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Contraceptive security requires comprehensive and integrated approaches that go beyond the public sector. Private sector involvement is critical not only in helping respond to growing market demand but also in ensuring equity in the contraceptive market. Redirecting well-off clients to the private sector will free up scarce donor and public resources for those most vulnerable and in need. Governments and donors cannot mandate private sector expansion and roles; however, they can create favorable conditions that induce private providers to enter the FP/RH market. [author’s description]

The manual is designed to help the ILO’s partners understand the issues and apply the ILO Code of Practice on HIV/AIDS and the world of work. The Code is at the core of the ILO’s Programme on HIV/AIDS, providing guidance to governments, employers and workers, as well as other stakeholders, on national action plans and workplace policies and programmes to combat HIV/AIDS.

The objective of this code is to provide a set of guidelines to address the HIV/AIDS epidemic in the world of work and within the framework of the promotion of decent work. The guidelines cover the following key areas of action: prevention of HIV/AIDS; management and mitigation of the impact of HIV/AIDS on the world of work; care and support of workers infected and affected by HIV/AIDS; elimination of stigma and discrimination on the basis of real or perceived HIV status. [from preface]

This is a summary report from the Africa Health Workforce Observatory meeting held September 26-29, 2006, at the ECSA headquarters in Arusha, Tanzania. The meeting focused on developing mechanisms to create up-to-date and reliable information that enables evidence-based decision making for HRH. [adapted from author’s description]

This study evaluates an intervention to raise healthcare provider morale and retention. Two different incentives-cash and a trophy, awarded to facilities rather than individuals-were tested in two districts. The program was implemented district-wide. Health centers and other small health facilities competed for the awards and were scored on the basis of management system indicators. Interviews with staff in both districts measured the effect of the awards on staff motivation and satisfaction. [publisher’s description]

This report examines the workforce issues surrounding HIV/AIDS service delivery. At the request of the Government of Rwanda, data were collected on current health sector staffing and from 20 public and private facilities of various sizes and characteristics on the time required to provide HIV/AIDS services and the quality of those services. The report presents data relative to the numbers of clients needing different types of HIV/AIDS services, providers’ degree of compliance with service delivery standards, and the time it takes to provide services.

There are few cost-minimisation studies in telemedicine. We have compared the actual costs of providing the telepaediatric service to the potential costs if patients had travelled to see the specialist in person. In November 2000, we established a novel telepaediatric service for selected regional hospitals in Queensland. Instead of transferring patients to Brisbane, the majority of referrals to specialists in Brisbane have been dealt with via videoconference.

Training managers within hospitals and health services do not just rely on transmitting packets of knowledge in a formal setting. This article argues that successful training should contain an emotional element to ensure engagement with the message. Immersion in real life circumstances is also important and leaders must develop training around shared objectives and team building. [abstract]

South African citizens have experienced many inequalities and these have extended to the health care setting. one of the major challenges that needs to be addressed is the accessibility and availability of health care and specialized medical services in rural areas in South Africa. Telemedicine is a potential solution to address some of the challenges within health care in a developing country like South Africa. This article looks at the experiences of developing and implementing a telemedicine solution. [abstract]

The international mobility of health workers is nothing new. In recent years, however, migration of health workers — from highly skilled physicians to those in lesser skilled positions, from the developing world to wealthier destinations — has increased. Moreover, the countries with the most alarming outflows include those sub-Saharan African nations suffering acutely from the HIV/AIDS epidemic and dwindling numbers of health workers. Controversy surrounds the proper role of policy interventions in the global labor market of health care professionals.

Typically, provider–client interactions are brief, and providers often behave condescendingly toward clients. As a result, clients are unable to express their concerns or describe the limitations they face in trying to implement the providers’ suggested course of action. A training intervention was developed for providers that focused on addressing the problems inherent in this dynamic. This research was undertaken to assess whether providers in the experimental area delivered services in a different manner than they had prior to the training intervention. [adapted from author]

The objective of this article is to examine in Peru the nature of dual practice (doctors holding two jobs at once - usually public sector doctors with private practices), the factors that influence individuals decisions to undertake dual practice, the conditions faced when doing so and the potential role of regulatory intervention in this area. [from abstract]

As many as 30% of doctors working for the National Health System of the United Kingdom of Great Britain and Northern Ireland have obtained their primary qualifications from a country outside the European Union. Factors driving this migration of doctors to the UK is not fully understood and merit continuing exploration. Our objective was to obtain training and employment profile of UK doctors who obtained their primary medical qualification outside the European Union (non-European doctors) and to assess self-reported reasons for their migration. [from abstract]

The most pressing challenge to achieving universal access to highly active anti-retroviral therapy (HAART) in sub-Saharan Africa is the shortage of trained personnel to handle the increased service requirements of rapid roll-out. Overcoming the human resource challenge requires developing innovative models of care provision that improve efficiency of service delivery and rationalize use of limited resources. We conducted a time-series intervention trial in two HIV clinics in central Mozambique to discern whether expanding the role of basic-level nurses to stage HIV-positive patients using CD4 counts and WHO-defined criteria would lead to more rapid information on patient status (including identification of HAART eligible patients), increased efficiency in the use of higher-level clinical staff, and increased capacity to start HAART-eligible patients on treatment.

