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In this paper, we focus on those policy instruments with monetary incentives that are used to contain public health expenditure in high-income countries.

Despite the limited, but growing, evidence base on the impact of HRM on organisational performance in other sectors, there have been relatively few attempts to assess the implications of this evidence for the health sector. This paper examines this broader evidence base on HRM in other sectors and examines some of the underlying issues related to “good” HRM in the health sector. [from abstract]

Recruitment and retention of medical staff are important issues in rural health. The aim of this study was to describe and understand the perceptions of women doctors working in rural hospitals in South Africa about their work. [from abstract]

This pilot study focused on self-identified factors of nursing students who expressed an interest in rural practice post-graduation. The sample included students from the USA and Canada, who were enrolled in graduate and undergraduate programs of nursing, and were attending an international rural nursing conference. [From abstract]

What makes one training experience better than another? Effective training can help providers of family planning/reproductive health (FP/RH) services to improve their performance. This handbook summarizes the tasks that should be completed at each stage of training to ensure an effective training course.

This paper reviews several theoretical perspectives to increase understanding of the key determinants of health worker performance, including theories of behavior change, diffusion of innovation, health education, and social influence. The main types of interventions that have been used to encourage health workers to perform in accordance with standards are described, and evidence from empirical research for their effectiveness is summarized. [author’s description]

The author argues that the migration of physicians and other trained health professionals undermines the ability of developing countries to meet agreed Millennium Development Goals and creates untenable health conditions for the poorer sections of their populations.

The authors report on a study in which unannounced visits were made to health clinics in Bangladesh with the intention of discovering what fraction of medical professionals were present at their assigned post. This survey represents the first attempt to quantify the extent of the problem on a nationally representative scale. [from abstract]

This research sheds light on the nature, design and provision of institutional services for providing training to the premier community health service providers in the public sector in Bangladesh. Virtually no major study exists on the training of the FWVs in the country. The methodology of the research mainly consists of a personal interview and questionnaire survey, covering the concerned trainers and officials of the major public health administration and training institutions of the country, including the National Institute of Population Research and Training, the Family Planning Directorate and the Family Welfare Visitors’ Training Institute.

Imbalance in the health workforce is a major concern in both developed and developing countries. It is a complex issue that encompasses a wide range of possible situations. This paper aims to contribute not only to a better understanding of the issues related to imbalance through a critical review of its definition and nature, but also to the development of an analytical framework. [from abstract]

This background paper aims to increase understanding of the requirements for introducing and scaling up provision of antiretroviral therapy (ART) as part of comprehensive HIV/AIDS programmes in resource-poor countries. The paper provides an overview of experience and lessons learned with regard to: the feasibility of ART in resource-poor settings; the different approaches being taken to delivery of ART; and the issues to be considered in scaling up ART provision, including human resources. [adapted from author]

This study indicates that healthcare professionals are using mostly clinical handover meetings, seminars and workshops for their continued professional development (CPD). There is need to improve access to relevant professional journals. The regulatory or licensing boards for healthcare professionals in Malawi should seriously consider mandatory CPD credits for re-certification. [author’s description]

This reference manual, part of a learning package developed through a collaboration between the World Health Organization and JHPIEGO, contains 12 modules on topics such as facilitating group learning, managing clinical practice, and preparing and using knowledge and skills assessments. The modules include examples related to maternal, reproductive and child health.

There has been a lively debate in the media about working conditions in rural South African Hospitals, with a particular focus on staffing and quality of care. From a medical perspective, it has been stated that poorly equipped and managed hospitals, inappropriate training and an excessive workload are significant contributors to the problem. This study was conducted to investigate the experiences of medical practitioners in performing their professional duties in rural district hospitals in the Western Cape. [from abstract]

This paper analyzes shortages of nurses in OECD countries. It defines and describes evidence on current nurse shortages, and analyzes international variability in nurse employment.

When health care workers participating in training are able to transfer their newly acquired knowledge and skills to their jobs, higher levels of performance and sustained improvements in service delivery are likely to result. A joint publication of PRIME II and JHPIEGO, Transfer of Learning uses a dynamic matrix to outline specific steps for supervisors, trainers, learners and co-workers to follow before, during and after a learning intervention to promote the transfer of learning. PRIME II has also created an interactive website based on Transfer of Learning.

This paper examines the issues relating to self-assessment, such as the different types of self-assessment, its uses, and its validity. It also reviews the literature (largely from developed countries) that informs our knowledge of self-assessment. The paper makes recommendations for future research and concludes that while much remains to be done to assure that self-assessment has the impact it promises, it may also be less costly and easier to implement than alternatives. [from author]

This document outlines five key areas requiring intervention: human resources planning and capacity building, management of personnel, evidence-based practice, education, and stewardship. It provides a tangible response to resolution WHA54.12, which was adopted by the World Health Assembly in May 2001, and facilitates the achievement of WHO’s four strategic directions as well as the United Nations Millennium Development Goals. The document consists of two sections. Part I introduces the Strategic Directions, Key Result Areas and Objectives with the Expected Results to achieve them.

This is the fourth of a series of policy briefs produced by the Community Health Department of the Aga Khan Health Service in Kenya. It focuses on a number of issues related to the management of health facilities: the rational for decentralisation of health services, the role of the community in the management of health facilities, the membership of local management committees, selection criteria and, finally, the involvement of local politicians.

These briefs are primarily intended for directors and managers of community-based health care programmes — whether working within ministries of health, international donor agencies or non-government organisations.

This paper provides practical guidelines for managers and health professionals looking to skill mix as a potential solution to health service delivery problems. These guidelines emphasise the need to evaluate the problem, and examine the context, before deciding if skill mix is the answer. The guidelines are provided in the knowledge that skill mix is rarely examined in a pure theoretical sense by organisations. They have to adopt a pragmatic approach which takes account of the day-to-day realities of their priorities and resources. [abstract]

This report emanates from the results of a study that examined the impact of HIV/AIDS on the public and private health facilities in South Africa, and outlines the subsystems that are affected. Both public and private sector health facilities have reported an increase in the number of patients seeking clinical care for people living with HIV/AIDS, leading to increased admissions to medical and pediatric wards and increased workloads. This study addresses these issues and makes recommendations for managing the HIV/AIDS case load. [from author]

Triple-drug combination antiretroviral (ARV) therapy has yielded remarkable results in affluent countries and some middle-income countries such as Brazil. Lessons can be learned from these examples, but this publication reviews the experiences of ARV programmes already underway in countries with very severe HIV epidemics but severely constrained resources, as in most of Africa and part of the Caribbean. The publication aims to show how some of the key policy issues for scaling up HIV/AIDS treatment have been dealt with and to identify common elements that should be considered by everyone seeking to provide HIV/AIDS care on a significant scale.

This study explored the factors that motivate lay volunteers to join tuberculosis (TB) control programmes in high burden but resource-limited settings. [adapted from abstract]

This study was carried out in order to determine factors that may facilitate the poor retention of registered nurses in the Malawian public health sector.

In the last few years, increasing attention has been paid to the development of health policies. But side by side with the presumed benefits of policy, many analysts share the opinion that a major drawback of health policies is their failure to make room for issues of human resources.