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This report concludes that assigning nurses to community locations where they provide basic curative and preventive care substantially reduces childhood mortality and accelerates progress towards attainment of the child survival MDG. The research in Navrongo demonstrates that affordable and sustainable means of combining nurse services with volunteer action can accelerate attainment of both the International Conference on Population and Development agenda and the MDGs. [from summary]

This document reviews the issues around midwives and others with midwifery skills: who they are, what they do and how to scale up professional attendance at all births. It also includes case studies of midwifery initiatives. [adapted from summary]

This report documents experiences and lessons from the First International Forum on Midwifery in the Community related to training and scaling-up the midwifery workforce.

Urgent support to increase the numbers and skills of midwives would save the lives of 5 million women, prevent 80 million illnesses and disabilities from pregnancy or childbirth and save the lives of countless newborns. The goal of this workshop is to contribute to that agenda, and respond to the global focus on human resources for health. [from executive summary]

This guidance note is designed for countries seeking to scale up midwifery services, especially at the community level. It outlines in detail the action required by policy-makers and program managers to effect change at country level and scale up midwifery capacity, specifically in poor and hard-to-reach areas.

Increased immunization coverage is an important step towards fulfilling the Millennium Development Goal of reducing childhood mortality. Recent cross-sectional and cross-national research has indicated that physician, nurse and midwife densities may positively influence immunization coverage. However, little is known about relationships between densities of HRH and vaccination coverage within developing countries and over time. This study examines HRH densities and coverage of the Expanded Program on Immunization (EPI) in Turkey from 2000 to 2006. [from abstract]

The purpose of this survey was to identify nurses' perceived challenges in implementing a community-based TB program in the Omaheke region of Namibia. The HIV pandemic has increased the number of TB patients and increased nurses' workloads, aggravating the burden of TB as a resurgent disease in this region. In order to implement a successful community-based TB program, the patient-related, access-related and knowledge-related challenges, perceived by the nurses, need to be addressed effectively. [from abstract]

This policy brief describes steps towards the determination and implementation of an optimal skill mix within a health system, including definition of the skill mix and how to achieve clarity regarding the key policy problems for which it is envisioned as a solution. [from executive summary]

A community health planning and service strategy was started in Ashanti region in 2001 with the intention of improving geographic access to comprehensive health care. The region used community-based surveillance as an entry point. The implementation process and health outcomes were tracked and evaluated after a year. [from summary]

This resource is a chapter from Disease Control Priorities in Developing Countries. Despite the best efforts of primary care providers and public health planners, not every emergency is preventable. Actual provision of emergency care may range from delivery using trained emergency professionals to delivery by laypeople and taxi drivers. Developing strategies to meet the range of needs posed by such diverse circumstances will require innovation and a reorientation of public health planning. [from introduction]

This presentation details the issues of migration and retention in Swaziland.

Imbalances in quantity and quality of human resources for health (HRH) are increasingly recognized as perhaps the most critical impediment to achieving health outcome objectives in most African countries. However, reliable data on the HRH situation is not readily available. Some countries have hesitated to act in the absence of such data; other countries have not acted even when data are available while others have moved ahead in spite of the lack of reliable information. This paper addresses the issue of data use for HRH policy-making. [from summary]

It is well-recognised that medical students whose training exposure is largely limited to tertiary-level training hospitals may be inappropriately equipped to deal with the most relevant health issues affecting rural communities. This article evaluated the perceived educational value of a 2 week clinical rotation undertaken by senior undergraduate medical students at rural district hospitals and health care centers in the Western Cape Province, South Africa. [from abstract}

The Capacity Project has been helping to strengthen human resources information systems (HRIS) in several African countries, and many of the systems are now able to produce useful reports about the health workforce. [from author]

This is the first study to systematically review the available published literature describing innovative models of comprehensive primary health care (PHC) in rural and remote Australia since the development of the first National Rural Health Strategy (1993-2006). The study aimed to describe what health service models were reported to work, where they worked and why. [from abstract]

