Private higher education

With the emergence of private higher education as an increasing worldwide phenomenon in the 21st century, the spotlight on growth in higher education subsequently intensified (Gupta, 2008:566; Setswe, 2013:98; Su,

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2012:157). This growth was fuelled by various factors such as the upheaval of information technology; growing internationalisation of higher education and The World Bank boosting of private higher education in the mid-1990s (Mabizela, Subotzky & Thaver, 2000:13). Yet, although the growth of PHEIs has shown remarkable development over the past decade (Adeyemo & Sehoole, 2015:25), literature indicates private higher education in itself has had different types of impact in countries worldwide (Kraak, 2012:3).

3.3.4.1. Private higher education: concept and demand

In a presentation at the World Conference on Higher Education in France, in 2009, Bjarnason (2009:2) indicated the demand for higher education worldwide would increase from 97 million students in 2000 to over 262 million by 2015. Even before Bjarnason (2009) shared those statistics, public institutions were quite unable to keep up with the demand for higher education − private higher education thus flourished worldwide (Hofmeyr & Lee, 2002:79; Kruss, 2002:15; Stone, 1990:154). The literature search revealed a

diversity of private higher education providers. Obviously, there is no “one size fit all” for the numerous types of private higher education institution models (Bjarnason, 2009:3; Fielden, 2013:4).

Private higher education institutions, also known in some countries as ‘private universities’, ‘private independent institutions’, ‘university colleges’ or ‘colleges’, are defined as institutions privately owned by individuals or organisations (Tham, 2013:650). The Higher Education Act 101 of 1997 (RSA, 1997:2) refers to higher education institutions (HEIs) as organisations which: (i) register students for its own accredited programmes on NQF levels 5 – 10; (ii) develop, teach and evaluate their own programmes; (iii) issue students with certificate in its own name; (iv) are financial sustainable and (v) have DHET registration,

HEQC accreditation and their programmes are registered by the South African Qualifications Authority (SAQA). A distinguishing characteristic among the HEIs is that PHEIs are usually self-funded and normally do not receive funds from the state or government (Garwe, 2016:233; Hughes, Porter, Jones & Sheen, 2013:7; Otieno, 2007:188; Varghese, 2006:23; Woodfield, 2014:11). For the purpose of this study the overarching term of ‘PHEI’ will refer to all institutions registered as a private higher education institution.

Although it seems that PHEIs are more adaptable to meet stakeholder and market demands and offer a wider choice of job-related programmes than public or government institutions (Bjarnason, 2009:2; Shah & Nair, 2012:1; Varghese, 2006:43), criticisms were raised against PHEIs because of their poor research output and focus on only niche programmes. Regardless of such criticisms, PHEIs were accepted and welcomed worldwide for providing greater access to higher education (Obasi, 2008:4) and for redressing the lack of quality education. A study done by Oketch (2009:31-32) in three African countries confirmed that private higher education had improved access to higher education. The next section provides an overview of private higher education as an international phenomenon.

3.3.4.2. Private higher education as an international phenomenon

Altbach’s (1999:1) statement that “private higher education is one of the most dynamic and fastest-growing segments of post-secondary education at the turn of the 21st century” implies over the world private higher education is vested in the “contemporary higher education marketplace” (Altbach, 2005:7). Some countries

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such as Japan, Taiwan, South Korea, the Philippines, Mexico and Brazil have a long history of private higher education (Altbach, 2005:1; Asmal, 2002:125). In these countries PHEIs succeeded to establish themselves

in the absence of regulatory norms during a period in which the demand for HET exceeded the supply of public higher education (Gupta, 2008:567; Otieno, 2010:175). As a consequence, PHEIs had to complement public institutions with quality higher education to prepare students for their working life (Arokiasamy & Fook, 2008:82; Gupta, 2008:566; Levy, 2002:31; Rahman, 2010:1-4).

However, the contributions made to private higher education differs from country to country (Garwe, 2016:233). In developed countries like Japan, the Philippines, South Korea and Taiwan PHEIs dominated higher education and training for centuries – enrolling more than 70% of all students (Altbach, 2005:1). The reason being that higher education became a requirement to obtain employment concomitant with public institutions’ inability to keep up with the demand for HET (Altbach, 2005:2; Arokiasamy & Fook, 2008:82; Levy, 2002:31; Rahman, 2010:1-4). By 2009 approximately 30% of the global higher education enrolments were perceived in the private sector in developed and developing countries with Latin America and Asia showing the greatest growth for the decade (Bjarnason, 2009:3 & 7; Kraak, 2012:2). Seventy-three per cent (73%) out of a total of 2.8 million students were enrolled at the 773 (70%) private universities in Japan (Hasan, 2008:168). This percentage increased to 80% in 2013 (Asmal, 2002:125).

