
Following the successful completion of their studies at the Cuban-based institutions, students then return to South Africa (SA) where they are expected to apply all the information gathered and demonstrate competency within the three semesters they undertake at the local universities. It can be argued that the discrepancy between the curriculum offered by SA and Cuban universities could be the possible obstacle that leads to a majority of these students taking two years or more to complete their studies after returning from Cuba.
Research Objectives
Research Questions
Rationale for the Study
Limitations of the Study
Summary
Introduction
International Mobility
Trends in International Mobility
The former student may be able to get out of their financial obligation by paying back the money the country may have used to educate them, but the skills acquired are lost. This is more of a loss for the country whose projections were based on the individual qualifying and actively contributing to the country's economic activity (Kritz, 2013).
Motivation for International Student Mobility
Others believe that the advanced technology offered by other countries is better than that in their country of origin. Although mechanisms are put in place to ensure that students return to their countries of origin to serve, this is sometimes not possible.
Push and Pull factors affecting Student Mobility
It is important to note that there is sometimes an imbalance in the direction of student flows, with students in developing countries most likely to migrate to more developed countries (Wildavasky, 2010). As indicated earlier, some of the students do not return to their country of origin and choose to stay in the country where they completed their studies.
Economic Structures
Socialist Economics
Critics of socialism argue that with this approach there is a loss of individual freedom as power rests primarily with the government. In socialist countries there is one owner of goods - the government - as a result, rational pricing is not possible, leading to imbalance in production and distribution.
Capitalist Economics
Unlike monopolies, the barriers to entry in this model are lower, but the firms that are first movers tend to maintain their dominance, making it difficult for competitors to enter the market. Critics argue that oligopolies reduce consumer choice. This then implies that, with the lack of competition, such companies can manipulate consumer decision-making (Ritzer & Jurgenson, 2012.
Mixed Economy
In a mixed market, the law protects private property and the people residing in the country have the right to freely work, live, buy, sell and produce whatever they want. With this model, the classes that exist in a country will be determined by how much a person earns depending on how much income they generate.
The Health Settings of Cuba and South Africa
The Cuba Health Setting
Substantial investments in education and health care have made the country a player on the world stage (Feinsilver, 2010). This is one of the reasons why their medicines are manufactured in the country (Keck & Reed, 2012).
The South African Health Setting
- Intervention Programme
The implementation of the National Health Insurance (NHI), which is similar to the universal health care system used in other countries, is expected to address the issue. By comparing the health care system of Cuba with that of South Africa, it is clear that there are major differences between the two countries.
Agreement between South Africa and Cuba
Cuba has used medical diplomacy as an instrument of soft diplomacy, a way of winning friends and influencing people that allows the country to gain reputation, affect goodwill and material capital given the hostile geopolitical environment in which the country finds itself. In addition, it is also a way of projecting the country as increasingly developed and technologically advanced on a global scale (DeVos et. al, 2007).
Role of Higher Education on the Production of Medical Doctors
The Traditional Recourse of South African Higher Education System
An important consequence of the previous statement is that social background has a strong influence on students' abilities when they enter higher education. Moreover, he emphasized the need for academic, financial and psychosocial support for these students (Letseka & Maile, 2008).
The Challenge faced by Higher Education
The increase in spending on higher education, as highlighted in the diagram above, shows how the government has prioritized the need to produce graduates to meet the country's needs. Furthermore, institutions, through research, can face and help manage and solve the problems discovered.
Plans to Improve Higher Education Infrastructure
In addition, community engagement and service learning can serve as “a means to connect universities and communities with development needs” and “for higher education staff and students to work with communities to address development goals” (Stanton.
Cost Benefit Analysis
Cost Benefit Analysis in Education
Such resources are considered essential for the survival of students in both host and home countries. The costs listed above will provide a basic framework for analyzing the costs associated with training medical students in Cuba.
Cost and Benefits of Training Medical Students in Cuba
Economists have argued that in addition to these direct tangible and intangible economic effects, studying abroad can also produce indirect effects in the form of positive and negative externalities. When they occur, they are attributed or borne by everyone within reach, and there is no market in which those who cause or experience such effects can be compensated or rewarded (Throsby, 2011).
