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Understanding the supply and utilization of nurses is critical to maintaining an effective community health system. There has to be sufficient staff and a work environment that builds on the existing strengths of community health nursing to meet emerging needs. This report provides a demographic profile of community health nurses (CHNs) in Ontario and identifies enablers that support optimal practice of their competencies. [from executive summary]

Rural health care is changing. Following restructuring in the 1990s some small hospitals remained independent, while others reorganized as amalgamations and alliances. In 2004, Ontario was divided into 14 Local Health Integration Networks (LHINs) to create accessible, quality health care at a local level. Th is study was designed to gain an understanding of the impact on nursing work and the workforce. [from executive summary]

This issue of the Health Policy Research Bulletin examines research on the state of working conditions facing Canada’s nurses and discusses the implications for the larger health care system. [author’s description]

In southern Africa, rapid out-migration of health professionals is compounding the problems of health systems already faced with budget constraints and the impacts of HIV/AIDS. The authors outline a program of research on how Canada and the international community might address the negative impacts of the brain drain. [abstract]

Achieving the health Millennium Development Goals will require a significant scaling up of health service delivery in many countries. The number of competent managers will also have to be scaled up at the same time – managers are an essential resource for ensuring that priority needs are met and resources are used effectively. This study describes various management strengthening activities in 3 countries – South Africa, Togo and Uganda. [from executive summary]

Hospice Africa Uganda introduced palliative medicine to Uganda in 1993 with enough funds to support a team of three clinicians for three months. Training in the medical and nursing schools was introduced in 1994. Since then, Uganda has achieved the three essential components of an effective public health strategy. It has also been the first country to have palliative care described as an essential clinical service and to change the law to allow nurses and clinical officers who complete special training in palliative medicine at Hospice Uganda to prescribe morphine. Palliative care is spreading throughout the districts of Uganda, ensuring that morphine will be available to everyone who needs it. [adapted from publisher’s description]

This model for strengthening the midwife and hilot partnership was developed to improve the quality and accessibility of maternity and newborn care services (MNCS) in the Autonomous Region in Muslim Mindanao (ARMM). It aims to provide quality MNCS at various service settings like the home, community and health facilities. [introduction]

Recent comments from the Global Fund suggest an intention to focus more on the three diseases, and to leave the strengthening of health systems and support for the health workforce to others. This could create a “Medicines without Doctors” situation in which the medicines to fight AIDS, tuberculosis, and malaria are available, but not the doctors or the nurses to prescribe those medicines adequately. [author’s description]

A foundation of collaborative partnership, strong technical staff and field presence, and practical monitoring and evaluation anchored the PRIME II Project’s successful efforts to improve the performance of primary providers of family planning and reproductive health (FP/RH) services. PRIME II’s global achievements and lessons learned are summarized in the first section; an overview of project results in each technical leadership and focus area is presented in Chapter 2. [author’s description]

The study sought to assess the knowledge of health-care providers about HIV/AIDS, determine the potential for discrimination in the provision of services based on patients’ HIV sero-status and review the factors that may contribute to such attitude. [from abstract]

The challenges inherent in planning, developing and supporting a sustainable health care workforce are all the more difficult in countries where conflict or the aftermath of conflict can impede the implementation of short- and long-term approaches to building human resources for health (HRH). Based on field experiences implementing programs in such situations and supplemented by a carefully targeted literature review, this resource paper explores operational challenges, opportunities and goals common to initiating HRH programs in conflict and post-conflict situations. [introduction]

The Centre for Health and Population Research, Dhaka, looked at the experiences of midwives attending homebirths in the rural region of Matlab. In Bangladesh, 91 percent of births still take place at home and only 13 percent are assisted by a doctor or midwife. In 1987, almost 20 years ago, a health initiative was introduced in Matlab to allow midwives to attend women in the home. Researchers conducted interviews and group discussions with 13 midwives in Matlab in 2003 and 2004 to learn what difficulties they faced during their work. [author’s description]

Infant feeding is a subject of worry in prevention of mother to child transmission (pMTCT) programmes in settings where breastfeeding is normative. Nurse-counsellors, expected to counsel HIV-positive women on safer infant feeding methods as defined in national/international guidelines, are faced with a number of challenges. This study aims to explore the experiences and situated concerns of nurses working as infant feeding counsellors to HIV-positive mothers enrolled in pMTCT programmes in the Kilimanjaro region, northern Tanzania. [abstract]

This is a guideline to replicate and scale-up a human resources promising practice documented by the Capacity Project for outsourcing human resources services (HRS) to obtain a rapid increase and deployment of the health workforce, making HIV services available in a short period of time, especially in underserved areas.