A similar tendency was evident in some developing countries. In Brazil, Mexico, Venezuela, Columbia and Peru, e.g., private higher education was as the fastest growing sector (Altbach, 2005:3). Brazil showed an increase of 84% undergraduate students enrolled in PHEIs in the six-year period from 1998 to 2004 with the private sector dominating 70% of the HET sector (Bjarnason, 2009:8-9; Kraak, 2012:3; McCowan, 2004:454). India also experienced a steady growth in PHEIs with 63% of the higher education institutions registered as PHEIs in 2006 and 52% of the total student population enrolled (Lei, 2012:275; Zha, 2011:753 & 759). In comparison, Russia had more than 500 private institutions accounting for roughly 10% of the higher education student enrolment (Gupta, 2008:570). Malaysia’s 54% enrolment (500 000 students) in 2010 placed this country also in the top highest private headcount bracket in the world (Tham, 2013:650 & 651).

Although the USA is regarded as a major role player in private higher education in the developed world, only 20% of American students studied at PHEIs in 2005. Similarly, China had a 20% enrolment of students in the private higher education system in the same year (Altbach, 2005:1-4). However, in 2009 a mix of developed (Germany and New Zealand) and developing (South East Asia, Cuba and SA) countries showed the lowest student enrolments in the private higher education sector – less than 10% (Bjarnason, 2009:8). Moreover, in the period 2011-2012 private healthcare education institutions in the UK catered for even smaller student numbers – only 160 000 students were enrolled in the 674 private healthcare education institutions compared to the 2.3 million students who were enrolled in public sector healthcare education institutions in the country. By comparison though, most of the 160 000 private healthcare education institutions students were absorbed in high-skilled jobs after graduation (Hughes et al., 2013:7; Woodfield, 2014:11).

95 Late developments in private higher education

It emerged from literature the development of private higher education in the Middle East started much later than in other countries. The first PHEIs commenced operations in 2003. Five years later the list of PHEIs had grown to eight institutions enrolling over 13 000 students. By 2009, another seven was in the pipeline and the prediction was that by 2025 the student population enrolled with PHEIs would reach the mark of 45 000 (Al-Atiqi & Alharbi, 2009:6).

Slow development of private higher education in Africa

Private higher education was slow to develop in Africa with a breakthrough only made in the mid-1980s continuing into the 1990s (Bjarnason, 2009:12; Setswe, 2013:100; Thaver, 2008:137; Varghese, 2006:32). Within a 5- to 10-year period more PHEIs than public higher education institutions were established (Varghese, 2006:25). By 1990, an average of 5 000 sub-Saharan African students were enrolled in PHEIs with approximately 100 new PHEIs established by 2004 (Setswe, 2013:98; Varghese, 2006:33). However, the percentage of students enrolled in PHEIs was still significantly lower than in Asian countries.

A study conducted by Setswe (2013:100) showed that PHEIs in Africa had grown exponentially. By 2011 more than 100 private higher education institutions were operational in sub-Saharan Africa with 87 registered PHEIs – of these 27 were provisionally registered in SA (Setswe, 2013:98). These PHEIs were making a significant contribution to ease the social demand for higher education. According to Matimbo (2016:51), private higher education is available in Ghana, Kenya, Tanzania, Senegal and Uganda with Kenya leading the way. In Kenya private higher education existed before 1962 (Matimbo, 2016:74; Otieno, 2010:33; Varghese, 2006:31) but only gained momentum in the 1990s. By 2010 Kenya had a well-developed private higher education system consisting of 18 PHEIs with 20% of the total higher education student population enrolled (Otieno, 2010:30 & 33). In Zimbabwe the enrolment also went up and by the mid-2010s the country had six PHEIs which greatly broadened the pool for degree studies (Garwe, 2016:233; Matimbo, 2016:74). Tanzania’s development of private higher education was more or less similar to Kenya’s (Matimbo, 2016:74) with 19 registered PHEIs offering programmes pitched at certificates to degree levels. However, very little is still understood about higher education development in Botswana and Nigeria (Altbach, 1999:vii). According to Obasi (2008:6), Botswana and Nigeria were late entrants to the private higher education industry, but the latter still showed a rapid growth in the number of PHEIs in the nine-year period between 1999 and 2008. In 2007 there were 34 private universities in Nigeria in comparison to the five private tertiary educational institutions in Botswana (Obasi, 2008:7).

Thus, although private higher education had a slow start in Africa, it had mushroomed since 2000 to make a significant contribution to ease the social demand for higher education (Altbach, 2005:3; Materu, 2007:9; Varghese, 2006:25).

