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This Voices discusses the experiences of nurse hired through the Emergency Hiring Plan in Kenya in providing family planning services, and the importance of confidentiality in the successful provision of these services.

In this paper we review the current situation of human resources for maternal health as well as the problems that they face. We propose seven key areas of work that must be addressed when planning for scaling up human resources for maternal health in light of MDG5, and finally we indicate some advances recently made in selected countries and the lessons learned from these experiences. [from abstract]

This paper argues that stronger and values-based public sector management and leadership is essential in building health systems that better address health inequities. It identifies the particular competencies of public sector managers and reviews evidence on how these competencies can be developed. Renewing the values base of public health system managers and professionals is an important requirement. [from summary]

These reports demonstratre that non-physician clinicians and nurses can take over many of the tasks in providing HIV care and treatment (including ART) in some resource-limited settings. [from author]

This article defines the concept of task shifting, outlines the World Health Organization’s “Treat, Train, Retain’s” recommendations and guidelines on task shifting, gives case study examples of how task shifting can be used, defines the remaining barriers and suggests the conditions necessary for the success of task shifting.

In the space of just a few years, close to 300,000 people with HIV have been put onto ART in Ethiopia and Malawi - two of the countries most severely affected by the human resources for health crisis. But while some might suggest that such a rapid scale-up could only have come at the expense of other general health services, Ethiopia and Malawi performed this remarkable feat using HIV/AIDS funding and technical support to launch ambitious and comprehensive human resource plans to strengthen their health sectors overall. [from author]

Demand for home care services has increased considerably, along with the growing complexity of cases and variability among resources and providers. Designing services that guarantee co-ordination and integration for providers and levels of care is of paramount importance. The aim of this study is to determine the effectiveness of a new case-management based, home care delivery model which has been implemented in Andalusia (Spain). [from abstract]

The evidence base for strategies and interventions for newborn care in community settings has substantially improved, with a range of interventions that can be potentially packaged for delivery at different times during pregnancy, childbirth, and after birth, through various health-care providers. More recently, efficacy trials in representative rural settings have added to the evidence base. Such studies used innovative approaches with community health workers and varied preventive and treatment interventions. [from author]

All long-term care agencies struggle to find and keep sufficient, reliable, and skilled staff capable of meeting client needs and providing great quality care. This workbook offers 12 concrete steps to guide agencies in developing excellent recruitment, selection and retention practices

This article compares the quality, quantity and distribution of tuberculosis physicians, laboratory staff, community health workers and nurses in Nigeria and Kyrgyzstan, and highlights implications for (re)training tuberculosis workers in developing countries. [from abstract]

This guide is a resource for trainers in developing in-service training for facility-based healthcare providers and community health workers (CHWs) who already have some basic experience with and understanding of RH/FP. This is not a training manual, but a reference guide which can be used and adapted by trainers based on whether or not trainees are facility-based or community-based. [from author]

The purpose of this guide is to explain why it is necessary to ground health workforce planning in human rights, and how to develop a plan that does just that. [from summary]

There is good evidence and compelling logic to support the principle of task shifting

The objectives of this paper are to highlight the situation of health workers in Pacific and Asian countries to gain a better understanding of the contributing factors to health worker motivation, dissatisfaction and migration; examine the regional and global evidence on initiatives to retain a competent and motivated health workforce, especially in rural and remote areas; and suggest ways to address the shortages of health workers in Pacific and Asian countries by using incentives. [from abstract]

The purpose of these guidelines is to assist practitioners and implementing partners to run Community-Based Worker (CBW) systems more effectively, maximising impacts for clients of the service, empowering communities, empowering the CBWs themselves, and assisting governments to ensure that services are provided at scale to enhance livelihoods. The guidelines focus on how to run the CBW system rather than technicalities around HIV/AIDS or natural resources issues. [from introduction]

Despite a pool of unemployed health staff available in Kenya, staffing levels at most facilities were only 50%, and maldistribution of staff left many people without access to antiretroviral therapy. Because in the current system it takes one to two years to fill vacant positions, even when funding is available, an emergency approach was needed to fast-track the hiring and deployment process. A stakeholder group was formed to bring together leaders from several sectors to design and implement a fast-track hiring and deployment model that would mobilize 830 additional health workers.

The report aims to document the present health workforce in the country in order to find out their strengths and weaknesses and put forward recommendations for improvement. It lays special emphasis on the profile and density of healthcare providers, quality of services provided by selected groups of providers, training, and production and future challenges for healthcare providers. [adapted from author]

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]

Improving the capacity of developing countries to respond to emerging diseases and especially influenza pandemics is essential to reduce both transmission around the globe and the human toll of outbreaks in the developing world. Investing in this capacity in developing countries is thus increasingly seen as a shared concern within the global community. [from introduction]

Prior to implementing male circumcision as a public health measure against the spread of HIV, the feasibility, safety and costs of the procedure within target countries should be evaluated to understand what measures need to be taken to ensure access to safe, affordable voluntary circumcision services. The aims of this study were to assess variation and safety of male circumcision practices, as well as resource and training needs related to the procedure, in a community that has been practicing circumcision traditionally for many generations. [from introduction]

Thousands of community workers are helping Ethiopia to deliver primary health-care services to people living in rural areas. However, critics say that the training these workers receive is not adequate for them to attend many of the health problems they encounter. [from introduction]

This article describes the achievements of 11 Sudanese-Canadian physicians who completed medical training and returned to Southern Sudan to practice. Few internationally educated physicians are prepared to return to a homeland as challenging as Southern Sudan; this goes against the globally entrenched flow of physicians migrating from developing to developed countries. [from introduction]

This report describes three health system developments introduced by the Rwandan government that are improving these barriers to care

Most children undergoing surgery in Kenya are anaesthetised by clinical officers or anaesthetists with minimal training in paediatric anaesthesia. This article details the statistics of how this personnel shortage impacts anaesthesia delivery. [from introduction]

This presentation discusses the current climate and prospects for health partnerships between the private and public sectors in Africa. [from presentation]

This presentation discusses the various aspects of private providers as they pertain to contracting for health services. [from presentation]

The NGO Code of Conduct for Health Systems Strengthening is a response to the recent growth in the number of international non-governmental organizations (NGOs) associated with the increase in aid flows to the health sector. It is intended to be used as a tool for service organizations and eventually for funders and host governments. The code serves as a guide to encourage NGO practices that contribute to building public health systems and discourage those that are harmful. [from introduction]

This book considers the topic of scaling up with a focus on ways to increase the impact of health service innovations that have been tested in pilot or experimental projects so as to benefit more people and to foster policy and program development on a lasting, sustainable basis.

Chapter 8 of this book describes an innovative educational approach to capacity building and scaling up reproductive health services in Latin America. It explains how the capacity to provide innovative training was scaled up in public sector reproductive health services in Brazil, Bolivia and Chile. [from introd

Rural nurses describe the nature of their practice as being embedded in working as a team where belonging is central to the success of the team and the individual nurse. As a result they form close professional and personal ties. The challenge for nursing students is to develop a sense of belonging to the rural hospital team so that preceptorship is successful. The objective of this article is to describe the cultural theme of a sense of belonging that nursing students develop during a rural hospital preceptorship. [adapted from abstract]

The researchers conclude that given the HRH crisis, ART delivery models requiring much less doctor time need to be developed. Overall, there is a need to shift tasks from medical doctors to nurses and from nurses to community health workers. In particular, the patients themselves need to play an important role in the delivery of ART. The outcomes of the various scenarios are predicted. [from author]