Latest Resources

Discrimination against people living with HIV or AIDS results in poor quality of care for those who are infected or ill (or suspected of being infected), frightens away potential clients in need of care, and undermines effective HIV prevention efforts by limiting individuals’ access to and use of health care services. As HIV treatment programs become increasingly available in resource-poor countries, access to and use of these lifesaving services will depend on the degree to which health facilities welcome and respect the rights of HIV-positive clients. To address these serious issues, EngenderHealth has developed Reducing Stigma and Discrimination Related to HIV and AIDS: Training for Health Care Workers, a two-volume curriculum offering a unique training opportunity for health workers in countries hardest hit by the AIDS pandemic. The curriculum consists of a participant’s handbook and a trainer’s manual. [publisher’s description]

Maldistribution of human resources for health is a worldwide phenomenon and may appear in different dimensions. The first and greatest concern is the inequitable distribution, particularly of high level professionals like doctors, both among countries in the world and within each country. [author’s description]

The Government of Ghana has adopted the WHO focused antenatal care (ANC) package in a move to improve access, quality and continuity of ANC services to pregnant women. As part of these efforts, the Government has exempted fees for ANC clients. The main objective of this study, undertaken by Noguchi Memorial Institute for Medical Research in collaboration with the Ghana Health Service (GHS), FRONTIERS, and with USAID funding, was to examine the extent to which adaptation of the package influenced quality of care received by pregnant women and its acceptability to both providers and clients. The study used a policy analysis and a situation analysis in ten intervention clinics in which the package had been introduced and four comparison clinics.

To promote the health and survival of mothers and babies, Kenya has adapted the WHO goal-oriented Antenatal Care (ANC) package, popularly known as focused ANC (FANC). The Ministry of Health (MOH) has designed new guidelines for ANC services, placing emphasis on refocusing antenatal care, birth planning and emergency preparedness, and the identification, prevention and management of life threatening complications during pregnancy and childbirth. ANC visits are now used as an entry point for a range of other services, thus promoting comprehensive integrated service delivery. A major challenge, however, is whether the Kenyan health care system can cope with the implementation of this package.

This report is the result of the meeting of the 47th Directing Council and 58th session of the Regional Committee in Washington DC. It is a summary of actions and proposals for a plan of action on human resources for health in the Americas submitted for the consideration of the Directing Council. This document summarizes the activities carried out to date in the countries and in the Governing Bodies. It provides an overview of the situation and the predominant trends in the Region, as well as a vision of the technical proposals and agreements for activities that are being developed.

To support good performance, health care workers need clear job expectations, up-to-date knowledge and skills, adequate equipment and supplies, constructive feedback and a caring supervisor (Luoma and Crigler, 2002). Workers also need motivation, especially when some of the other factors that support good performance are lacking. Indeed, highly motivated individuals can often overcome obstacles such as poor working conditions, personal safety concerns and inadequate equipment. Given the current challenges related to human resources for health (HRH) in most developing countries (Joint Learning Initiative, 2004), helping workers to be as productive as possible in the face of such obstacles can be an important outcome of increased motivation.

Few countries in Latin America have experienced in such a short period the shift from a socialist government and centrally planned economy to a liberal market economy as Nicaragua. The impact of such a change in the health field has been supported by the quest for reform of the health system and the involvement of external financial agencies aimed at leading the process. However, this change has not been reflected in the planning of human resources for health.

The objective of this article is to explore the type of private practice supplementary income-generating activities of public sector doctors in the Portuguese-speaking African countries, and also to discover the motivations and the reasons why doctors have not made a complete move out of public services. [objective]

This paper discusses human capital outflow from Africa from a developmental perspective. The focus is on the high skill content of African emigration to industrial countries, its impact on development in the region, and the challenges faced by institutions of higher learning to help the region deal with this problem. This paper further takes up the issue of African brain drain in the context of relevant changes taking place globally: globalization, movement towards a knowledge-based economy, and global demographic trends. [adapted from author]

This monograph presents a conceptual framework to help healthcare systems and organizations analyze, plan, build and sustain efforts to produce quality healthcare. The framework synthesizes more than ten years of QA Project experience assisting in the design and implementation of QA activities and programs in over 25 countries. [author’s description]

This monograph provides an introductory overview of QA for developing countries. It will be of interest to policy makers, upper-level ministry of health (MOH) officials, and district-level health service managers. Part I describes how quality assessment and improvement have been carried out in less developed countries (LDCs). Part II discusses the feasibility and rationale for applying QA in the developing world. Part III proposes some definitions and dimensions of quality. Part IV reviews the definition and basic tenets of QA.