Programmes offered by private higher education institutions

Although private higher education as global enterprises flourished, it is evident that the anatomy of private higher education at present differs internationally. Some PHEIs focus on certificate and diploma programmes

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while others offer first degrees and professional degrees. There are some PHEIs which provide all the aforementioned (Altbach, 2005:3 & 7). Most PHEIs specialise in specific academic disciplines – generally those which appeal to a large number of students – with very few offering medicine and other health-related programmes (Altbach, 2005:7). The majority of PHEIs in European and Asian countries offer vocational- and market-oriented training (Bjarnason, 2009:13) in the professional and technical disciplines (Fielden, 2013:4). The fields covered are aviation, business studies, computer science, finance, hospitality, legal studies, management and global management, marketing, social care, tourism and so forth (Altbach, 2005:7; Fielden, 2013:7; Gupta, 2008:573). Further, most of the programmes offered have low set-up costs and a guaranteed market demand (Fielden, 2013:7; Gupta, 2008:570).

In sub-Saharan Africa programmes are mainly offered according to demand and labour market needs (Ndiaye, 2006:119; Varghese, 2006:22), e.g., accounting, agriculture, business administration, commerce and information, communication, computer science, economics, engineering, language, marketing, social and health sciences, theology and technology (Garwe, 2016:234-235; Matimbo, 2016:74; Thaver, 2008:131). Other less popular programmes offered include agriculture, arts, biblical studies, biochemistry, Christian ministries, education, engineering technology programmes, environmental science, law, natural sciences, physics, psychology, public relations and special education at undergraduate and postgraduate levels (Abagi, 2006:82-83; Ajayi, 2006:101; Garwe, 2016:234-235; Thaver, 2008:131).

In SA the focus is also on business, commerce, management, education, training and development (Mabizela et al., 2000:2-7), information technology, beauty therapy and hospitality (Gupta, 2008:572) with the majority of enrolments for the undergraduate diploma and certificate level programmes (Asmal, 2002:125; Mabizela et al., 2000:4). A more detailed description of the private higher education system in SA is provided in section 3.4. Despite the literature evidence confirming a major worldwide upsurge of PHEIs offering a wide range of programmes, only a few PHEIs offer health-related programmes (Altbach, 2005:3) as discussed in the next section.

3.3.4.3. Private higher education in health sciences

The researcher, with the assistance of a University of Stellenbosch librarian, thoroughly searched the available literature on PHEIs offering health sciences or health-associated professions education and training. Yet, although private higher education evolved worldwide, the literature search provided little information pertaining to PHEIs offering health sciences or health-associated professions education and training worldwide. The majority of PHEIs seem to offer non-health sciences programmes as alluded to in the previous section. Research done by Hughes et al. (2013:7) and Woodfield (2014:11) indicate that only nine of the 674 United Kingdom PHEIs offer health and social care programmes. In India, only three health

science programmes were offered, namely medicine, dentistry and physiotherapy (FICCI Higher Education Committee, 2011:18 & 19).

According to Otieno (2007:190 & 192), only a few health sciences programmes are offered in Kenya with most of the PHEIs retaining specific niches. Although these PHEIs have a mandate to offer health sciences

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programmes (i.e. medicine and pharmacy), they tend to avoid it due to its time demanding and capital intensive nature; by implication thus heavy investment and qualified staff (Abagi, Nzomo & Otieno,

2005:35; Otieno, 2007:190; Varghese, 2006:43). Only two PHEIs in Kenya offer health sciences programmes (Abagi, 2006:83) which includes nursing. In Nigeria (Ajayi, 2006:101), Tanzania (Matimbo, 2016:74) and Malaysia (Tham, 2013:651) there is indeed a focus on health sciences; however, Ajayi (2006) does not elaborate on the nature of the programmes offered in Nigeria. It was established that in Tanzania four PHEIs offer a degree in medicine and nursing (Kuhanga, 2006:183) and in Malaysia one private university has a medicine faculty (Tham, 2013:651).

Mabizela et al. (2000:6&7) state in 2002 only 4% of all student enrolments in SA were in the health sciences and social services fields offered by PHEIs, but the researchers do not elaborate on the nature of the health sciences programmes offered. In 2016, only five of the 94 registered and 31 provisionally registered PHEIs in SA offered health professions programmes such as nursing (general, critical care, operating theatre, trauma and emergency nursing), emergency medical care and operating department assistance (Department of Higher Education and Training (DHET), 2016a:10-106). Although the majority of these programmes are indeed related to nursing, only two PHEIs were registered to offer the ODA programme at the time of study (Mafetsa, 2015:1; Qonde, 2015a; Qonde, 2015b; SAQA, 2018a:6).

