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An annual review done against the priorities set in the South Africa Health Sector Strategic Framework, 1999 to 2004, and in the Strategic Plan of the National Department for 2003/04 to 2005/06. Section 2 is devoted to Human Resource Management Data.

This paper provides a framework for understanding the key factors that affect provider competence. Different methods for measuring competence are discussed, as are criteria for selecting measurement methods. Also, evidence from various research studies on measuring the effectiveness of different assessment techniques is presented. [author’s description]

Action is underway to increase access to antiretroviral drugs, especially in countries with high rates of HIV. The role of private providers is largely ignored, although they are an important source of care for stigmatizing diseases in many poor countries. Evidence is emerging that antiretroviral drugs are leaking into formal and informal private markets. Uncontrolled use of drugs in the private sector will lead to rapid development of HIV resistance. Countries require guidance and support from international policy makers and pharmaceutical companies to implement strategies for working with private providers.

The core objective of the plan is national, comprehensive treatment and care for HIV/AIDS with equal access to services, long-term commitment, improvement of Rwanda’s general health services infrastructure beyond HIV/AIDS, and financial transparency. The approach for implementation will involve service integration with existing health system infrastructure, community mobilization, linkage between treatment and care and prevention, multi-country procurement economies of scale, and rapid scale-up and iterative learning based on a collaboratives model.

Using Thailand as a case study, this paper aims to explore the potential implications of integrated health system intervention. Within the Thai context, it is argued in this paper that autonomy of a network of public providers, rather than autonomy of individual hospitals, should be encouraged if management of health manpower is to be optimized. [from abstract]

In the face of rising demand for medical services due to ageing populations, physician migration flows are increasingly affecting the supply of physicians in Organisation for Economic Co-operation and Development (OECD) countries. This paper offers an integrated perspective on the impact of physician migration on home and host countries and discusses international regulation and policy approaches governing physician migration. [from abstract]

This paper reviews the challenges facing the public health workforce in developing countries and the main policy issues that must be addressed in order to strengthen the public health workforce.

Chapter 1 of this document describes the environment that affects the health workforce. Chapter 2 presents an overview of what lessons can be learned from priority programmes that have already struggled with the consequences of HRH limitations. Chapter 3 discusses possible strategies that can help to overcome HRH constraints. The last chapter proposes an agenda for action. [Adapted from authors]

This booklet has been prepared to assist policy makers in international organizations, governments and civil society. The authors hope that it will help design, introduce and implement public service and health sector reforms in the most effective and sustainable way, taking into account human resource policies. At the heart of the booklet are a set of critical questions which aim to help policy makers, including all social partners, to construct an effective path through the complex process of reform and restructuring. [author’s description]

This document is a combined Human Resources Development Plan and Human Resources Strategic Plan for the health and social welfare sector of Lesotho. The Development Plan is presented in Chapters 2 through 5, and the Strategic Plan is presented in Chapter 6. The essential difference between the two is that the HR Development Plan represents a technical assessment of the total labor supply and training requirements for the sector in the absence of any budget or production constraints. It reflects a technical assessment of what is needed and what should be produced and financed if we faced no constraints.

Public-Private health sector Interactions (PPI) are on the increase in South Africa. However, there are few mechanisms for the two sectors to routinely engage with each other. Such mechanisms are necessary to allow all stakeholders to understand better the motivations of, and the challenges that face, each sector and are a key part of the process of building trust between the sectors. The overall purpose of PPIs, and therefore of engagement between the public and private sectors, is to strengthen the overall health system for the benefit of all South Africans. [author’s description]

QAP implemented the first randomized control trial to measure the impact of accreditation in a developing country setting and reports its findings in this Operations Research Results report. The central issue to the report addresses the extent to which accreditation, known to favorably impact measurable indicators relating to the quality of care, actually improves patient outcomes. While exploring this issue, the report also sheds light on the importance of careful planning and communication in implementing complex research and would serve as a guide to others in undertaking similar efforts.

