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The Traditional Birth Attendants (TBAs) Survey in Swaziland was undertaken between March 27th 1996 and April 8th 1996. The objective of the survey was to generate reliable information regarding activities of TBAs in Swaziland. The survey was conducted in 25 Chiefdoms sampled out of a total of 206 Chiefdoms registered in Swaziland. [from abstract]

In order to identify reasons clinicians in Malawi might not offer HIV testing to patients, a cross-sectional descriptive postal census with telephone and fax follow-up was conducted. Proportions were calculated for each reason given for not offering HIV testing. Multiple logistic regression was used to determine whether responses differed by demographic characteristics. The five most common reasons for not offering HIV testing were: inadequate training in HIV counselling; perception that the patient is not ready; no indication; testing facilities unavailable; and insufficient time.

The quality and quantity of health care services delivered by the Malawi public health system is severely limited, due to, among other things the shortage of adequate numbers of trained health care workers. In order to suggest policy changes and implement corrective measures, there may be need to describe the perceptions of the legislature on how they perceive as the cause of the problem, which could be the solutions and an evaluation of those solution. In this paper, I present the finding from a qualitative study of Hansards (official verbatim record of parliamentary speeches) analysed by discourse analysis.

The African Region continues to experience loss of a sizeable number of highly skilled health professionals (physicians, nurses, dentists and pharmacists) to Australia, North America and European Union. Past attempts to estimate cost of migration were limited to education cost only and did not include the lost returns from investment. The objective of this study was to estimate the social cost of emigration of doctors and nurses from the African Region to the developed countries. [from abstract]

Very little information is available on the extent to which the private health sector is involved in clinical management of HIV/AIDS in Nigeria. This study assessed the potentials and existing capacity of 15 private health facilities in Nassarawa state for clinical management of HIV/AIDS. [from abstract]

Nurses are falling ill, incurring workplace injuries, and suffering disabilities from exposure to workplace hazards. As a result, the global community is losing critical members of the health care team, compounding the already existing nurse staffing crisis and adversely affecting the health and well-being of the world’s population. Yet, despite the evidence of broad support for health and safety programmes, nurses worldwide continue to be exposed to serious and preventable work place hazards. [from introduction]

Credentialing is a means of assuring quality and protecting the public by confirming that individuals, programmes, institutions or products meet agreed standards. Credentialing is becoming increasingly important as health systems strive to address issues of public safety and quality services. [author’s description]

The results [of this study] combined with the small size of El Salvador suggest that alternative strategies to community health workers may be a more cost effective approach. While prevention is desirable, community health workers do not have the skills or services that the communities value, which makes them less effective in promoting prevention. Alternative modes of reaching the community could reduce costs and raise the effectiveness of public health spending. [from abstract]

Remarkable improvements in key health indicators have been achieved in the six years since payment for performance was phased in. Although it is difficult to isolate the effects of performance-based payment on these improved indicators from the efforts aimed at strengthening NGOs and other factors, panel regression results suggest that the new payment incentives were responsible for considerable improvements in both immunization coverage and attended deliveries. [from abstract]

This paper analyzes the use of financial and material incentives for patients and healthcare providers to improve tuberculosis detection and successful completion of treatment.

This report describes a performance needs assessment of family planning and other health care providers in three regions of Guinea. Its purpose was to identify performance gaps or problems and determine the most appropriate interventions to improve providers’ performance and clients’ and communities’ access to and use of long-term and permanent methods of contraception (LTPMs)—specifically, male and female sterilization and the intrauterine device (IUD). [adapted from author]

As strides are made in the prevention and treatment of HIV, it is important to take advantage of opportunities to expand and integrate reproductive health services. Integration is an approach that uses a client visit as an opportunity to address other health and social needs beyond those that prompted the current health visit.

This document provides a systematic framework for establishing and maintaining community home-based care (CHBC) in resource-limited settings for people with HIV/AIDS and those with other chronic or disabling conditions.

As part of the process to develop more community-oriented medical teaching in Vietnam, eight medical schools prepared a set of standard learning objectives with attention to the needs of a doctor working with the community. Because they were prepared based on government documents and the opinions of the teachers, it was necessary to check them with doctors who had already graduated and were working at different sites in the community. [abstract]

This article discusses the potential contribution of community health workers to child survival rates. Several trials show substantial reductions in child mortality, particularly through case management of ill children by these types of community interventions. However, community health workers require focussed tasks, adequate remuneration, training, supervision, and the active involvement of the communities in which they work. This article discusses the need for evaluation of programmes for community health workers. [from summary]

The author focuses on a community health worker (CHW) intervention in India, where state-wide CHW programmes are under way as part of the National Rural Health Mission. The Mitanin programme of Chhattisgarh state in India highlights the many dilemmas and possibilities in the scaling-up of such programmes. [adapted from author]

Before the project began, 300,000 remote rural inhabitants in the Mayan highlands lacked basic primary care, the NGO civil society in health lacked cohesion, and the MOH NGO granting program needed revising. From 2000 to 2004, the NGO Networks Project implemented a grants program that helped form networks of NGOs, strengthening health services and testing innovations in service delivery, and improved monitoring and evaluation.

