One of the current challenges facing the National Department of Health of South Africa is the
shortage of skilled healthcare professionals. Trained South African health professionals have been
migrating abroad, largely due to push and pull factors. In response to this, the South African
National Department of Health began to explore other available mechanisms of increasing the
quantity of skilled healthcare providers. In 2004, a national task team was assembled to establish a
training curriculum, identify a scope of practice and outcomes for a new healthcare provider. This
new cadre of mid-level providers is known as Clinical Associates. Clinical Associates perform an
important part of the medical team and work under the supervision of medical doctors. They
undergo three years university training and work in district hospitals throughout South Africa upon
completion. Clinical Associates are similar to physician assistants in the United States of America
(USA) and non-physician clinicians in the United Kingdom (UK). Similar use has been identified
in other African countries such as Kenya, Tanzania and Uganda. They perform many of the tasks
previously performed by physicians, including examination, diagnosis, carry out investigations,
and treat patients. A full evaluation of the impact of Clinical Associates has not yet been
conducted and challenges have already been identified. In this study, both qualitative and
quantitative research methodologies were used. The target population comprised of Clinical
Associates, medical doctors, allied healthcare professionals and members of senior management.
The measuring instrument used was multiple questionnaires, assessing the effectiveness of Clinical
Associates in addressing the skills shortage of healthcare professionals at Tshwane District
Hospital. The instrument focused on team capacity, efficiency, flexibility, the role and scope of
practice of Clinical Associates.