The ability of health organizations in developing countries to expand access to quality services depends in large part on organizational and human capacity. Capacity building includes professional development of staff, as well as efforts to create working environments conducive to high levels of performance. The current study evaluated an approach to public-private partnership where corporate volunteers give technical assistance to improve organizational and staff performance. [from abstract]

Effective teamwork between doctors and clinical nurse practitioners (CNP) is essential to the provision of quality primary care in the South African context. The Worcester Community Health Centre (CHC) created dedicated practice teams offering continuity of care, family-orientated care, and the integration of acute and chronic patients. The teams depended on effective collaboration between the doctors and the CNPs. This inquiry focuses on the question of how more effective teams of doctors and clinical nurse practitioners offering clinical care could be created within a typical CHC. [adapted f

The crisis of human resources for health that is affecting low-income countries and especially sub-Saharan Africa has been attributed, at least in part, to increasing rates of migration of qualified health staff to high-income countries. We describe the conditions in four Organisation for Economic Cooperation and Development health labour markets that have led to increasing rates of immigration. [from summary]

In this paper an analytical framework is developed based on the production of health care services and the multiple determinants of health human resource requirements. Attention is focused on estimating the flow of services required to meet the needs of the population that is then translated into the required stock of providers to deliver this flow of services. [from abstract]

This chapter aims to determine the current demand for medical practitioners and nurses in South Africa by looking at the number of positions that are filled and the number that are currently vacant. It attempts to determine the number of medical practitioners and nursing positions that will be required until 2011, establishes the expected output from higher education over the next ten years, and determines the gap between supply and demand of health professionals. [adapted from introduction]

Although effective teamwork has been consistently identified as a requirement for enhanced clinical outcomes in the provision of healthcare, there is limited knowledge of what makes health professionals effective team members, and even less information on how to develop skills for teamwork. This study identified critical teamwork competencies for health service managers. [from abstract]

This study documents the contribution made by religion and religious entities to the struggle for health and wellbeing in Zambia and Lesotho, in a context dominated by poverty, stressed public health systems and the HIV/AIDS pandemic. By mapping and understanding these Religious Health Assets (RHAs), the study calls for a greater appreciation of the potential they have for the struggle against HIV/AIDS and for universal access and offers recommendations for action by both public health and religious leaders at all levels.

Recent efforts to improve maternal health have focused on skilled attendants and emergency care at health facilities. Skilled birth attendants and access to emergency obstetric care are essential to saving mothers lives. In developing countries, 60 million women give birth at home without skilled care and with high maternal and neonatal mortality. Nearly all essential newborn care can be provided safely, effectively, and at a low cost at the household level. The same is true for care of the mother, and many effective interventions can be implemented at the household and community level that will save mothers’ lives.

The African continent is facing 25% of the world’s morbidity rate with only 3% of its healthcare personnel. This is the result of years of neglect and underinvestment by African governments and the international community, plus harsh IMF restraints on nations’ budgetary expeditures. [author’s descripton]

Many countries around the world are now facing a huge brain drain of highly skilled professionals to well-paid jobs in developed countries. One of the worst affected sectors is healthcare, an area in which developing countries are struggling to keep professionals at home and encourage others to return. [auhor’s description]

This article discusses the issue the brain drain of doctors to more developed countries and Ghana’s efforts to supply an adequate health workforce in the face of this problem.

This paper explores the potential for private-sector midwives to provide services beyond their traditional scope of care during pregnancies and births to address shortcomings in less developed countries’ ability to reach MDGs. This paper examines factors that support or constrain private practice midwives’ ability to offer expanded services in order to inform the policy and donor communities about PPMWs’ potential. [from executive summary]

The focus of this guide is the measurement of capacity for the purpose of monitoring and evaluating capacity-building interventions. It responds to a demand among public health planners, evaluators, and practitioners for advice on assessing the many aspects of health programming that fall under the rubric of capacity building. [author’s description]

The HRH Action Framework presented here is designed to assist governments and health managers to develop and implement strategies to achieve an effective and sustainable health workforce. By using a comprehensive approach, the Framework will help you address staff shortages, uneven distribution of staff, gaps in skills and competencies, low retention and poor motivation, among other challenges. [publisher’s description] This website guides users through the HRH development process using indicators, resources, tools and guidelines.

This technical brief discusses various approaches for strengthening professional associations and outlines the benefits and challenges of such efforts. [author’s description]

This Praxis Note provides an overview of the impact of HIV/AIDS on the Malawi health care system and on the organisational capacity of Mulanje Mission Hospital. It describes the experiences and lessons learnt from a capacity building program designed to address capacity deficits and erosion caused by HIV/AIDS attrition. Less emphasis was placed on external training courses and increasing attention given to short-course inputs and distance learning. [from introduction]