Given the very limited health infrastructure and resources and the need to provide a palliative care service to about one percent of the population each year, community and home-based care is viewed as the key to responding to these needs. Some countries have already developed strong home-based care networks in coordination with the PHC system to respond to the HIV/AIDS epidemic. Palliative care, as part of the continuum of care of HIV/AIDS, cancer and other chronic conditions can be integrated into this existing network. [author’s description]

This report covers the work done to complete another phase of the Initiatives Inc. program of work in human resource development (HRD) in the Ministry of Health (MOH) in Jordan. The essence and purpose of this assignment was to conduct a workshop and produce as a result the first strategic projection of staff requirements and supply in the health sector as a whole, with particular emphasis on the public sector, over the period 2004 to 2014. [from introduction]

Significant numbers of African-trained health workers migrate every year to developed countries including Canada. They leave severely crippled health systems in a region where life expectancy is only 50 years of age, 16 per cent of children die before their fifth birthday and the HIV/AIDS crisis continues to burgeon. The population of Sub-Saharan Africa totals over 660 million, with a ratio of fewer than 13 physicians per 100,000. [from introduction]

The migration of doctors and nurses from Africa to developed countries has raised fears of an African medical brain drain. But empirical research on the causes and effects of the phenomenon has been hampered by a lack of systematic data on the extent of African health workers’ international movements. We use destination-country census data to estimate the number of African-born doctors and professional nurses working abroad in a developed country circa 2000, and compare this to the stocks of these workers in each country of origin. [from abstract]

The overall objective of this study is to evaluate the capacity as well as the performance of the health facilities (HF) and community associations (community health workers associations (CHW), traditional birth attendant associations (TBA) and associations of people living with HIV (PLWHA), operating in the Gisagara (formerly Kibilizi) District. [from summary]

This article discusses the cost-effectiveness of a recent programme that involved training shopkeepers and community mobilisation for treating childhood fevers in the rural Kilifi District in Kenya. The programme offered workshops for shopkeepers on appropriate treatment for malaria in young children and also ran community information activities, with impact maintained through refresher training and monitoring. [author’s description]

Occupational stress and burnout merit concern in South Africa as the severity and intensity of the HIV epidemic is often perceived as overwhelming, leaving many caregivers with intense feelings of hopelessness and despair. This study explores and describes the experiences, feelings and perceptions of South African caregivers working in various capacities (healthcare, counselling and teaching) in the HIV/AIDS field. [from abstract]

This report presents the findings of the Ministry of Health and Long Term Care (MOHLTC) directed research on the topic of nurse-physician relationships, and includes recommendations arising from the in depth literature review conducted and which are directed toward the Research Unit and Nursing Secretariat, at the MOHLTC.

Policy makers and hospital administrators are seeking evidence to support nursing staffing decisions that includes both the volume and mix of nurses required to provide efficient and effective care. The principal objective of this study was to examine the interrelationships between variables thought to influence patient, nurse, and system outcomes. The results provide quality, evidence-based standards for adjusted ranges of nursing productivity/utilization and for staffing levels for patients receiving cardiac and cardiovascular nursing care. [from executive summary]

This paper begins by clarifying the terms shortage and underserviced. Provincial and federal programs for underserviced areas in Ontario are then described and considered in terms of their relevance to nursing. A discussion of the issues associated with policies addressing shortage and underserviced areas follows. The paper concludes with recommendations for change. The importance of making funding decisions based on a clear understanding of relevant concepts and models is emphasized. [introduction]

Th is report focuses on the supply and employment of nursing graduates in Ontario and their absorption into the workforce over the two-year period from 2003/4 to 2004/5. It begins with a review of labour market trends in the health care sector and discusses nursing supply, mobility, and cross-border migration in the recent past. The major repositories of data on
nurse education are identified and an overview of the entry of new nurses into the workforce is provided. Based on a survey of new graduands, a profile of new nurses is presented.

This data creates a profile of the nursing workforce, which is useful for projecting trends and estimating future requirements. At the corporate level, longitudinal examination over a series of years would demonstrate the relationship between the characteristics of the nursing workforce and the overall requirements for patient care. At the unit level, the data is helpful to examine human resource needs and fluctuations in the workforce characteristics.

The three sources of nursing supply in Canada are new graduates, internationally educated nurses (IENs) and nurses returning to the workforce. This report focuses on IENs. Globalization has led to high rates of migration of professionals to economically vibrant countries such as Canada. Because many skilled and educated migrants do not always realize their full potential in their new country, policies to maximize brain gain are imperative. [from executive summary]