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In South Africa, first-contact primary care is delivered by nurses in small clinics and larger community health centres (CHC). CHCs also employ doctors, who often work in isolation from the nurses, with poor differentiation of roles and little effective teamwork or communication. Worcester CHC, a typical public sector CHC in rural South Africa, decided to explore how to create more successful practice teams of doctors and nurses.

Community-based education (CBE) was developed thirty years ago in response to the maldistribution of physicians and subsequent inequity of health care services across geographical areas in developed and developing countries. Several medical schools in Nigeria report adopting CBE. This study seeks to identify and describe the CBE programs in accredited Nigerian medical schools and to report students’ assessments of the knowledge and skills gained during their community-based educational experience. [from abstract]

To date, traditional biomedical hospital-centered models of medical education have not produced physicians in quantities or with the competencies and commitment needed to meet health needs in poor communities worldwide. The Global Health Education Consortium conducted an initial assessment of selected medical education programs/schools established specifically to meet these needs.

Evaluations of Community Health Worker programs consistently document improvements in health, yet few articles clearly describe the roles of Community Health Workers (CHWs) from the CHWs’ perspective. This article presents the CHWs’ points of view regarding the various roles they played in a community-based participatory research (CBPR) project, Poder es Salud/Power for Health in Portland, Oregon, including their roles as community organizers and co-researchers. [introduction]

In this study, the overall job satisfaction of medical laboratory scientist graduates of one Kuwaiti University was examined in relation to the environment and organizational features of their places of employment. [from abstract]

This review aims to support efforts to integrate, plan and manage mid-level health workers by collating what we know about experiences with mid-level cadres in low-income countries in Africa, south-east Asia and the Pacific, regions that heavily rely on them. It interrogates the existing evidence on the evaluation of different types of mid-level workers and their impact on health outcomes and it identifies knowledge gaps. The review focuses specifically on the role of mid-level workers as independent practitioners in areas that suffer from severe shortages of professionals. [adapted from execu

India has traditionally had a bureaucratic approach to regulating its health service. Research suggests that this approach has failed to protect the interests of poor and vulnerable groups and has not gained the trust of providers or the public. So are there any other ways to make India’s health systems more accountable? [from author]

There is a gross shortage of nurses, yet there is a need to provide quality care and defend patient care. Widening scope of practice is not new to all categories of nurses and given the Occupational Specific Dispensation for nurses there is a need to critically engage with these issues.

This brief considers the policy implications in Europe of the international migration of health workers and addresses the question of how the migration of health service professionals can be managed in ways that reduce any negative effects on supply. [from executive summary]

In what areas do the HIV/AIDS donor programs interact with key operational parts of health systems? To answer it, and to better inform the ongoing discussion of AIDS and health systems, the report investigates and compares the donors’ interactions in three countries (Mozambique, Uganda, and Zambia) with three components of health systems: the health information system, the supply chain system for essential medicines, and human resources for health. [from summary] Chapter 4 is dedicated to the HRH aspects of this issue.

Leaders of the University of Belize’s Faculty of Nursing and Allied Health had a vision. Their country has the third highest HIV prevalence in the region, after Haiti and Guyana, yet it lacked an effective system for training providers in counseling and testing. As faculty members, they dreamed of establishing a national training center that would provide the latest resources and trainings for both students and providers. [from author]

The Voluntary Code of Ethical Conduct for the Recruitment of Foreign-Educated Nurses to the United States reflects the mutual recognition of stakeholder interests relevant to the recruitment of foreign educated nurses. It is based on an acknowledgement of the rights of individuals to migrate, as well as an understanding that the legitimate interests and responsibilities of nurses, source countries, and employers in the destination country may conflict.

Preparing health workers to confront the HIV/AIDS epidemic is an urgent challenge in Haiti. There is a critical shortage of doctors, leaving nurses as the primary care providers for much of the population. Haiti’s nurses play a leading role in HIV/AIDS prevention, care and treatment. However, they do not receive sufficient training at the pre-service level to carry out this important work. The Ministry of Health and Population collaborated with the International Training and Education Center on HIV to create a competency-based HIV/AIDS curriculum to be integrated into the the national schools

Contracting out public services is a way for governments to complement their own delivery of services. It is particularly effective for high risk or hard-to-reach populations that can be more effectively served by private groups. It can also contribute to more efficient delivery of primary health care. [from introduction]

