Journal Articles

The aim of the study was to estimate the use of skilled attendants’ delivery services among users of antenatal care and the coverage of skilled attendants’ delivery services in the general population in Kikoneni location, Kenya. Antenatal care attendance, deliveries by skilled attendants, and the percentage of antenatal care attendees who delivered in a healthcare facility were assessed. Targeted programmatic efforts are necessary to increase skilled attendant-assisted births, with the ultimate goal of reducing maternal mortality. [from abstract]

This document provides a brief history of training of traditional birth attendants (TBAs), summary of evidence for effectiveness of TBA training, and consideration of the future role of trained TBAs in an environment that emphasizes transition to skilled birth attendance. [adapted from abstract]

Funding for scaling-up antiretroviral treatment (ART) in low-income countries has increased substantially, but the lack of human resources for health (HRH) is increasingly being identified as an important constraint for scaling-up ART. ART is labour intensive. Important reductions in doctor-time per patient can be realized during scaling-up. The doctor-based ART delivery model analysed seems adequate for Cambodia. However, for many districts in sub-Saharan Africa a doctor-based ART delivery model may be incompatible with their HRH constraints. [from abstract]

This paper describes the socio-economic profile of medical students in the 1998/99 academic year at the Universidade Eduardo Mondlane (UEM) Medical Faculty in Maputo. It aims to identify their social and geographical origins in addition to their expectations and difficulties regarding their education and professional future. [from abstract]

To improve birth spacing services in Cambodia, the development of the communication and counselling skills of all providers is critical. A a large part of this issue focuses on these skills. [editor’s description]

This paper aims to review current knowledge and experiences from ongoing efforts to monitor and evaluate capacity building interventions in the health sector in developing countries.

As healthcare systems around the world are facing increasing physician shortages, more physicians are migrating from low to high income countries. As an illustrative case of international migration of physicians, we evaluated the current number and historical trends of Lebanese medical graduates in the US, and compared their characteristics to those of US medical graduates and other international medical graduates. [abstract]

The objectives of this paper are to: lay out the facts on what we know about the HRH for EMR countries; generate and interpret evidence on the relationship between HRH and health status indicators for LMICs and middle and high income countries (MHICs) in the context of EMR; identify and analyze the information gaps and provide forward thinking by identifying priorities for research and policy. [abstract]

This document outlines the Programme for Development of Human Resources for Health (HRH) in the WHO South East Asia Region, whose overall aim is to collaborate with the Member Countries to correctly plan, effectively train, efficiently deploy and optimally utilize the types and numbers of health personnel that they require to meet the needs of their health systems. [from introduction]

One of the challenges of continuing professional development (CPD) is to ensure that members of the medical profession maintain and improve the competencies in medical practice. CPD is an evolving system and different countries in Africa are at different levels of development. This article focuses on the developments and challenges of CPD among medical and dental practitioners in Africa. [abstract]

There are few cost-minimisation studies in telemedicine. We have compared the actual costs of providing the telepaediatric service to the potential costs if patients had travelled to see the specialist in person. In November 2000, we established a novel telepaediatric service for selected regional hospitals in Queensland. Instead of transferring patients to Brisbane, the majority of referrals to specialists in Brisbane have been dealt with via videoconference.

Typically, provider–client interactions are brief, and providers often behave condescendingly toward clients. As a result, clients are unable to express their concerns or describe the limitations they face in trying to implement the providers’ suggested course of action. A training intervention was developed for providers that focused on addressing the problems inherent in this dynamic. This research was undertaken to assess whether providers in the experimental area delivered services in a different manner than they had prior to the training intervention. [adapted from author]

The objective of this article is to examine in Peru the nature of dual practice (doctors holding two jobs at once - usually public sector doctors with private practices), the factors that influence individuals decisions to undertake dual practice, the conditions faced when doing so and the potential role of regulatory intervention in this area. [from abstract]

As many as 30% of doctors working for the National Health System of the United Kingdom of Great Britain and Northern Ireland have obtained their primary qualifications from a country outside the European Union. Factors driving this migration of doctors to the UK is not fully understood and merit continuing exploration. Our objective was to obtain training and employment profile of UK doctors who obtained their primary medical qualification outside the European Union (non-European doctors) and to assess self-reported reasons for their migration. [from abstract]

The most pressing challenge to achieving universal access to highly active anti-retroviral therapy (HAART) in sub-Saharan Africa is the shortage of trained personnel to handle the increased service requirements of rapid roll-out. Overcoming the human resource challenge requires developing innovative models of care provision that improve efficiency of service delivery and rationalize use of limited resources. We conducted a time-series intervention trial in two HIV clinics in central Mozambique to discern whether expanding the role of basic-level nurses to stage HIV-positive patients using CD4 counts and WHO-defined criteria would lead to more rapid information on patient status (including identification of HAART eligible patients), increased efficiency in the use of higher-level clinical staff, and increased capacity to start HAART-eligible patients on treatment.

