Original Research

Needs-based gap analysis for service transformation in the Eastern Cape

Kiran Sukeri, Orlando Alonso-Betancourt, Robin Emsley
South African Journal of Psychiatry | Vol 21, No 1 | a609 | DOI: https://doi.org/10.4102/sajpsychiatry.v21i1.609 | © 2015 Kiran Sukeri, Orlando Alonso-Betancourt, Robin Emsley | This work is licensed under CC Attribution 4.0
Submitted: 29 March 2014 | Published: 01 February 2015

About the author(s)

Kiran Sukeri, Department of Psychiatry, Faculty of Medicine and Health Sciences, Walter Sisulu University, Mthatha, South Africa, South Africa
Orlando Alonso-Betancourt, Department of Psychiatry, Faculty of Medicine and Health Sciences, Walter Sisulu University, Mthatha, South Africa, South Africa
Robin Emsley, Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, Cape Town, South Africa, South Africa

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Objectives. Part I of this research article presents a needs-based analysis for the management of schizophrenia, bipolar mood disorder and major depression for the Eastern Cape (EC) Province, South Africa. This part of the research paper focuses on quantifying human resources and bed needs for these three severe mental illnesses. Human resource expenditure is calculated for nursing staff at acute, ambulatory and medium-to-long-stay services. A further objective was to conduct a gap analysis for human resources and beds for the EC in order to assist mental health planners in the commissioning of services. 

Methods. Data from previous research conducted in the province, and international and national epidemiological studies were utilised to quantify the requirements for human resources (psychiatrists, medical officers/registrars, psychologists, nurses, occupational therapists and social workers) and beds for acute, medium-to-long-stay and ambulatory services at provincial and regional levels, to provide mental healthcare. The authors focused on three of the eight priority conditions set by the World Health Organization. A target coverage rate of 80% was used in all calculations. A gap analysis was conducted to demonstrate deficits and excesses, utilising available data on human resources and beds available in the province.

Results. The results showed that the districts of Alfred Nzo and Ukhahlamba have no human resources or beds for the provision of mental health services. The province has a deficit of 23 psychiatrists and 243 nurses trained in psychiatry, and an oversupply of 486 other nurses. The results also clearly demonstrated an inequitable distribution of resources in the province. 

Conclusions. This is the first study that has provided detailed estimates of human resource and bed deficits in the EC. The study demonstrates that the areas of greatest need in terms of bed and human resource requirements are in the eastern regions of the province, which includes the former homelands of the Transkei and Ciskei. This study will assist provincial mental health planners/commissioners in developing an equitable mental health delivery programme.


South Africa; Mental Health Planning


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