Before the coronavirus disease 2019 (COVID-19) pandemic in early 2020, the unemployment rate in South Africa was at its highest in history at 29.1%. During the COVID-19 pandemic to date, unemployment rose even higher to 35.3%. In this context, there has been an increase in the number of unemployed health professionals in South Africa.
This study aimed to determine the employment rates of newly graduated South African audiologists and identify the challenges in obtaining and maintaining employment for audiologists in South Africa.
A descriptive online survey design was used. Participants were recruited online through professional association webpages using the snowball sampling technique. All qualified audiologists registered with the Health Professionals Council of South Africa were eligible to participate.
A total of 132 audiologists completed the survey. In the first-year postgraduation, 16% of the participants were unemployed, and this increased to 19% in the second-year postgraduation. In the majority (81%) of employed participants, almost a fifth (19%) were working within non-audiology/healthcare fields. The most common workplace challenges reported were remuneration (37%) followed by lack of resources (18%), workload (18%), work environment (10%), working hours (9%) and, lastly, interprofessional relationships (8%).
Findings from this study are the first to document employment rates amongst South African audiologists. These findings have the potential to influence the critical discourse on hearing healthcare human resource planning, hearing healthcare labour capacity and potential for growth in the South African context post-COVID-19.
Unemployment is a socio-political challenge worldwide and a major challenge in South Africa where the current national unemployment rate is the highest (Du Toit, De Witte, Rothmann, & Van den Broeck,
More than 15 years ago, the growing unemployment crisis in South Africa was described then, as a ‘beast’, with an ‘effect on economic welfare, erosion of human capital, crime and social instability’ (Kingdon & Knight,
Currently, South Africa’s labour market consists of formal and informal employment. Formal employment is defined as employment created by businesses or the government where an employee is hired under established working agreements (Alenda-Demoutiez & Mügge,
Audiologists are the primary hearing healthcare professionals involved in the identification, prevention and evaluation of auditory and balance disorders. Moreover, audiologists are the single most important resources for the rehabilitation of hearing loss (Gelfand,
It is also worth noting that the coronavirus disease 2019 (COVID-19) pandemic brought with it many challenges that will undoubtedly have an impact on unemployment or employment across many sectors, including audiology. Manchaiah, Eikelboom, Bennett and Swanepoel (
A descriptive cross-sectional online survey was used. A descriptive survey was chosen as both a research design and a tool for the data collection of this study (Barbour,
This study was facilitated online using the web-based SurveyMonkey platform with target participants from the South African hearing healthcare sector that comprises both public and privately practicing audiologists. An online survey setting was chosen as it would enable target participants to have anonymity to share their responses to the research question openly and honestly (Barbour,
The sample size was calculated using an online calculator on the SurveyMonkey platform. An acceptable margin of error for survey studies is between 5% and 10% (Suresh & Chandrashekara,
The snowball sampling technique was used to allow for recruited participants to recruit other eligible participants they had access to (Etikan, Alkassim, & Abubakar,
For inclusion in the study, participants had to be graduate audiologists registered with the Health Professions Council of South Africa.
A 24-item questionnaire was designed for the study to collect data on (1) participant demographics, (2) education information and (3) unemployment or employment status and details. The questionnaire response formats included closed sets like multiple choices and open-ended narratives. The questionnaire was piloted prior study commenced to determine validity.
According to previous research using questionnaires, face and content validity were essential psychometric properties to measure when developing such instruments (Connell et al.,
Data were collected online using the SurveyMonkey platform where the questionnaire was administered. The online link to the questionnaire was open for 6 months, and data were stored online on a password-protected cloud that only the researcher had access to.
Descriptive statistical methods were used to analyse quantitative data. Categorical data were analysed using frequency tables and percentages. Numerical data were analysed using means and standard deviation.
A thematic analysis was conducted for the qualitative data collected. The following steps were included in the thematic analysis:
This study was guided by the ethical principles outlined by the World Medical Association (WMA) in the Declaration of Helsinki (World Medical Association, 2013). Ethical approval was granted by the Human Research and Ethics Committee (HREC) of the University of Cape Town (Reference no: 815/18).
A total of 219 audiologists responded to the study questionnaire, and 132 complete responses were collected. Only the results from the 132 completed questionnaires were included in the analysis.
Majority of the participants (89%) were female, South African youth between the ages of 25–34 (67%) (see
Participant demographic information (
Characteristics | % | |
---|---|---|
Female | 118 | 89 |
Male | 14 | 11 |
18–24 | 13 | 10 |
25–34 | 88 | 67 |
35–44 | 27 | 20 |
45–54 | 2 | 2 |
> 55 | 2 | 1 |
Bachelor’s degree | 103 | 78 |
Master’s degree | 25 | 19 |
Doctoral degree | 4 | 3 |
Yes | 130 | 99 |
No | 2 | 1 |
Of the 132 participants, the majority (84%) were employed by the government in the public sector through the community service (CS) program.
Of the 16% unemployed participants, 9% experienced a delay (1–2 months on average) in their employment through the CS program placement, 7% were not employed at all (not placed in CS program at all) and 1% did not meet requirements for CS program employment as they were non-SA citizens.