This manual was developed to assist district health management teams in countries where malaria is endemic to improve the quality of malaria treatment given by private clinics, pharmacies, shops and kiosks. It gives step-by-step instructions for how to implement a public health activity that will involve wholesalers in communicating malaria guidelines to retailers and private clinics. [author’s description]

The Quality Assurance Project investigated how job aids could increase compliance with guidelines for the Integrated Management of Childhood Illness (IMCI) in cooperation with the Zambia Central Board of Health beginning in 1999. One of the first countries to introduce IMCI, Zambia had a large number of IMCI-trained providers, and several IMCI job aids were already in use: a chartbook, recording form, poster, and mother card.

The involvement of district-level workers in local-level practical approaches to mainstreaming gender is central to facilitating change and informing health strategies. There are very few practical examples of mainstreaming gender in health, especially at the lower levels of the health sector. One approach is to build the capacity of staff to conduct and respond to gender analysis. [author’s description]

Workers tend to go where the working conditions are best. Income is an important motivation for migration, but not the only one. Other reasons include better working conditions, more job satisfaction, career opportunities and the quality of management and governance. Political instability, war, and the threat of violence in the workplace also are strong drivers in many countries. [author’s description]

The Sector Policy Review Tool offers a kit for involving important stakeholders more directly in reviewing health sector development, including specific programmes or areas within the health sector. It is made up of an introduction and several modules that guide different aspects of the review process. [author’s description]


Module 4 is dedicated to human resources for health.

Many articles on the loss of health professionals in sub-Saharan Africa highlight migration to higher paying jobs in wealthier countries as a major cause of the shortage of health professionals. In fact, emigration is not the greatest drain on the supply of health professionals in some countries severely affected by AIDS. Death is depleting the ranks of health professionals more rapidly than recruitment abroad. [author’s description]

Training and innovative tools were key to the success of the Tanzania Essential Health Interventions Project, along with small funding increases. The tools and strategies allowed the districts of Rufiji and Morogoro to target their new resources on the largest contributors to the burden of disease and on health care delivery. The most dramatic result, among many, has been an average decline in child mortality of more than 40%. [from author]

This checklist is designed to be completed by clinical trainers preparing for clinical training courses. It covers the areas of Participant Selection and Management, Classroom Logistics, Clinic Logistics, and Classroom Preparation/ Management.

A key purpose of the manual is to enable hospital administrators, clinic managers and healthcare professionals working in limited resource settings to develop their own uniform infection prevention policies and service delivery guidelines. It is recognized, however, that the strategies, priorities and proven methods of infection risk reduction described in this manual will need to be adapted to reflect the existing conditions in each country. Only through this process can much needed changes be implemented and patient care in hospitals and clinics improved. [from preface]

The methodology for improving quality in healthcare has evolved rapidly over the past decade. This has come about as a result of several factors: the large number of field experiences that have taken place in many countries worldwide and in a variety of different areas and specialities in healthcare delivery; the increasing complexity of healthcare delivery and with that the emerging new needs for efficient and cost-effective care; the increased expectations of our customers; and lastly, the advances in our knowledge on improvement, management, and clinical practice.

This newsletter concentrates on planning, preparing, delivering and reviewing training sessions designed for employees like health workers.

The objective of this document is to implement and evaluate a public–private partnership to deliver the internationally recommended strategy DOTS for the control of tuberculosis (TB) in Lalitpur municipality, Nepal, where it is estimated that 50% of patients with TB are managed in the private sector. [author’s description]

This report presents estimates of the total cost of providing comprehensive antiretroviral (ARV) treatment in the public sector in Nigeria, using the AIDSTREATCOST model to estimate the cost of providing Highly Active Antiretroviral Therapy (HAART), Voluntary Counseling and Testing (VDT), and Opportunistic Infection (OI) treatment, and other resource requirements for implementing the national antiretroviral (ARV) treatment program

The 2003 technical review report covers only one main strategy: district health services. It looks at district health service performance from the viewpoint of Council Health Management Teams (CHMT) and LG. The report presents a short general appraisal of district health services (section 1). Planning and budgeting for better health (section 2) looks at what the requirements are for a performing planning and budgeting process (section 2.1, including guidelines and process) and what information should be available at council level to develop a comprehensive council health plan (section 2.2). Issues related to implementing the council health plan (section 3) include financial resources (3.1), non-financial resources (3.2), systems development (3.3) and service delivery (3.4).