Education and Training

Despite progress in developing more effective training methodologies, training initiatives for health workers continue to experience common pitfalls that have beset the overall success and cost-effectiveness of these programs for decades. These pitfalls are now seen as aggravating the current crisis in human resources for health and impeding the effective scale-up of training and the potential impact of promising strategies such as task shifting to address health worker shortages.

While evaluation is, in theory, a component of training programmes in health planning, training needs in this area remain significant. Improving health systems necessarily calls for having more professionals who are skilled in evaluation. This article describes a four-week course taken by two cohorts of health professionals from 11 francophone African countries. We discuss how the course came to be, its content, its teaching processes and the master’s programme results for students. [from abstract]

The purpose of this primer is to document and promote best practices gleaned from worldwide experience in training private sector providers. [from introduction]

While the recruitement of rural doctors is steadily rising, there is concern about their long-term retention. In response, an orientation course for recently established rural doctors was set up in 2003, based on a training needs assessment. This paper draws lessons from this experience, focusing on processes and mechanisms operating in the relation between training and retention in rural practice. [adapted from author]

This presentation on the domestic training and international recruitment of health workers was offered during a dialogue hosted by the WHO and OECD.

Managers are an essential component of the health workforce. Good management is essential for quality service delivery and achieving desired health outcomes. This resource details a balanced, strategic approach to strengthening management capacity. [from introduction]

The PARiHS framework (Promoting Action on Research Implementation in Health Services) has proved to be a useful practical and conceptual heuristic for many researchers and practitioners in framing their research or knowledge translation endeavors. However, as a conceptual framework it still remains untested and therefore its contribution to the overall development and testing of theory in the field of implementation science is largely unquantified.

This paper provides an integrated summary of the conceptual and theoretical thinking thus far regarding PARiHS. It introduces a typology used to distinguish between the terms conceptual framework, theory and model

This report calls for a rapid and significant scaling up of the education and training of health workers as part of a broader effort to strengthen health systems. It highlights the importance of training to meet a country’s own health needs and the great opportunity represented by the increased use of community- and mid-level workers. [from foreword]

There are also case studies from Ghana, Malawi, Pakistan, Ethiopia and Bangladesh on strategic implementation of health worker training plans.

Measuring and monitoring the whole education and training pipeline is essential to the planning, management and quality control of the health workforce in a country. This requires timely and reliable data on each of its phases. [from author]

Modernizing the way health care professionals are educated and engaged in their vital work requires a collaborative and coordinated approach among many players. The Health Council convened the summit on health human resources to focus on practical, short-term solutions. This report attempts to capture the lively discussion and encouraging examples of innovation brought forward at that forum, organized into four theme areas: education and training, scopes of practice, workplace practices and planning. [adapted from author]

This article describes the efforts within the Cuban medical system to collaborate with health authorities around the globe to develop medical education programs to train such urgently-needed professionals with curricula formulated to meet international standards and local health needs. Special emphasis is placed on the assistance that Cuba provided to Gambia in establishing a medical school in that country. [from author]

This article describes the Cuban medical education system. The role of Cuban physicians internationally is discussed, as well as the placement of international students in Cuban medical schools.

The world’s 1,691 medical schools and 5,492 nursing schools are not producing enough graduates to cover the massive global deficit of doctors, nurses, and midwives. One scaling-up initiative addressing these critical shortages is Cuba’s Latin American Medical School. This article describes those efforts. [adapted from introduction]

This presentation was given at the First Forum on Human Resources for Health in Kampala. It details the financial issues involved in scaling up health worker training such as the cost of hiring additional staff, educating health workers and expanding training capacity. It also outlines the current and possible future sources of increasing expenditure for health worker training. [adapted from author]

This presentation was given at the First Forum on Human Resources for Health in Kampala. It discusses the need for scaled-up management and leadership training to equip healthcare professionals with the skills, experience and knowledge to manage health programs effectively and how private sector approaches to this challege offer a strategic resource to improve the management and output of health systems. [adapted from author]

This presentation was given at the First Forum on Human Resources for Health in Kampala. It introduces the reasons behind the formation of the Task Force for Scaling up Education and Training of Health Workers and what it will accomplish.

