Documents & Reports

Achieving significant reductions in maternal and newborn morbidity and mortality will be facilitated by developing a comprehensive approach to address the social and health system issues in the community, and at both peripheral and district-level facilities. This integrated approach to community and facility based maternal and newborn programming and implementation is called the Household-to-Hospital Continuum of Care. [from author]

The objective of this paper is to enable health sector leaders and managers to make data-driven decisions for human resources planning, policy making and management through strengthening human resources information systems. [author’s description]

This Kwik-Skwiz addresses the important area of clinic supervision. This document is aimed at district management teams; clinic supervisors and program managers may find it especially useful. Key areas of effective supervision are presented with the aim of assisting district management teams to critically assess clinic supervision in your district. [author’s description]

This document attempts to review the HRH situation in the WHO European Region. Section 2 addresses the problems associated with varying definitions to ensure a common understanding of the issues involved. In section 3, a number of key methodological issues (the relevance of HRH, education, management, regulation, etc.,) are analyzed. Section 4 summarizes the key HRH facts and figures for the region. In conclusion, section 5 describes the way forward and the main EURO policy proposals for supporting member states in this complex sphere. [author’s description]

Many health service managers are familiar with the problem of absenteeism in district hospitals. It affects the running of the hospital and can seriously compromise the quality of care which patients receive. For the purpose of this Kwik-Skwiz absenteeism is defined as staff taking time off that has not been scheduled or staff taking more leave than is necessary or reasonable. Clearly there are many legitimate reasons for taking sick or other types of leave. It is often debatable how much leave is reasonable. It often depends on the pattern and circumstances, rather than the actual total amount of leave that an individual takes. Managers have a responsibility to balance the rights and needs of individual staff members, with the needs of the hospital. High levels of absenteeism, both on the part of individuals or in the whole hospital, are often symptomatic of underlying problems. Addressing these issues can result in lower absenteeism levels that benefits staff, managers and patients. [author’s description]

The competency-based approach used in JHPIEGO-supported training improves performance by ensuring that trainees go back to their worksites with the knowledge and skills required to provide FP services. Once back at the workplace, however, participants often face constraints that limit their ability to provide quality services. Factors that can affect the performance of the healthcare provider include: job expectations, performance feedback, supplies and equipment, motivation, possessing the knowledge and skills to provide services, and supervision.

The Performance Improvement approach gives organizations the tools they need to find out which essential components of good performance are missing, and then match interventions to root causes, closing the gaps between the performance they are experiencing and the performance they desire.


This document is in English, French and Spanish.

The handbook includes descriptions of the facilitative approach to supervision and the roles and characteristics of facilitative supervisors in involving staff in the QI process, leading staff through change, creating a nonthreatening environment, and helping staff use data for decision making. [publisher’s description]

While the need to measure performance in the field of family planning and reproductive health care FP/RH) is widely recognized, there is no consensus on a standard definition of the term. Consequently, when organizations and projects describe or measure performance, particularly in the context of health worker or program evaluations, the term may be used in ambiguous and confusing or even contradictory ways. [author’s description]

AVSC defines facilitative supervision as an approach to supervision that emphasizes mentoring, joint problem solving, and two-way communication between the supervisor and those being supervised. This definition recognizes that supervisors play an essential role as intermediaries who can facilitate the implementation of institutional goals and who can facilitate local-level problem solving and quality improvement.

This report is designed as a general resource to help family planning program managers strengthen their programs and meet growing family planning needs…It offers a broad overview of key programmatic considerations. Each subsection includes a list of practical specialized resources and hands-on tools that can support program managers desiring to bring about programmatic change…

Chapter 19 of this report discusses “Palliative Care in Resource-Poor Settings.”

Palliative care is crucial in every care setting, rich or poor, for it is a philosophy of care that centers on improving quality of life for patients and their families. In this chapter, we focus attention on the need to integrate palliative care into national government strategies in order to address the pandemic in resource-poor settings, which includes many developing countries and low-income areas in some industrialized countries. [author’s description]

This paper focuses on lessons learned about building quality improvement into service delivery programs. Addressed to the program leaders and donor agencies that allocate resources for service delivery programs, the paper offers guidance on the actions that must take place to improve the quality of reproductive health and child survival programs. This guidance is based on the field experiences of members of the Management and Supervision Subcommittee of the MAQ Initiative. [publisher’s description]

This paper explores the implications and impact of knowledge management on family planning and reproductive health care. Using case studies and illustrative vignettes, the paper highlights the experiences of a number of developing country family planning/reproductive health organizations in integrating knowledge management tools and strategies to improve work processes and outcomes. [publisher’s description]

This document aims to facilitate the development of quality-oriented health sector reforms by providing a clear conceptual framework that can serve as a roadmap for policymakers and senior managers. By taking advantage of opportunities to integrate quality assurance activities into health sector reforms, healthcare leaders can maximize the effectiveness of reform and move toward optimizing health outcomes for the citizens of Latin America and the Caribbean. [author’s description]

This paper summarizes the importance of improving maternal and reproductive health, the progress made to date and lessons learned, and the major challenges confronting programs today. The paper highlights the progress that some countries, including very poor ones, have made in reducing maternal mortality, but cautions that progress in many countries remains slow. Relying on evidence from the most recent research and survey information, the paper also analyzes the key determinants and evidence on effective interventions for attaining the maternal health MDG. [from abstract]


Section 3 dis

Human resources become increasingly relevant in this context. Health human resource (HHR) is currently experiencing a three-fold problem, which encompasses old issues, together with the effects of reform, and the consequences of globalisation. This includes the workforce crisis in nursing which, facing all kinds of difficulties, requires complex in-depth analysis, synergies and alliances in order to ensure quality nursing services.