Summary
Introduction
Study Design
A qualitative research design approach was used for this study as the intended purpose of the study is to provide related understanding of the complex interrelationships associated with the benefits and costs of the collaborative program (Houghton, Casey, Shaw & Murphy, 2010). An in-depth understanding and interpretation of the issues surrounding the costs and benefits of educating medical students in Cuba were discussed openly and in detail.
Sampling
The students selected to participate in this study were from different provinces in an attempt to ensure representativeness. Since participation was voluntary, the total number of students who participated in this study was eight. The selection of students enrolled at UKZN to participate in this study was twofold, first, the students enrolled at UKZN are representative of all the provinces participating in the collaborative program.
Assumptions and Delimitations
Assumptions
Second, this university agreed to provide data on these students and the students were readily available to the researcher.
Delimitations
Data Collection
Interviews
The Interview Process
- Semi- Structured Interview Questions
- Recruitment of Participants
- Accuracy of Data Collected
- Capturing the Data
This means that 'the sequence and wording of the questions are programmed' (Cohen et.al. The interviews were conducted in a relaxed, non-threatening environment to ensure that the participant was comfortable and would not there were interruptions during the interview.
Data Analysis
- Interpreting the Data
- Transcription
- Coding and Theme Identification
- Honesty and Trustworthiness
In order to ensure anonymity, all data collected through the interview process was coded. The most important test of any research study is its quality' (Bryman 2012). It is said that the quality of the study is determined by its relevance, consistency and neutrality.
Ethics
Alternatively, the criteria in the qualitative paradigm are to ensure reliability and credibility (Cohen et.al., 2005).
Summary
This mechanism of checking and verifying the information was carried out continuously throughout the data collection and interpretation process. As highlighted in this section, qualitative research seeks to establish in-depth understanding of the phenomenon, this can only be achieved by ensuring that the correct data collection instrument is used.
Introduction
Costs Associated with Training Students in Cuba
- Tuition Fees
- Travel and Accommodation Costs
- Stipend
- Health Insurance
- Adjustment to Environment
- Technology
- Pass Rates
Upon arrival in Cuba, students are transported to the various universities where they would study. On their return to South African institutions, students are transported back to their provinces by the Department of Health each semester, these costs varied from student to student 'The local boys (KZN) often went home, but because I am from Limpopo come, I had to wait until the province confirmed my bus or plane ticket' (S6).
Benefits Associated with Training Students in Cuba
- Access to Medical Education
- Exposure to Global Arena
- Exposure to Two Health Care Systems
- Value of Education
- Political Education and Patriotism
- Increased Interns
- Personal Development
This will raise awareness and lead to curative measures.' This then poses a challenge for the Department of Basic Education to work with the Ministry of Health to ensure that health education is included in the curriculum taught in schools from grade one taught. Respondents indicated that the lack of patriotism is one of the missing elements in the South African community.
Summary
It is unfortunate that applying the cost benefit model is not as simple as assigning numbers to all the components that contribute to the decision of whether or not the project is worthwhile. As far as we can estimate the costs associated with the program, there is no figure that can be linked to the benefits of the project, but the themes presented in this chapter will help us to try to draw conclusions in the next chapter .
Introduction
Overview of the Findings
The responses collected outline the financial costs of the program and equate those costs with the benefits of the program. An analysis of the project reflects that while there may be some merit to the program, there are also disadvantages.
Recommendations
This could possibly reduce the psychosocial trauma experienced by the students and help the government to achieve its goals in terms of increased number of doctors per faster. A memorandum of understanding between the two parties could potentially lead to a greater number of qualified practitioners being requested to teach as part of their key performance area.
Areas for Future Study
It is also essential that a collaborative approach is adopted between the Department of Health and the academic institutions.
Closing Statement
Academic Freedom and Institutional Autonomy: Beyond the Paradigmatic Traps of the Past and Towards New Concepts More Appropriate for South African Constitutional Democracy. Ministry of Public Health Department of Teaching and Research Cuba-South Africa Third Joint Academic Interuniversity Meeting.
Ethical Clearance
Letter to Participants
GRADUATE SCHOOL for business and leadership. Participant's full names) hereby confirm that I understand the content of this document and the nature of the research project and agree to participate in the research project.
