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Although adequate knowledge about HIV infection and effective antitransmission measures, such as taking universal precautions in the handling of blood and other body fluids, are important factors in minimizing the risk of HIV transmission in the healthcare setting, little has been reported on the knowledge of nurses with regard to HIV infection and their attitude toward patients with AIDS in Iran. The aim of the present study was to assess these matters. [author’s description]

This paper examines recent experiences in Zambia, and Ethiopia that illustrate why policy matters for developing the private health sector and underscoring the need for rational regulatory policies and practices. [author’s description]

One major challenge for all countries is to establish workforce planning mechanisms that effectively meet the demands for health care and provide workforce stability. However, few nations have developed strategic plans for meeting nursing resource requirements that effectively address supply and demand. Instead, many developed countries choose to implement short term policy levers such as increased reliance on immigration, sometimes to the detriment of developing countries.

This study examines the opinions of health professionals about the capacity and performance of the ‘tecnico de cirurgia’, a surgically trained assistant medical officer in the Mozambican health system. Particular attention is paid to the views of medical doctors and maternal and child health nurses. [from abstract]

In Senegal, traditional supervision often focuses more on collection of service statistics than on evaluation of service quality. This approach yields limited information on quality of care and does little to improve providers’ competence. In response to this challenge, Management Sciences for Health (MSH) has implemented a program of formative supervision. This multifaceted, problem-solving approach collects data on quality of care, improves technical competence, and engages the community in improving reproductive health care. [abstract]

This article reports a project that investigated the way government policies, health and community services, population characteristics and local peculiarities combined for residents in two small rural towns in New South Wales. Interviews and focus groups with policy makers, health and community service workers and community members identified the felt, expressed, normative and comparative needs of residents in the case-study towns. [from abstract]

This edition focuses on the role of the private sector, a part of the health system that has not previously been accorded extensive coverage in the SAHR. The contrast between the public and private sectors remains stark in many facets and the deepening inequity is cause for profound concern. The significance of the private sector cannot be underestimated both with regard to its potential contribution to the health and well-being of this country’s people, as well as its role in drawing resources (financial and human) from the public sector.

The nurse is the single most important frontline health worker. Without nurses the clinics, community health centres and hospitals cannot function. It is therefore critical that nurse education and the supply of nurses form an integral part of transformation of health services in South Africa. According to the Department of Health there is a need to significantly increase the production of all categories of nurses in order to fulfil the requirements of South Africa. Attracting new recruits to the profession is an integral part of increasing production. It is for this reason that a study was undertaken to assess the attitudes of school leavers towards taking up nursing as a profession, and the reasons for these attitudes.

The objectives of the study were to assess the extent to which CHW deployment has been addressing important health priorities; document success stories and lessons, identify champions; understand the range of ways that CHW programmes have evolved in South Africa and compile recommendations and lessons learned to improve practice. [from executive summary]

In both Asia and Latin America, community-based health workers have been trained in safe injection techniques and routinely provide injectable contraception. However, the African continent still resists this service delivery mechanism with the rationale that it is unsafe for clients to receive injections from paramedical personnel. This argument is weakening, however, as non-reusable syringes become the norm and with the recent development of a checklist, based on the latest WHO Medical Eligibility Criteria, for safe provision of DMPA by community-based agents.

This report first reviews the policy and programmatic challenges of weak health systems, health care worker shortages, and related issues in HIV/AIDS affected countries, and concludes by outlining three key options for strengthening health systems during PEPFAR’s next five-year phase. [from introduction]

One of the most important steps in the Performance Improvement Approach is the performance needs assessment (PNA). The PNA focuses on understanding the environment in which service providers work, i.e. the different systems within an organization that affect their performance, as well as the client and community perspectives which influence their family planning access. The performance factors, or those elements that providers need to be able to perform well, are the framework that guides the PI approach and what the PNA is geared to capture. [author’s description]

The goal of the human resources development policy is to ensure availability of suitably qualified appropriately skilled and motivated human resource for health at appropriate geographic level of pre-defined disciplines, for provision of essential health services of acceptable quality at affordable cost to the community. [author’s description]

In [Tanzania’s] response to HIV, the Ministry has deemed its shortfall in human resources for health (HRH) as an emergency. To begin to address this gap, the Ministry is expanding antiretroviral therapy services through an Emergency Hiring Program that will bring 365 new health workers to 25 underserved districts in two phases. The first phase, now underway, will place 176 new hires in 19 districts. [author’s description]