All PHEIs and programmes offered in African countries are regulated by the state or government to maintain the quality and standard of admission, teaching and infrastructure (Ajayi, 2006:106; DHET, 2016a:10-106; Kuhange, 2006:190; Mabizela, 2006:136-138; Tham, 2013:652). For PHEIs to endorse quality and standard measures on all levels and in all instances is essential. Recognition is given to this serious aspect by Altbach (2005:8) as follows: “Quality assurance is one of the central issues in higher education debates today.”

3.3.4.4. Regulation of private higher education

Together with the emergence of private higher education, quality assurance surfaced as a response to the call for regulation and accountability of PHEIs (Suspitsin & Suspitsyna, 2007:62). This was necessitated by the few controls which existed (Altbach, 2005:8) and the perception that the quality of private higher education is questionable. On the contrary, there seems to be a general consensus in Kenya that a number of PHEIs

seem to be better equipped to offer quality education than public institutions (Abagi et al., 2005:35). Yet, in SA the Council on Higher Education (CHE) reported, in 2006, the overall quality of education provided by the PHEIs is sub-standard (Mabizela, 2006:160-161).

To ensure quality education many countries moved towards instituting acts, regulations and policies to regulate PHEIs. These days, it is the responsibility of a complex array of government laws, policies, and control mechanisms (Suspitsin & Suspitsyna, 2007:62) that ensure proper and credible accreditation systems set minimum standards for programmes. In the view of Adeyemo and Sehoole (2015:26), this points to the nature and form of some curriculum standards. Globally, these regulations − which should make sure PHEIs provide quality and relevant education to adequately prepare graduates for the existing job market (Kuhanga, 2006:190) − varies from weak to extremely rigid (Thaver, 2008:133).

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In China, e.g., a reasonable quality assurance system is lacking (Lei, 2012:281) and in India the private sector has grown due to the absence of a restraining national government (Otieno, 2007:179). In the UK no public policy on the private higher education sector exists resulting in the lack of a comprehensive regulation and registration process (Fielden, 2013:5-8). In the Philippines the accreditation of programmes and institutions are voluntary (Adeyemo & Sehoole, 2015:37). Meanwhile, in many African countries (including SA) strict legislation governs PHEIs by means of a professional body (e.g., the CHE) which exerts close supervision of PHEIs (Abagi et al., 2005:36). The South African private higher education regulatory context is explored in more detail in sections 3.4.2 and 3.4.3.

Suspitsin and Suspitsyna’s (2007:62) interpretation of the complexity of the laws, policies and control mechanisms directed at both the private and public higher education sectors, is that more stringent accreditation requirements seems to be applicable for the PHEIs in many countries. Whether this is, in fact, the case can only be deduced by exploring the situation in a number of countries. One example is the standard and identical criteria for academic governance structures across private and public sectors enforced in both Nigeria and Kenya (Thavor, 2008:133). In the Philippines, PHEIs require a government permit to offer curricular programmes whereas it is not a requirement for public higher education institutions (Adeyemo & Sehoole, 2015:35). In Malaysia the number of PHEIs dropped from 704 in 1996 to 468 in 2011 due to the more stringent enforcement of regulations with the implementation of the Private Higher Education Institutions Act in 1996 (Tham, 2013:654). The high government regulations for private higher education in Japan, South Korea and Taiwan are observed by Altbach (2005:1) while Yonezawa (2005:21- 22) comments in Japan private universities protested against the strict accreditation policies.

Kenya is an example of a country in Africa which has strict regulations for establishing a HEI (Abagi, 2006:78; Varghese, 2006:42-43). Kenya was also the first country to establish a Commission of Higher Education in 1985 (Otieno, 2007:179) resulting in this country having 17 private universities by 2008 of which only seven were fully accredited (Thaver, 2008:130). Tanzania and Uganda followed suite with the establishment of their accrediting bodies which concentrated more on the private than public higher education institutions (Otieno, 2007:179). For example, in Uganda the National Council for Higher Education revoked the license of one PHEI in 2005 due to it its incapacity to effectively deliver higher education.

As regards the situation in SA, Mabizela (2006:140) states, “private higher education institutions are expected to perform at unreasonably high levels. For example, none of the private higher education institutions in South Africa are universities and yet they are expected to compare to universities”. According to Otieno (2007:179), much of the direction, type and level of private provision are influenced by the rigid regulation of the private higher education sector as discussed above.

From the literature it is clear that private higher education, in the majority of countries, is governed to address public and government concerns. Although different types of Acts and accreditation bodies regulate private higher education, they all seems to focus on quality assurance, equity and access, and institutional accountability to the society they serve (Kuhanga, 2006:190). Translated into private higher education in

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health sciences, this means that quality assurance ensures PHEIs are properly quality assured to offer quality programmes assuring a highly qualified and skilled calibre of graduates are produced to enter the workforce, including that of the healthcare sector. The next section focuses on the South African national health system as well as the higher education and private higher education contexts.