Ngcobo, SaneleBust, LynnCouper, IanChu, Kathryn2024-07-312024-07-312024-05Ngcobo, S., Bust, L., Couper, I. & Chu, K. The role of clinical associates in South Africa as a health workforce: A scoping review. African Journal of Primary Health Care and Family Medicine 2024;16(1), a4421. https://doi.org/10.4102/phcfm.v16i1.4421.2071-2928 (print)2071-2936 (online)10.4102/phcfm.v16i1.4421http://hdl.handle.net/2263/97347DATA AVAILABITY STATEMENT: Data sharing is not applicable to this article as no new data were created or analysed in this studyBACKGROUNG: South Africa’s health care system grapples with persistent challenges, including health care provider shortages and disparities in distribution. In response, the government introduced clinical associates (Clin-As) as a novel category of health care providers. AIM: This study mapped Clin-As’ history and practice in South Africa, assessing their roles in the health workforce and offering recommendations. METHODS: Following the framework outlined by Arksey and O’Malley, we conducted a comprehensive literature search from January 2001 to November 2021, utilising PubMed, Scopus and EBSCOhost databases. One thousand six hundred and seventy-two articles were identified and then refined to 36 through title, abstract and full-text screening. RESULTS: Strengths of the Clin-A cadre included addressing rural workforce shortages and offering cost-effective health care in rural areas. Challenges to the success of the cadre included stakeholder resistance, rapid implementation, scope of practice ambiguity, inadequate supervision, unclear roles, limited Department of Health (NDoH) support, funding deficits, Clin-As’ perceived underpayment and overwork, degree recognition issues, inadequate medical student training on Clin-A roles, vague career paths and uneven provincial participation. CONCLUSION: As a health care provider cadre, Clin-As have been welcomed by multiple stakeholders and could potentially be a valuable resource for South Africa’s health care system, but they face substantial challenges. Realising their full potential necessitates enhanced engagement, improved implementation strategies and precise scope definition. CONTRIBUTION: This study acknowledges Clin-As in SA as a promising solution to health care workforce shortages but highlights challenges such as stakeholder resistance, insufficient NDoH support and unclear policies, emphasising the need for comprehensive efforts to maximise their potential.en© 2024. The Authors. Licensee: AOSIS. This work is licensed under the Creative Commons Attribution License.Clinical associatesHuman resources for healthBachelor of clinical medical practiceDistrict hospitalsClinical officersPhysician assistantsPhysician associatesMidlevel health workersMid-level medical workersSDG-03: Good health and well-beingSDG-04: Quality educationSDG-08: Decent work and economic growthHealth sciences articles SDG-03SDG-03: Good health and well-beingHealth sciences articles SDG-04SDG-04: Quality educationHealth sciences articles SDG-08SDG-08: Decent work and economic growthHealth sciences articles SDG-10SDG-10: Reduced inequalitiesArticle