A final challenge in interpreting the survey findings lies in the poor documentation of the community service programme.
Our findings suggest that South Africa's community service programme is an excellent recruitment strategy for health professionals.
The National Department of Health stated that the main objective of the community service programme is "to ensure improved provision of health services to all the citizens of our country" [ 21].
Despite challenges in equitable distribution of practitioners, participant satisfaction with the compulsory community service programme appears to be high among those who responded to a 2009 questionnaire.
Although the community service programme articulates the goal of 'equitably' distributing health professionals throughout the country, our analysis suggests that important inequities deserve attention.
Although the South African community service programme has been in effect since 1998, little is known about how placement and practical support occur, or how community service may impact future retention of health professionals.
Government initiatives, including the grandiosely-named 2008 'Transforming community services programme', have all failed to achieve this aim, remaining largely concerned with the structure and ownership of community organisations while the services themselves were neglected.
In Nigeria, we have engaged in programmes to create short-term job opportunities, including a community services programme for unskilled youth, and a graduate internship scheme, which will support 50,000 university graduates to acquire work experience in private-sector entities.
"How did it get like this?" I asked Cassandra Montgomery, a retired city employee who now runs a community services programme.
One initiative would provide a $4,000 tax credit to pay the university fees of any student who promises to perform 100 hours of community service, a programme Mr Obama's campaign says would cost $10 billion a year.
