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This report assesses progress on the Millennium Development Goals 4 and 5 on child mortality and maternal health and proposes best strategies for reaching them. Chapeter 3 (p.81) discusses the impact of skilled attendance and emergency obstetric care on maternal and child survival rates, and chapter 4 (p.119) outlines the broader importance of health workforce management to maternal and child health. [adapted from author]

This toolkit provides a package of HRIS procedures and tools to HRH stakeholders, HR information system managers and software developers to facilitate applying the HRIS strengthening processes and iHRIS software developed by the Capacity Project. The toolkit collects briefs, forms, case studies, resources and other materials to assist with all five steps of the HRIS strengthening process: introduction, building HRIS leadership, assessing and improving existing systems, developing software solutions, using data to make decisions, and ensuring sustainability. [from author]

The issue of participation by medical providers from wealthy countries in short-term medical volunteer work in resource-poor countries has been reaised as being potentially harmful to recipient communities. This exploratory study examines the perception of short-term medical volunteer work in Guatemala from the perspective of members of recipient communities affected by or participating in these programs. [adapted from sbstract]

Retention continues to be a serious challenge in the human resources for health crisis. There is increasingly widespread commitment to initiatives to attract and retain skilled workers, especially in rural areas. The purpose of this brief is to update and document some contributions made from 2005 to 2008 in the area of worker retention. [from author]

In the face of medical workforce shortages, governments are looking to displace doctors with alternative health care providers like nurse practitioners, physician assistants, and other health professionals such as psychologists and pharmacists to relieve bottlenecks in health care delivery. Displacing doctors in this way, or role or task substitution as it is also termed, has been actively pursued in the United Kingdom and United States. How should the medical profession react to these developments? [from author]

This study undertook an in-depth exploration of the unintended consequences of pay-for-performance programs In England and California. The authors interviewed primary care physicians in California and England and compared unintended consequences in each setting. [adapted from abstract]

Health facility assessments are being increasingly used to measure and monitor indicators of health workforce performance, but the global evidence base remains weak. The World Health Organization coordinated a series of facility-based surveys using a common approach in six countries: Chad, Cote d’Ivoire, Jamaica, Mozambique, Sri Lanka and Zimbabwe. The objectives were to inform the development and monitoring of human resources for health policy within the countries; and to test and validate the use of standardized facility-based human resources assessment tools across different contexts.

This presentation covers the state of the health workforce in Ethiopia and defines the crisis in health worker coverage including numerous charts and staistics that track the decline in the number of doctors.

East African countries have in the recent past experienced a tremendous increase in the volume of antiretroviral drugs. Capacity to manage these medicines in the region remains limited. Makerere University established a network of academic institutions to build capacity for pharmaceutical management in the East African region. The initiative includes institutions from Uganda, Tanzania, Kenya and Rwanda and aims to improve access to safe, effective and quality-assured medicines for the treatment of HIV/AIDS, TB and Malaria through spearheading in-country capacity.

The Ministry of Health and Medical Education in the Islamic Republic of Iran has undertaken a reform of its health system, in which-lower level managers are given new roles and responsibilities in a decentralized system. To support these efforts, a series of courses for health managers and trainers was developed. A total of seven short training courses were implemented, and a detailed evaluation of the courses was undertaken to guide future development of the training programs. [adapted from abstract]

This paper will use India as a lens to examine the broader issues surrounding human resources and public health. It will explore some of the HR strategies employed in a variety of settings with mixed results. Finally, it will look at several very contrasting approaches employed by two Indian states, Tamil Nadu and Gujarat, in dealing with human resource shortages as they struggle to reduce maternal mortality. [from author]

The results of this survey shed light on several aspects of problems faced by reproductive health services regarding provider performance, equipment and supplies in facilities and laboratories, availability of medicine, initial staff qualification and in-service training, and supervision of health care providers. The results will serve as a guide for monitoring and evaluation of maternal and child health programs, reproductive health programs, HIV/AIDS programs, and other infectious diseases programs. [from preface]

The study assessed knowledge and practice of health care providers on current concepts on malaria prophylaxis in pregnancy. [from abstract]

This assessment was designed to provide detailed information on the availability and quality of facility infrastructure, resources, and management systems. Detailed information was also collected on services for child health, family planning, maternal health, antenatal care, and delivery care. Furthermore, selected infectious diseases, namely STIs and tuberculosis, were also covered under the survey. Information was collected on the capacity of health facilities to provide quality HIV/AIDS services.

This study focused on factors associated with the readiness of Kenyan health facilities to provide quality and appropriate care to family planning clientele; the degree to which health care providers foster informed selection of an appropriate contraceptive method; and the extent to which clients perceive services to be of high quality. [from abstract]

Given the worrying trends in infant and child mortality rates, there is a clear need to assess current practices in the management of childhood illnesses and to identify opportunities for intervention. The 2004 Kenya Service Provision Assessment Survey (KSPA) findings indicate that most health care providers are not taking care of sick children holistically, but rather are treating children only for the presenting illness.

Empirical investigations of health worker training in Kenya have been limited to mappings of health service providers in terms of cadre and distribution and assessments of the training needs for various skills. However, there has not been a comprehensive study of the influence of training on the provision of quality Emergency Obstetric Care (EmOC). We seek to fill this gap by assessing the link between health provider training and practice with regard to the provision of EmOC. [from author]

The Trauma Management Program (TMP) was developed to improve the capacity of local health workers to deliver effective trauma care. This report illustrates a method to increase the capacity of indigenous health workers to manage traumatic injuries. These health workers are able to provide trauma care for otherwise inaccessible populations in remote and conflicted regions. The principles learnt during the implementation of the TMP might be applied in similar settings. [from introduction]

A growing number of international donors are promoting an expansion of private-sector health-care delivery to achieve universal and equitable access. But this paper shows there is an urgent need to reassess the arguments used in favour of scaling-up private-sector provision in poor countries. The evidence shows that prioritising this approach is extremely unlikely to deliver health for poor people. [adapted from author]

There is a general consensus that another influenza pandemic is inevitable. Although health care workers (HCWs) are essential to the health system response, there are few studies exploring HCW attitudes to pandemic influenza. The aim of this study was to explore HCWs knowledge, attitudes and intended behaviour towards pandemic influenza. [from abstract]

Mid-level cadres of health workers provide the bulk of emergency obstetric and neonatal care in Malawi. This study set out to explore the perceptions of mid-level providers regarding the factors affecting their performance and retention within the Malawian health system. [adapted from author]

The study had three objectives: to determine the current competency levels of the workforce attending women during labor, delivery, and the early postpartum period; examine conditions at the workplace to determine environmental and organizational factors that affect workforce productivity and performance; and assess implications for regional training and performance improvement at the workplace. [from author]

The goal of the assessment was to review the quality of HIV care, antiretroviral treatment and tuberculosis services provided in private-for-profits in Uganda in order to generate appropriate recommendations and inform the development of a strategy to improve the quality of those services. [from author]

This study explores the factors that affect performance of nurses in Namibia with the aim of providing a management framework for improving the performance of professional nurses. [from author]

The objective of this study was to investigate the effect of scaling up antiretroviral treatment (ART) on the working environment and motivation of health workers in South Africa; and to suggest strategies to minimize negative effects and maximise positive effects. [from summary]