Fukuyama, Francis; IMF Institute International Monetary Fund - Working Paper WP/00/74, 2000
Social capital is important to the efficient functioning of modern economies and is the sine qua non of stable liberal democracy. It constitutes the cultural component of modern societies, which in other respects have been organized since the Enlightenment on the basis of formal institutions, the rule of law, and rationality. Building social capital has typically been seen as a task for "second generation" economic reform; but unlike economic policies or even economic institutions, social capital can not be so easily created or shaped by public policy. This paper define social capital, explore its economic and political functions, as well as its origins and make some suggestions for can it be cultivated.
Human Resources
Peter S. Heller and Christian Keller, 2001 Washington: International Monetary Fund IMF Working Paper No. 01/35
The high unemployment rates seen in many of the transition economies make it difficult for households to improve their living standards and escape from poverty, while existing labor market regimes at times appear to be obstacles to job creation. Labor laws must be examined to see whether they strike the right balance between protecting workers' rights, on the one hand, and allowing for sufficient labor market flexibility, on the other. Overly restrictive employment protection legislation might have to be liberalized, minimum wage practices reevaluated, and flexible fixed-term contracts permitted in order to increase labor market flexibility and make labor codes more appropriate for prevailing labor market conditions. The transition countries' often extensive menus of active labor market policies must be continually reassessed with respect to their cost and effectiveness.
Health MEC, Sibongiseni Dhlomo, says that South Africa should produce about 8,000 doctors annually to meet the dire shortage at public hospitals. He referred to a programme to study medicine in Cuba, which targets students mainly from underprivileged areas who would otherwise not have had the financial means for the studies. Dhlomo said universities were not producing enough doctors, which was contributing to the discrepancies in the country's health care system. ‘Producing 200 doctors per university per year is not good enough. We will be speaking to deans and pushing universities to produce at least 2,000 doctors annually, starting in the next year or two,’ he said. Dhlomo said the country had a total of about 8,000 doctors employed by the Health Department. However, he said Limpopo would be able to meet its doctor-patient ratio if all 8,000 doctors were deployed in that province.
South Africa is failing to produce more nurses to deal with its health demands, according to the Democratic Nursing Organisation of South Africa (Denosa). The closure of some nursing colleges by the government, citing 'funding' as a reason, did not assist in the production of nurses, it reported. Denosa called on government to re-open the training colleges that were closed, to accommodate those who were interested in pursuing this career. The union said one of the contributing factors to the shortage was that school-leavers lacked interest in becoming nurses because of the unsavoury working environments that nurses face daily. Poor salaries also drive nurses away from the profession and the country. Denosa called on the state to improve health services nationwide.
As South Africa rolls out its national treatment programme, the country continues to lose skilled healthcare professionals to wealthier nations abroad, leaving severe shortages in an already over-stretched public health system. On a Tuesday morning earlier this month at Johannesburg General Hospital's medical wards, an exhausted-looking Dr Candace Latilla was about to go off duty. But, as the only doctor on call that night, she would be back in a couple of hours. Latilla has been working at the hospital as an intern doctor for the past nine months. With a staff component of 470 doctors and 1,300 nurses, Johannesburg General handles more than 1.5 million patient visits a year.
More than 95% of medical aid scheme members have access to HIV/AIDS cover exceeding the state's proposed package of minimum benefits, but less than 1% of them are coming forward to take advantage of the available care. This is one of the key findings of a study released by the Centre for Actuarial Research at the University of Cape Town in association with the Treatment Action Campaign (TAC).
Representatives from the Democratic Nursing Organization of South Africa (Denosa), a trade union that represents nurses and professional midwives, say that nursing staff work under bad conditions. A Denosa spokesman said South African nurses and nursing staff were seeking work out of the country where they were appreciated and would get better salaries. “People who rely on the services of public healthcare workers are disadvantaged when public health workers are understaffed or strike due to unresolved grievances,” said Ashwell Jenneker of Statistics South Africa. In a dialogue, the South Africa Minister of Health, Aaron Motsoaledi said, “We will do our best to ensure that all health workers are given better working conditions. We will also work on making sure that the minimum service level of health workers is implemented.” Those attending the dialogue agreed that a formal investigation was needed into the working conditions of all health workers.
Latest review reveals that voluntary community care can help and prevent SA losing R6bn a year to AIDS. IF SA began a massive home-based care programme for people infected with HIV/AIDS, it could slash hospital costs and relieve a fiscus already losing R6bn a year to AIDS. The losses are recorded in the latest intergovernmental review, while the cost benefits of using Home-Based Care are being proved by a two-year programme, Enhancing Care Initiative (ECI), run by the University of Natal, with the US's Harvard University and the KwaZulu-Natal government.
In South Africa’s new human resources for health strategy, eight thematic priorities have been identified to form the strategy’s framework: leadership, governance and accountability; health workforce information and health workforce planning; re-engineering of the workforce to meet service needs; scaling up and revitalising education, training and research; creating the infrastructure for workforce and service development in the form of academic health complexes and nursing colleges; strengthening and professionalising the management of human resources and prioritising health workforce needs; ensuring professional quality care through oversight, regulation and continuing professional development; and improving access to health professionals and health care in rural and remote areas. The strategy aims to ensure necessary and equitable staffing of the health system and to ensure a workforce fit for purpose to meet health needs by: developing health professionals and cadres to meet health and health care needs; ensuring the health workforce has an optimal working environment and rewarding careers; ensuring innovative and efficient recruitment and retention of the health workforce; enabling clinical research which enhances clinical and service development; and providing the organisation and infrastructure for health workforce development. The Strategy also contains forecasts on the numbers of health workers required to fill critical gaps in public health service delivery.
When Mercy Makhalemele's husband died of HIV/AIDS seven years ago her home was taken away after the insurance company refused to pay out his life cover. "At the time, I decided not to fight it because I had too many things to deal with," she told IRIN. As the executive director of a local community organisation, Makhalemele has been working with members to create a burial scheme for people with HIV/AIDS. Through her work, Makhalemele said she has encountered people who have been treated with injustice and a lack of respect, because of their status.