This presentation was given at the First Forum on Human Resources for Health in Kampala. It discusses educational strategies for training health workers to scale up service delivery in Brazil.

This article describes the work of the Task Force for Scaling Up Education and Training for Health Workers, which was established to create to create practical proposals for a massive increase in the education and training of health workers, as part of a systematic effort to build up health systems in developing countries. [adapted from author]

As a group, indigenous Australians are much less healthy and more likely to die at younger ages than their non-indigenous counterparts. Training more indigenous people as health workers could help to reduce these startling inequalities, say experts. [author’s description]

This HRH policy document addresses the production and utilization of Human Resources within the Ministry of Health and Sanitation in Sierra Leone. It also responds to the contemporary challenges and developments including the exodus of human resources and advancement in technology. This policy intends to regulate and direct planning, production, management, utilization and monitoring of HR within the health sector. [from foreword]

This tool provides a process for periodically reviewing and revising training sessions or courses in a systematic manner. [author’s description]

The aims of these guidelines are to provide information about the concepts and processes essential for quality assurance of basic nursing and midwifery education in the African Region; propose a process and content for evaluating existing basic nursing and midwifery education programs; stimulate ideas for establishing a quality assurance system for basic nursing and midwifery education; guide allocation of human and financial resources in current and future programmes and services; provide well-defined international and regional standards of education. [from introduction]

This paper presents a discussion regarding public health’s main challenges in Latin America: knowledge of it, professional practice and training human resources. Emphasis is placed on three components: knowledge of public health, social practice and human resources training. [from abstract]

The health worker crisis is particularly acute in rural and hard to reach areas, where 80% of the population in Africa live. The resultant low capacity at the peripheral level of the health system is a crucial barrier to good health. AMREF believes that developing capable, motivated and supported health workers at all levels of the health system is essential in ensuring the delivery of accessible and effective health care across Africa… This briefing draws on AMREF’s experience to look at three key issues: the importance of appropriate training, task-shifting to lower cadres of worker, and training and supporting community health workers (CHW) in order to bring health care closer to communities.

A cross-sectional study was carried out in Mkuranga District of Tanzania with the aim of comparing the ability of trained and untrained traditional birth attendants (TBAs) in identifying women with danger signs for developing complications during pregnancy and childbirth as well as their referral practices. Study findings revealed that majority of the TBAs (86.5%) had not received any training. Trained TBAs were more knowledgeable on danger signs during pregnancy and childbirth and were more likely to refer women with complications to a health facility, compared to untrained TBAs. The authors recommend that in resource constrained countries like Tanzania and especially in remote rural areas, TBAs should be trained on early identification of mothers with obstetrical complications and on their prompt referral to health facilities that can provide emergency obstetric care.

This manual presents Learning for Performance, a systematic instructional design process based on IntraHealth’s experience in designing reproductive health and HIV/AIDS training and performance improvement programs over the last 27 years in countries around the world. The manual and accompanying tools help connect learning to specific job responsibilities and competencies. To facilitate use and adaptation of the 14 Learning for Performance tools in the manual, Microsoft Word versions of the tools are available for downloading. [adapted from publisher]

This report on the Consultation on AIDS and Human Resources for Health, WHO, Geneva, 11-12 May, 2006 outlines the Treat, Train Retain plan to address AIDS and HRH. The plan comprises three sets of elements: a package of HIV treatment, prevention, care and support services for health workers in countries affected by HIV (Treat); measures to empower health workers to deliver universal access to HIV/AIDS services (Train); and strategies to retain health workers in the public health system, including financial and other incentives and strategies to improve pay and working conditions and manage the migration of health care workers (Retain).

All health care professionals need to understand and implement the principles of EBM to improve care of their patients. Interactive and clinically integrated teaching and learning activities provide the basis for the best educational practice in this field. [summary]

This article discusses the need for effective staff training for qualiy immunization services and describes one non-governmental organization’s experience of training partners in countries. [adapted from author]

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]