Of the 132 participants, the vast majority (81%) were employed. Important to note is that of the employed participants, up to 19% were working within non-audiology fields:
Employment characteristics of those working in audiology fields ( When asked to rate workplace challenges, most ratings (37%) were on remuneration followed by lack of resources (18%), workload (18%), work environment (10%), working hours (9%) and, lastly, interprofessional relationships (8%).
Employment demographics within audiology (
Characteristics | % | |
---|---|---|
Eastern Cape | 3 | 3 |
Free State | 2 | 2 |
Gauteng | 38 | 35 |
KwaZulu-Natal | 10 | 9 |
Limpopo | 16 | 15 |
Mpumalanga | 7 | 6 |
Northern Cape | 3 | 3 |
North West | 3 | 3 |
Western Cape | 25 | 23 |
Public | 50 | 47 |
Private | 42 | 39 |
Both | 15 | 14 |
Full-time | 81 | 76 |
Part-time | 12 | 11 |
> 20 h per week | 4 | 4 |
< 20 h per week | 8 | 7 |
Other | 2 | 2 |
Clinical | 90 | 52 |
Teaching | 31 | 18 |
Sales and training | 17 | 10 |
Research | 15 | 9 |
Other | 19 | 11 |
The number of unemployed graduates increased to 19% in the second-year postgraduation (see
Unemployed participants in the second-year postgraduation (
Characteristics | % | |
---|---|---|
< 3 months | 15 | 60 |
< 6 months | 6 | 24 |
1 year or more | 4 | 16 |
Current postgraduate student | 3 | 12 |
Pending community service placement | 1 | 4 |
Limited job opportunities | 24 | 26 |
HPCSA suspension | 0 | 0 |
HPCSA, Health Professions Council of South Africa.
Challenges obtaining employment.
Themes | Emerging codes |
---|---|
Limited job opportunities | Jobs far away from home |
Not enough jobs | |
Not enough jobs in the province of choice | |
Not enough jobs in the government | |
Frozen job posts | |
Post not funded | |
Limited job advertisements | |
No available locum posts | |
Discrimination | Private practice race issues |
Wearing head scarf not allowed | |
Employer not wanting Indian employees | |
Racial discrimination | |
Language barrier | Private practice wanting fluent Afrikaans speakers |
Afrikaans speaking audiologists required | |
Experience | Low remuneration for new graduates |
Don’t have enough experience for private | |
Not enough years of experience | |
Not enough experience for private sector | |
Qualification preference | Jobs for dually qualified audiologists only |
Only dually qualified posts available in Gauteng |
With the highest unemployment rate and the increasing challenges in healthcare human resourcing in South Africa, this study sought to describe challenges in obtaining and maintaining employment for audiologists (Pillay et al.,
This is the first study, to the knowledge of the researcher, to document and describe unemployment rates in audiology graduates in South Africa. A similar study was done recently to describe human resource challenges in environmental health graduates in South Africa (Mbola, Human, & Melariri,
It is important to note that in the first- and second-year postgraduation, since 1998, all South African health professional graduates are mandated to work for the National Department of Health (NDoH) for community service (CS) in order to be certified by the Health Professions Council of South Africa (HPCSA) as qualified-independent practitioners (Mbola et al.,
This state of affairs has debilitating implications for the public healthcare system as well as the CS program and pertinent to this study, CS for audiologists. Therefore, it is key to consider that moving forward, if the NDoH is unable to sustainably maintain and fund CS, it is fitting to interrogate (1) the mandatory nature of the CS program as it stands for South African health graduates and (2) the linking of CS program to the health regulator’s, HPCSA, independent practice certification. Although well-intentioned, the mandatory CS program, as shown by this study findings, may be doubly disadvantaging health professional graduates as it not only cannot employ all graduates but further denies the unemployed graduates an opportunity to obtain the necessary accreditation to enter and serve in the broader healthcare market outside the NDoH (Mbola et al.,
In the last 20 years in post-apartheid South Africa, research proposed that increasing access, quality and levels of education will increase employability and benefit multiple sectors through skilled labour (Acquah,
Globally, there is a growing interest and proven value in using technology in hearing healthcare (Aggarwal, Dhanshree Gunjawate, Yerraguntla, & Ravi,
This study is, to the knowledge of the researcher, the first to explore and document unemployment rates and challenges in audiologists in South Africa. This study’s findings can be foundational to guide future research to expand investigations into the subject matter. A possible limitation of the study is in its cross-sectional design in that findings cannot be used to predict and/or analyse unemployment over a period, and the snapshot nature of the design means that findings may not be representative of the whole population of interest.
Up to 16% of audiologists are unemployed in their first-year postgraduation, and this increases to 19% in the second-year postgraduation. This study’s findings are the first to document the unemployment rate of newly graduated hearing healthcare professionals in South Africa. These findings have the potential to influence the critical discourse on hearing healthcare human resource policies and planning, hearing healthcare labour market needs versus capacity, and hearing healthcare context and potential for growth in the South African context, especially post-COVID-19.
The author would like to acknowledge and thank the University of Cape Town audiology students (Tersia Davids, Yusrah du Toit, Mendy Luthuli, Shanine Meyer, Thashil Pillay, Ilhaam Rejaldien) for their contribution to data collection for this study.
The author declares that they have no financial or personal relationships that may have inappropriately influenced them in writing this article.
V.H. is the sole author of this article.
This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Raw survey data (anonymised) can be made available on request.
The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of any affiliated agency of the author.