Health professionals' sick absenteeism and determinants of incapacity leave approvals in a South African provincial health department

Abstract BackgroundA well-performing health workforce is critical to the successful implementation of universal health coverage. Sickness absenteeism influences health worker performance, with potentially negative consequences for quality of patient care and staff morale. Within the South African public sector, incapacity leave is additional sick leave granted at the discretion of the employer.ObjectivesThe aim of this study was to examine approved incapacity leave and its determinants among health professionals in a provincial health department in South Africa.MethodologyElectronic records of approved incapacity leave absences of health professionals employed in the Gauteng Department of Health (GDoH) were obtained from the government’s Personnel Salary Administration System. The period of analysis was 1 January 2016 until 31 December 2016. A structured record review form was used to extract demographic, occupational and medical information on each approved leave episode. STATA ® 15 was used for descriptive and multivariate statistical analysis.ResultsIn 2016, the GDoH approved the incapacity leave of 518 health professionals. The mean age of health professionals with incapacity leave was 46 years (SD ± 10.2 years). Professional nurses accounted for 41.5% of incapacity leave approvals. The main medical reasons for incapacity leave episodes were mental disorders (12.8%) and musculoskeletal disorders (12.0%). The risk factors for incapacity leave among health professionals were: female, 35 years and older, from district hospitals and working in the Sedibeng health district (p < 0.001). The odds of incapacity leave was three times higher for health professionals who were older than 45 years (45 to 54 years – adjusted odds ratio (AOR) 3.0 95% CI 2.3-4.0) (≥ 55 years - AOR 3.1 95% CI 2.3–4.3). The odds of incapacity leave among health professionals was highest for those working in the Sedibeng health district (AOR 2.2 95% CI 1.5–3.3).ConclusionsSickness absenteeism is complex and influenced by individual, workplace and health system factors. The study findings suggest the need to improve the management of incapacity leave in the GDoH, through inter alia, improved information systems, monitoring of sickness absenteeism and the creation of positive practice environments.