This study conducted structured interviews with 204 health care providers in three public hospitals in Dar es Salaam, Tanzania, to evaluate the prevalence of stigma and discrimination among providers toward people living with HIV/AIDS (PLWHAs) and the factors associated with stigmatizing attitudes. Information on HIV/AIDS-related knowledge, perceived risk of infection, willingness to care, and availability of protective gear was also obtained. [from executive summary]

This pack contains workforce planning checklists, together with case studies and frequently asked questions (FAQs) that other organisations have developed to solve common issues. This pack includes examples of good practice and the contact details of teams working in maternity services to enable organisations to follow up any issues raised. [from introduction]

This is an exploratory descriptive study that examined migration of locally trained doctors from Ghana using graduates of the country’s first medical school as a proxy. The objectives of the study were to describe trends in the loss of medical personnel to emigration and the influence this has on human resources planning, including forecasting of staff supply and requirements. It was also to provide some information towards the development of strategies to counteract such losses. [from abstract]

The migration of health professionals from developing countries in general, and sub-Saharan African countries in particular, has become the subject of considerable theoretical and case study research attention in international migration and human resources for health (HRH) literature. This report is a review of all available literature on the costs and benefits of the migration of health workers from East and Southern African (ESA) countries to developed nations. [from executive summary]

In this paper we present a comprehensive analysis of the literature and argue that, from a human rights perspective, there are competing rights in the international migration of health professionals: the right to leave one’s country to seek a better life; the right to health of populations in the source and destination countries; labour rights; the right to education; and the right to nondiscrimination and equality. Creative policy approaches are required to balance these rights and to ensure that the individual rights of health professionals do not compromise the societal right to health.

In this paper we attempt to provide an overview of the concepts and practice of community health workers (CHWs) from across a range of (developing and developed) countries, and draw some insights into policy challenges that remain in designing effective CHW schemes, particularly in the Indian context. In the subsequent sections, we provide a review of the various ways in which community health workers have been deployed in different settings. [from introduction]

Health care providers play a crucial role in determining access to reproductive health services and their influence is likely to be heightened in delivering services to HIV-infected women. We examined the attitudes of health care policy makers and providers towards reproductive decision- making among HIV-infected individuals. [from abstract]

This report summarizes studies that examined the geographical distribution or mobility of a wide variety of health care providers in Canada. [adapted from introduction]

This is a QI package for the private sector that includes a review of service statistics, accompanying a QI self-assessment tool for midwives to identify quality issues, and a linked action plan for midwives and supervisors to help solve issues the QI tool identifies. [publisher’s description]

This article reflects on the state of the art in providing a safe working environment for HCWs and to consider a future path towards equitable access to its basic elements. [author’s description]

The objective of this paper is to explore the context of sexual harassment of women in the health sector in Kolkata, West Bengal. Specifically, it explores women’s perceptions of the occurrence of sexual harassment in hospital settings, and probes women’s own experiences of sexual harassment and incidents of sexual harassment in the hospital environment about which women are aware. The study also investigates the nature of action taken to seek redress, and the extent to which working women are aware of the complaint mechanism outlined by the Supreme Court. [from introduction]

Delivery by a skilled birth attendant (SBA) serves as an indicator of progress towards reducing maternal mortality worldwide – the fifth Millennium Development Goal. Though WHO tracks the proportion of women delivered by SBAs, we know little about their competence to manage common life-threatening obstetric complications. We assessed SBA competence in five high maternal mortality settings as a basis for initiating quality improvement. [from abstract]

Home-based management of malaria (HMM) is promoted as a major strategy to improve prompt delivery of effective malaria treatment in Africa. The published literature was searched for studies that evaluated the health impact of community- and home-based treatment for malaria in Africa. [from abstract]

This paper reports the findings at baseline in a multi-phase project that aimed at reducing maternal mortality in a local government area of South-West Nigeria. The objectives were to determine the availability of essential obstetric care services and to assess the quality of existing services. The first phase of this interventional study, which is the focus of this paper, consisted of a baseline health facility and needs assessment survey using instruments adapted from the United Nations guidelines. [from abstract]

In hospitals, the costs of employee turnover are substantial and intentions to leave among staff may manifest as lowered performance. We examined whether team climate, as indicated by clear and shared goals, participation, task orientation and support for innovation, predicts intention to leave the job and actual turnover among hospital employees. [from abstract]

In responding to the goal of rapidly increasing access to antiretroviral treatment (ART), the government of Botswana undertook a major review of its health systems options to increase access to human resources, one of the major bottlenecks preventing people from receiving treatment. In mid-2004, a team of government and World Health Organization (WHO) staff reviewed the situation and identified a number of public sector scale up options. The team also reviewed the capacity of private practitioners to participate in the provision of ART. Subsequently, the government created a mechanism to include private practitioners in rolling out ART.