This publication provides a framework for health and information professionals, as well as stakeholders, for improving the use of information to guide policymaking, program design, management, and service provision in the health sector in developing countries. [adapted from introduction]

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 overall human resource shortages and the distributional inequalities in the health workforce in many developing countries are well acknowledged. However, little has been done to measure the degree of inequality systematically. This paper describes and measures health worker distributional inequalities in Tanzania on a per capita basis; and it suggests and applies additional health care needs indicators in the measurement of distributional inequalities. [adapted from abstract]

This country study in Swaziland thus sought to map and assess incentives for retaining heath workers, particularly non-financial incentives. Specifically it sought to identify existing policies and measures for incentives for retention of health workers, their relevance to current factors driving exit and retention, and propose inputs for guidelines for introducing and managing incentives for health worker retention to maximize their positive impact. [from summary]

In sub-Saharan Africa, the private health sector ranges from traditional healers, pharmacies, and shopkeepers selling health care products, to nonprofit and for-profit clinics and hospitals. There are a variety of reasons people use the private health sector including convenience, perceived quality, confidentiality, or because nothing else is available. Moreover, private health care in sub-Saharan Africa is not just for the rich. Africans of all socioeconomic backgrounds turn to the private sector for their health care needs. [from author]

The Central America Field Epidemiology Training Program (CA FETP) is a public health capacity-building training programme aimed at developing high-caliber field epidemiologists at various levels of the public health system. The curriculum is competency-based, and is divided into a three-tiered training pyramid that corresponds to the needs at the local, district and central levels of the health system.[adapted from abstract]

Strong leadership and management skills are crucial to finding solutions to the human resource crisis in health. Health professionals and human resource (HR) managers worldwide who are in charge of addressing HR challenges in health systems often lack formal education in leadership and management. The Virtual Leadership Development Program is a web-based leadership development program that combines face-to-face and distance learning methodologies to strengthen the capacity of teams to identify and address health challenges and produce results. [adapted from abstract]

The two main objectives of this study were to examine aspects of the acculturation of overseas-born and Australian-trained health professionals in the Australian health discourse and identify key coping strategies used by them when in working in the rural context. [from abstract]

The toolkit was developed to facilitate improved access to appropriate and effective contraception for clients with HIV, especially through the strategic integration of family planning with HIV prevention, care, and treatment services.

The preclinical years of undergraduate medical education provide educational content in a structured learning environment whereas clerkships provide clinical training in a more experiential manner. Although early clinical skills training is emphasized in many medical schools, students still feel unprepared and anxious about starting their clerkships. This study identifies the skills medical students perceive as essential and those skill areas students are most anxious about prior to starting clerkship rotations. [from abstract]

The current global tuberculosis (TB) epidemic has pressured health care managers, particularly in developing countries, to seek for alternative, innovative ways of delivering effective treatment to the large number of TB patients diagnosed annually. One strategy employed is direct observation of treatment for all patients. In high-burden settings innovation with this strategy has resulted into the use of lay community members to supervise TB patients during the duration of anti-TB treatment.

Interviews were conducted with staff of 4 hospitals thought to be functioning relatively well. The purpose of this study was to understand some of the factors contributing to the relative success of 4 South African distric hospitals, in order to share lessons learned with other institutions. A number of key factors were identified through this process, many of which relate to the performance, management and interactions of the health workers, which appear to be important in effective functioning of district hospitals. [adapted from summary]

This paper provides a review of the reported barriers that prevent doctors from managing HIV infected patients. The four most commonly reported barriers were: fear of contagion, fear of losing patients, unwillingness to care, and inadequate knowledge /training about treating HIV patients. [from abstract]

The International Council of Nurses expressed concerns regarding the aggressive international recruitment of nurses and maintained that internationally recruited nurses might be particularly at risk of exploitation or abuse. The purpose of this study was to explore and describe how recruitment agencies contributed to the emigration of South African nurses. [adapted from abstract]