Recruiting and keeping the right staff are key challenges for health policy-makers. The performance and quality of a health system ultimately depend on the quality and motivation of health human resources. Therefore, recruitment and retention problems should be appropriately addressed, as nursing staff shortages and low motivation are likely to have adverse effects on the delivery of health services and the outcome of care. The main objective of this paper is to examine how to develop and retain a motivated nursing workforce. [author’s description]

In the majority of low and middle-income countries, the private sector presents significant opportunities for expanding the reach of essential child health services and products. Through better coordination with the private sector, governments and donors can improve the availability, quality, and effectiveness of child health services…This document assesses the current importance, and potential, of the private sector in contributing to child health. [author’s description]

Health care labor is central to managing and delivering health services. Because recruitment and retention policies are key issues for purchasers, gaining insights into labor-purchasing mechanisms may permit them to be addressed more effectively. This paper is intended to provide a brief introduction to health care labor purchasing and the mechanisms through which it can have an impact on the delivery of health services and on health system performance. A framework is developed to foster understanding of health labor purchasing mechanisms. [abstract]

Planning for the efficient and effective delivery of health care services to meet the health needs of the populations is a significant challenge. Globally policy makers, educators, health service researchers, leaders of unions and professional associations, and other key stakeholders struggle with the best way to plan for a workforce to fulfill the health needs of populations.

It is becoming increasing important that policymakers be aware of health worker motivation and it’s impact on health sector performance. Health care delivery is highly labor-intensive, and service quality, efficiency, and equity are all directly mediated by workers’ willingness to apply themselves to their tasks. While resource availability and worker competencies are essential, decision makers should know that they are not sufficient in themselves to ensure desired worker performance. Worker performance is also dependent on workers’ level of motivation stimulating them to come to work regularly, work diligently, and be flexible and willing to carry out the necessary tasks.

The long-term objective of this paper is to galvanize action to ensure that all current and future health managers are well prepared to lead and manage to achieve results. With good preparation, they will be able to develop and manage the kind of health services that achieve health goals, reduce illness, and save lives. [author’s description]

One Million More presents some of the interventions, debates, discussions and conclusions of a conference held in London.

The HRH Framework provides a pathway for governments and health managers to develop a comprehensive plan for addressing the critical shortage of health staff in HIV/AIDS and health services in general. [author’s description]

This chapter of the World Health Report provides a framework for developing a national HRH strategic plan including: building trust and managing expectations; fair and cooperative governing; leadership; strategic intelligence; and workforce institutions.

Intended to complement Working Together for Health: The World Health Report 2006, these policy briefs are intended to assist those who make and carry out health policy worldwide. The briefs address the following, Strengthening information and research on the health workforce: strategies for action; Investing in education for expanded capacity and lifelong learning; Making the most of the existing health workforce; Addressing the complex challenges of health worker migration; Bridging between health workers in separate public health programs; and Financing health workforce development. After describing an issue, the briefs propose ways to address it, many of which have been drawn from experience in countries. [author’s description]

This report has been prepared by the International Labour Office as the basis for discussions at the Joint Meeting on Terms of Employment and Working Conditions in Health Sector Reforms. It reviews the impact of health sector reforms on health workers and the implications of changes in employment and pay, labour relations, working conditions and terms of employment on the general performance of health systems in the light of the links between health policy, human health and the economy. [preface]

One of the current recommendations for tackling the health sector staffing crisis faced by many countries is that they should have comprehensive and coherent human resources for health (HRH) strategic plans. Such plans normally include strategies for strengthening performance of staff, improving staff retention and adapting to any major structural changes that may be occurring. A key component of the wider HRH strategic plan is a workforce plan. This plan enables senior managers to scan and analyze human resources (HR) data routinely, determine relevant policy questions and institute policies to ensure that adequate numbers of staff with appropriate skills are available where and when they are needed. [author’s description]

There is currently much debate about the role Global Health Initiatives (GHI) should play in strengthening health systems. There is increasing realization that without more support to help countries build health system capacity, the resources mobilized by GHIs are unlikely to reach their full potential. This paper argues that health-system strengthening requires improving capacity in critical components of health systems in order to get more equitable and sustained improvement across health services and outcomes. This paper discusses these critical components, including human resource development within the broader context of health system strengthening. [adapted from author]