The ability of health organizations in developing countries to expand access to quality services depends in large part on organizational and human capacity. Capacity building includes professional development of staff, as well as efforts to create working environments conducive to high levels of performance. The current study evaluated an approach to public-private partnership where corporate volunteers give technical assistance to improve organizational and staff performance. [from abstract]

Effective teamwork between doctors and clinical nurse practitioners (CNP) is essential to the provision of quality primary care in the South African context. The Worcester Community Health Centre (CHC) created dedicated practice teams offering continuity of care, family-orientated care, and the integration of acute and chronic patients. The teams depended on effective collaboration between the doctors and the CNPs. This inquiry focuses on the question of how more effective teams of doctors and clinical nurse practitioners offering clinical care could be created within a typical CHC. [adapted f

The crisis of human resources for health that is affecting low-income countries and especially sub-Saharan Africa has been attributed, at least in part, to increasing rates of migration of qualified health staff to high-income countries. We describe the conditions in four Organisation for Economic Cooperation and Development health labour markets that have led to increasing rates of immigration. [from summary]

Although effective teamwork has been consistently identified as a requirement for enhanced clinical outcomes in the provision of healthcare, there is limited knowledge of what makes health professionals effective team members, and even less information on how to develop skills for teamwork. This study identified critical teamwork competencies for health service managers. [from abstract]

The study of the health workforce has gained in prominence in recent years, as the dynamic interconnections between human resource issues and health system effectiveness have come into sharper focus. This paper reviews lessons relating to strategic management challenges emerging from the growing literature in this area. [from abstract]

This article discusses the issue the brain drain of doctors to more developed countries and Ghana’s efforts to supply an adequate health workforce in the face of this problem.

This text presents the context and background, the methodology and some of the main results of the regional consultation on the critical challenges for human resources in health in the Americas. This consultation hopefully documents how the countries in the Americas are facing the main challenges to the development of the health workforce. The main results and suggestions by the actors consulted with regard to the role of international cooperation in the countries of the Region are presented, so that the countries and international agencies can better formulate common strategies of development and strengthening of the work force in health.

Using a representative sample of 478 doctors, nurses, and lab technicians working with people living with HIV/AIDS (PLWHA), a cross-sectional study was conducted to assess the impact of the AIDS epidemic on medical care systems and service providers in China. The study findings suggest that improved institutional support for AIDS care at the facility level and HIV-related stigma reduction intervention are crucial to maintain a high quality performance by the workforce in the health care system. [from publisher’s description]

This article outlines the development and content of a community-based research capacity building framework for Aboriginal and Torres Strait Islander health workers. The focus is on the major issues that enhance a proactive service delivery model using culturally appropriate research methods. The overall aim of the framework is to supplement current institutionally-based education and training resources for health workers with community-based research training modules. These modules can be tailored to provide research and evaluation skills relevant to health workers taking a more proactive role in facilitating health and wellbeing programs in their own communities.

Despite the expanding literature on how reforms may affect health workers and which reactions they may provoke, little research has been conducted on the mechanisms of effect through which health sector reforms either promote or discourage health worker performance. This paper seeks to trace these mechanisms and examines the contextual framework of reform objectives in Uganda and Bangladesh, and health workers responses to the changes in their working environments by taking a realistic evaluation approach. [abstract]

The risk of transmission of Mycobacterium tuberculosis from patients to health-care workers is a neglected problem in many low- and middle-income countries. Most health-care facilities in these countries lack resources to prevent nosocomial transmission of tuberculosis. [author’s description]

Many countries in Latin America and the Caribbean have too many specialists and too few primary care providers and community health workers. These countries need to overhaul their training and payment practices to address this imbalance, say human resources experts. [author’s description]

Many women choose to use traditional birth attendants in Guatemala to deliver their babies - a fact that can’t be ignored, according to local public-health officials. They hope a new culturally sensitive approach to training traditional birth attendants will help improve their quality of care and save lives. [adapted from author]

The migration of health professionals trained in Africa to developed nations has compromised health systems in the African region. The financial losses from the investment in training due to the migration from the developing nations are hardly known. Developing countries are losing significant amounts of money through lost investment of health care professionals who emigrate. There is need to quantify the amount of remittances that developing nations get in return from those who migrate. [from abstract]

Rewards are important in attracting, motivating and retaining the most qualified employees, and nurses are no exception to this rule. This makes the establishment of an efficient reward system for nurses a true challenge for every hospital manager. A reward does not necessarily have a financial connotation: non-financial rewards may matter too, or may even be more important. Therefore, the present study examines nurses’ reward perceptions, in order to identify potential reward options. [abstract]