Care for most women before, during and after delivery can be provided within a well equipped primary care setting. Since the 1980s Indonesia has attempted to improve women’s access to maternal health care by assigning professional midwives to each village. Despite an increase in the number of midwives, maternal mortality remains high compared to other countries with similar Gross Domestic Product per capita. [from introduction]

While previous Egyptian studies have identified provider practices contributing to maternal mortality, none has focused on neonatal care. This report details a survey of reported practices of birth attendants. As well, 217 recently-delivered mothers in rural areas of three governorates were interviewed about antenatal, intrapartum and postnatal care they received. [from abstract]

Neonatal mortality accounts for a high proportion of deaths in children under the age of 5 years in Bangladesh. This article describes a project for advancing the health of newborns and mothers implementing a community-based intervention package through government and non-government organisation infrastructures to reduce neonatal mortality. [from abstract]

This report details the findings of the Forum on Engaging the Private Sector in Child Health held in Uganda in 2005. It discusses the potential of private providers and the private sector as a resource for improving community health outcomes. [from executive summary]

With external assistance, developing countries in sub-Saharan Africa are beginning to establish better human resources information systems (HRIS) as part of a comprehensive and integrated response to some of the fundamental challenges posed by the health crisis. While this is a positive development, it is equally important to begin thinking about simple, practical approaches for supporting HR planners and senior decision-makers to be effective leaders and managers of HR data. [from author]

Health workforce planning is necessary in order to ensure that trained and knowledgeable health workers are available to deliver health care services when and where they are needed. The aim of this technical brief is to provide a rapid review of different health workforce projection approaches. [from author]

Task shifting should not be viewed as a panacea for the human resources challenges facing sub-Saharan Africa. Rather, it must be part of an overall strategy that includes measures to increase, retain, and sustain health staff. [from author]

Gender differences contribute to patients’ health and illness. However in current healthcare practices attention to gender differences is still underdeveloped. Recognizing these differences and taking them into account can improve the quality of care. In this study we aimed to investigate whether GPs’ gender sensitivity can be stimulated by a training program. [from abstract]

The AVICENNA Directories is a publicly accessible database of schools, colleges, and universities for education of academic professions in health. The database includes medical schools, schools of pharmacy, schools of public health and educational institutions of other academic health professions. For medical educational institutions, this database replaces the World Directory of Medical Schools published by WHO since 1953. [adapted from publisher]

Swaziland has taken the lead in caring for overburdened health workers with the opening of the first Wellness Centre in Manzini for them and their families. This article reports on this innovative response to the deepening crisis in human resources for health in sub-Saharan Africa. [adapted from author]

In 2001 the Faculty of Medicine of the University of Gezira (FMUG) introduced the Integrated Management of Childhood Illness (IMCI) strategy into its medical curriculum. The emphasis was on pre-service training that addresses standard case management and the IMCI community component. This report presents the experience of FMUG in integrating such a training package into the medical curriculum. It explains the rationale for introducing the IMCI community component and the guiding principles for doing so.

This case study evaluates a project in Kenya that concentrates on HIV and AIDS care and prevention through support and training of community volunteers to provide PLHA with HBC, widespread and diverse efforts to promote behavior change and raise awareness about HIV and AIDS, improving access to VCT, as well as capacity building efforts and direct material assistance for OVC and PLHA. [adapted from introduction]

Incentives such as P4P can be very powerful in their effects. Caution in their design and deployment is essential. However, ignoring their potential would be unwise, as they offer the possibility of improving value for money for taxpayers and patients. The first section of the paper will review evidence of common provider problems in all health care systems and their implications for introducing a P4P system. This will be followed by a review of P4P reforms in the United Kingdom and United States in particular. [from author]

Scaling up the implementation of new health care interventions can be challenging and demand intensive training or retraining of health workers. This paper reports on the results of testing the effectiveness of two different kinds of face-to-face facilitation used in conjunction with a well-designed educational package in the scaling up of kangaroo mother care. [from abstract]

The Tanzanian health system is currently undergoing major reforms. As part of this, a study was commissioned into the delivery of services and care at the Muhimbili National Hospital. One of the main components of this comprehensive study was to measure the extent to which workers in the hospital were satisfied with the tasks they performed and to identify factors associated with low motivation in the workplace. [from abstract]

This paper looks at the HRH crisis as experienced by the Uganda Catholic Medical Bureau network giving the trend, examining the reasons, the destinations of attritional cases and what the network is trying to do to improve human resource stability. [from abstract]