This guideline is for human resources planners and managers in the health sector and sets out the steps required to extend the health workforce by incorporating lay workers (field officers), especially in the delivery of antiretroviral therapy (ART) to home-based clients.

Many countries have health-care providers who are not trained as physicians but who take on many of the diagnostic and clinical functions of medical doctors. We identified non-physician clinicians (NPCs) in 25 of 47 countries in sub-Saharan Africa, although their roles varied widely between countries… Low training costs, reduced training duration, and success in rural placements suggest that NPCs could have substantial roles in the scale-up of health workforces in sub-Saharan African countries, including for the planned expansion of HIV/AIDS prevention and treatment programmes. [summary]

In 1989, the government of Indonesia launched the Midwife in the Village programme. Its purpose was to reduce maternal death by assigning a resident midwife to each village in the country. By definition, she would live in the village and be part of the community she served. In 2005, Immpact examined the effect of the programme on the health and survival of mothers in two districts in Java. [from author’s description]

To evaluate the quality of maternal clinical care, Immpact, a global research initiative, developed an innovative method, called TRACE, to trace adverse and favourable events in pregnancy care. It is based on the confidential enquiry technique, whereby expert panels of health care professionals assess the quality of health care provided to clients in an
adverse event, such as a maternal death. [author’s description]

This case study examines the scale up of family planning services in Romania through primary care providers. It disucces the process, the challenges, the successful results and the lessons learned.

Work capacity correlates weakly to disease concepts, which in turn are insufficient to explain sick leave behavior. With data mainly from Sweden, a welfare state with high sickness absence rates, our aim was to develop an explanatory theory of how to understand and deal with work absence and sick leave. In this paper we present a theory of work incentives and how to deal with work absence. [from abstract]

This manpower projection was undertaken by using the Canadian Medical Association Physician Resource Evaluation Template. This spreadsheet-based stock and flow model incorporates key parameters in estimating physician supply over the next 2 decades and enables planners to create various scenarios to test the effects on future supply. [author’s description]

This training manual is designed for use as part of the comprehensive family planning and reproductive health training of service providers. It is designed to be used to train physicians, nurses, and midwives. Sessions in this Training of Trainers (TOT) module include discussions, identification of trainer’s own learning style, training exercises, conducting training needs assessments, developing action plans, developing visual aids, and training practice sessions which are videotaped and critiqued. [from purpose]

This training manual is designed to prepare trainers who already have skills as reproductive health trainers to proceed to a higher level of training implementation. This module prepares them to conduct a training needs assessment, develop detailed plans for training, develop and pilot test a training curriculum, conduct training using more advanced training techniques, conduct training follow up and evaluate training. [publisher’s description]

In 1996, the REWARD Project identified a need for effective interventions to increase women’s communication about reproductive health among themselves and with their husbands. Project staff formed women’s groups, called Communication Action Groups (CAGs), in three rural districts. The project provides group leaders with training on communication, leadership, group dynamics, condom use, condom negotiating skills, and HIV/AIDS and sexually transmitted infections (STIs).

This report evaluates the success of a program to improve family planning services in Malawi. It discusses the importance of community-based distribution, i.e. mobile clinics and community health workers, to the success of family planning in the country since so much of the population is rural.

This modular training resource intended to help trainers integrate aspects of reproductive health (RH) into training curricula.

This report evaluates the BHAPP project including an analysis of its service and communication activities for outreach and capacity strengthening of personnel in 23 health centers to diagnose and treat STIs and use STI case management as a referral point for HIV testing. It also discusses the effectiveness of the project’s policy work at the central level.

The goal of this training is to enable health workers to address the sexual and reproductive health (SRH) needs of HIV-positive women and adolescent girls by offering comprehensive SRH services within their own particular service-delivery setting. [from introduction]

The objective of this study was to assess whether adding a training intervention for clinic staff to the usual DOTS strategy (the internationally recommended control strategy for tuberculosis (TB)) would affect the outcomes of TB treatement in primary care clinics with treatemet success rates below 70%. [from abstract]

This report provides a comprehensive picture of HRH in Nova Scotia, a snapshot of the number of people working in each health occupation and health care setting; education and training characteristics; age, gender and other demographics, and wokplace injury and illness informatio.