Human resources are an essential element of a health system’s inputs, and yet there is a huge disparity among countries in how human resource policies and strategies are developed and implemented. The analysis of the impacts of services on population health and well-being attracts more interest than analysis of the situation of the workforce in this area. This article presents an international comparison of the health workforce in terms of skill mix, sociodemographics and other labour force characteristics, in order to establish an evidence base for monitoring and evaluation of human resources for health.

Human resources in health care system in sub-Saharan Africa are generally picturing a lack of adequacy between expected skills from the professionals and health care needs expressed by the populations. It is, however, possible to analyse these various lacks of adequacy related to human resource management and their determinants to enhance the effectiveness of the health care system. From two projects focused on nurse professionals within the health care system in Central Africa, we present an analytic grid for adequacy levels. [from abstract]

The difficulty of ensuring an adequate and appropriate distribution of health services, together with increasing financial pressures in the public sector, are forcing many countries to consider using more rigorous methods for determining staffing levels in the health facilities. The Workload Indicators of Staffing Need (WISN) method is one such method. It uses a form of activity analysis (activity standards), together with measures of utilisation and workload to determine staffing requirements. The method provides a vehicle for assessing localised staffing needs that is believable and which at the same time is sharply different to historic methods.

This paper aims to summarize strategies to solve inequitable distribution of human resources for health (HRH) between urban and rural areas, by using four decades of experience in Thailand as a case study for analysis. [from abstract]

This article considers some of the effects of health sector reform on human resources for health (HRH) in developing countries and countries in transition by examining the effect of fiscal reform and the introduction of decentralisation and market mechanisms to the health sector. [adapted from abstract]

This paper seeks to provide a compelling evidence base to reveal the factors that lead to high turnover and to promote tested responses to retain health workers. The literature researched is presented to support country-level action. [abstract]

Four articles by separate authors on institutional responses and policies for managing HIV/AIDS in Africa, with specific emphasis on the role of tertiary institutions, such as schools and colleges. The articles are not specific to health training institutions, but are relevant to this context.

The WHO IMAI guidelines support the rapid expansion of access to ART by supporting the shifts of key tasks to multi-purpose health workers at first-level facilities located in the community (health centres and clinics). By preparing nurses and clinical aids to provide acute care to adults, many opportunistic infections can be treated and the patient stabilized for ARV treatment without referral to district clinic. Management of patients near their home is important for equity and to achieve high levels of ARV adherence. [adapted from publisher’s description]

Health sector workers respond to inadequate salaries and working conditions by developing various individual coping strategies; some, but not all, of which are of a predatory nature. The paper reviews what is known about these practices and their potential consequences (competition for time, brain drain and conflicts of interest).

This brief report describes four different accreditation programs in South Africa: one is nationwide and addresses hospitals; the second accredits privately financed healthcare programs; the third is a provincial program accrediting all public healthcare facilities, and the fourth assesses clinics providing adolescent reproductive health. This operations research study interviewed stakeholders of the South Africa healthcare system to elicit their views of the best possible options for South Africa and of the strengths and weaknesses of the four existing programs. [author’s description]

Donor funds may be inadequate to support the growing demand for services provided by community-based distribution (CBD) programs. One solution may be to reduce the remuneration of CBD agents, but this approach may lower their productivity. Programs also need to consider reducing other costs, including those for supervision and training. The cost per agent visit—including costs associated with payments to agents and to supervisors and the costs of training—was calculated for three CBD programs in Tanzania. The output measure was visits in which contraceptives were provided or referrals made for family planning services.

OECD countries face a number of challenges in matching the supply to the demand for the services of physicians. These include making the right decisions on the numbers and training of new entrants, on the retention and retirement of the existing stock of physicians, and on migration policies for physicians. It also requires policies to ensure that there is the right specialty mix and geographical distribution of physicians. It will require appropriate decisions on terms and conditions of service and on methods of remuneration — not only to ensure that the right number of individuals is attracted to work in medicine but also to ensure that those who are attracted are motivated to be as productive as possible.

This paper analyses in detail the changing international health paradigms and the situations that challenge international mechanisms existing globally and in Thailand. Human resources development on international health and negotiation skills constitute the core responses. The initial success of the recent development in Thailand is also reviewed. Finally, the conceptual framework, possible strategies and priority activities are proposed to be carried out for future international health development. [from abstract]