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While the scale of the [health worker shortage] crisis is huge, solutions do exist. Many countries and communities around the world have begun to develop and implement innovative initiatives to sustain and build the health workforce. Several such examples are highlighted here. They address such issues as retention in rural areas, AIDS treatment for health workers, and the deployment of paraprofessionals to extend health care access deeper into communities. Many of these examples focus on rural areas, which typically have only a fraction of the number of health workers as urban areas due to more difficult living conditions, social and professional isolation, and weaker health infrastructure. [publisher’s description]

The objective of this article was to compare the cost-effectiveness of the tuberculosis programm run by the Bangladesh Rural Advancement Committee, which uses community health workers (CHWs), with that of the government program which does not use CHWs. [adapted from author]

The Public Private Partnership in Health (PPPH) is an element of Uganda’s Health Sector Strategic Plan II. The private sector includes not-for-profit providers, for-profit providers called private health practitioners (PHPs), and traditional and complementary medicine providers. A representative sample of facilities was selected and surveyed to provide in-depth information on PHP facilities, which could be extrapolated to the national database. The survey collected information from 359 facilities on facility ownership, human resources, staff employment in other facilities, infrastructure and equipment, health services provided including in-depth information on HIV/AIDS services, drug availability, health management information systems, financial management procedures, and registration and organizational affiliation.

The goals of this presentation include introducing the performance improvement (PI) approach, framework and factos influencing performance; how PI works; and the benefits of using PI. [adapted from author]

The objectives of this presentation are to provide participants with an understanding of the role of leaders and managers in promoting quality services and to have participants identify action steps/interventions to promote quality at different levels of the health system. [from author’s description]

This presentation was part of the 2006 Global Health Mini-University. This session will provide an overview of factors that support or constrain the delivery of expanded services by midwives. It will discuss successful case studies to build sustainable practices. This includes a program to promote business training and access to financing to grow and improve private midwife practices in the Philippines. Presenters will also discuss the use of networks for private midwives for service expansion, quality improvement, and sustainability in Kenya. [adapted from publisher’s description]

This presentation was part of the 2006 Global Health Mini-University. A key approach to address the global shortage of healthcare providers is to improve the productivity of existing workers, thereby improving the quality and coverage of services. Improving the work environment and task shifting of health functions to different cadres of providers are two promising interventions that are being used for this purpose. This session will describe and discuss these and some of the other innovative solutions to enhance the capacity and productivity of the current workforce and to build coherence into the management of human resources for stronger health systems. [publisher’s description]

Home-based care (HBC) for HIV/AIDS is increasingly looked to as a more accessible and affordable alternative to more costly inpatient care, both for patients who are unable to travel to or pay for inpatient care as well as for governments that must fund inpatient facilities. Partners for Health Reformplus estimated the cost of HBC for HIV in Rwanda, based on a sample of eight programs offering care in early 2004. The sample comprised facility- and community-based programs. Both types of program implement the medical care recommended in the Ministry of Health guidelines for HBC. [from abstract]

There is a growing acknowledgment of the importance of the continuum of care and support services to people living with HIV/AIDS outside of health facilities. Greater reliance on communities to provide care and support to people living with HIV/AIDS as well as non-complex maintenance and adherence support for treatment of those who are under antiretroviral treatment is seen as a way to alleviate the burden placed on traditional health systems in countries highly affected by HIV/AIDS. This report presents findings from the field-test of the Partners for Health Reformplus guidelines developed for costing home-based care (HBC) programs, with cases drawn from nine HBC programs in Uganda.

This paper describes the specific policy measures that the Zimbabwean government has recently implemented to try to improve health sector performance, and promote higher levels of motivation amongst public sector health care workers. The overall reform package is to include financial reforms (user fees and social insurance), strengthening of health management, liberalization and regulation of the private health sector, decentralization, and contracting out. Unfortunately, the process of reform implementation in Zimbabwe and the government’s poor communication with workers, combined with a conflict between local cultures and the measures being implemented, has undermined the potentially positive effect of reforms on health worker motivation.

