Workforce Assessment

This report is an attempt to systematically document and evaluate the state of the health workforce in Africa. It draws on academic published literature (which is limited), the WHO statistical database (which is incomplete and only sporadically updated), studies of bilateral donors, national documents, and newspaper articles. The report shows clearly that for more than a decade HR issues have received very little attention. [from foreword]

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.

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.

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 report presents the findings of a study conducted at 16 healthcare sites in Zambia offering voluntary counseling and testing (VCT), prevention of mother-to-child transmission of HIV (P-MTCT), and antiretroviral (ARV) therapy. The study period, including design, implementation, and data analysis, was April to June 2003. The purpose of the study was to assist the Government of Zambia in determining whether it will have sufficient staff to be able to scale up VCT, P-MTCT, and ARV treatment to reach its targeted numbers of clients.