This paper reports the experiences of primary care reform in the Zhezkazgan region of Kazakhstan. After the collapse of the Soviet regime, Kazakhstan undertook a radical program of reform to restructure the health sector, making primary care the centerpiece of their health reform agenda. The reforms included the creation of independent family group practices financed on a capitation basis directly from the Ministry of Health, allowing free choice of primary care providers through open enrollment, and creating a non-governmental primary care physician association. This program has had remarkable success in improving motivation among primary health care workers.

A conceptual framework of motivation processes is presented and used to identify strategies and options for the measurement of health worker motivation in developing countries. Measures of motivation are broadly organized into determinant and consequent categories, and determinants are further distinguished in terms of measures that influence worker–organization goal congruence (“will do” motivation) and those directed toward goal striving (“can do” motivation).

Problems related to health worker motivation are remarkably pervasive, but to-date little attention has been paid to them in developing and transition countries. Basic tools to measure the determinants and consequences of motivation have not been adapted to contexts outside the industrialized world. This paper assesses the feasibility of transferring psychometric tools, typically used in industrialized countries to measure motivational processes, to other contexts. The paper draws upon two field studies conducted in two hospitals in the Republic of Georgia and two hospitals in the Hashemite Kingdom of Jordan.

This paper offers a conceptual framework for considering the many layers of influences upon health worker motivation. It suggests that worker motivation is influenced not only by specific incentive schemes targeted at workers, but also by the whole range of health sector reforms which potentially affect organizational culture, reporting structures, channels of accountability, etc.

This presentation was part of the ECSACON Conference. It discusses the advantages and disadvantages of traditional teaching versus distance education for nurses and midwives.

This is a glossary of terms commonly used in the field of Human Resources for Health.

The global crisis in the healthcare workforce has attracted much attention in recent years. There is a global imbalance of human resources for health and, in particular, a shortage of healthcare workers in developing countries. To meet the growing global demands of caring for the increasing numbers of patients with chronic conditions, we need to develop a new approach to training [author’s description]

This presentation is part of the MAQ Exchange and discusses leadership as enabling groups of people to make progress in complex conditions. It states that leadership is helping groups of people to identify their critical challenges, and mobilizing them to learn and take effective action. What about those leaders in our midst, those people who enable groups to make progress at the local and district levels. This presentation is a report of findings about “everyday leaders,” those who lead others everyday, in difficult conditions. [adapted from speaker notes]

Family planning and other health care organizations in developing countries increasingly must do more with the same resources, and sometimes with fewer. Reorganizing work processes offers one common-sense way to help staff members at all levels cope with growing demands. [author’s description]

A potentially effective strategy for bringing early, appropriate and low cost treatment of malaria closer to the home is through the use of community health workers. The objective of this study was to determine peoples’ stated and actual preferences for different strategies for improving the timeliness and appropriateness of treatment of malaria before and after the implementation of a community health workers strategy in their community. [from abstract]

Human resources for health are non-existent in many parts of the world and the outer islands of Marshall Islands in Micronesia are prime examples. While the more populated islands with hospital facilities are often successful in recruiting qualified health professionals from overseas, the outer islands generally have very limited health resources, and are thus less successful. In an attempt to provide reasonable health services to these islands, indigenous people were trained as Health Assistants (HA) to service their local communities.

The medical brain drain has been described as rich countries looting doctors and nurses from developing countries undermining their health systems and public health. However this brain-drain might also be seen as a success in the training and export of health professionals and the benefits this provides. This paper illustrates the arguments and possible policy options by focusing on the situation in one of the poorest countries in the world, Malawi. [author’s description]

This review of the South African Health Information System (HIS) maps essential health-related information, discusses the District Health Information System, details the current status of the HIS and the challenges the HIS faces.

This Manual is designed to be a quick-and-easy, user-friendly reference for the development of health management information systems (HMIS), with the focus on applications. It serves as a primer on HMIS development and provides a general overview of the basic principles, as well as the fundamental steps and issues involved in the different activities to be undertaken. It aims simply to provide the basic elements on HMIS development for people who do not have the time or the need to read deeply on the subject.

Public health decision-making is critically dependent on the timely availability of sound data. The role of health information systems is to generate, analyse and disseminate such data. In practice, health information systems rarely function systematically. This article discusses some of the historical problems inherent in these systems and describes the Health Metrics Network, a global collaboration intended to help bring solutions to the countries most in need. [adapted from abstract]