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A conceptual framework of motivation processes is presented and used to identify strategies and options for the measurement of health worker motivation in developing countries. Measures of motivation are broadly organized into determinant and consequent categories, and determinants are further distinguished in terms of measures that influence worker–organization goal congruence (“will do” motivation) and those directed toward goal striving (“can do” motivation).

Problems related to health worker motivation are remarkably pervasive, but to-date little attention has been paid to them in developing and transition countries. Basic tools to measure the determinants and consequences of motivation have not been adapted to contexts outside the industrialized world. This paper assesses the feasibility of transferring psychometric tools, typically used in industrialized countries to measure motivational processes, to other contexts. The paper draws upon two field studies conducted in two hospitals in the Republic of Georgia and two hospitals in the Hashemite Kingdom of Jordan.

This paper offers a conceptual framework for considering the many layers of influences upon health worker motivation. It suggests that worker motivation is influenced not only by specific incentive schemes targeted at workers, but also by the whole range of health sector reforms which potentially affect organizational culture, reporting structures, channels of accountability, etc.

This presentation was part of the ECSACON Conference. It discusses the advantages and disadvantages of traditional teaching versus distance education for nurses and midwives.

The global crisis in the healthcare workforce has attracted much attention in recent years. There is a global imbalance of human resources for health and, in particular, a shortage of healthcare workers in developing countries. To meet the growing global demands of caring for the increasing numbers of patients with chronic conditions, we need to develop a new approach to training [author’s description]

This presentation is part of the MAQ Exchange and discusses leadership as enabling groups of people to make progress in complex conditions. It states that leadership is helping groups of people to identify their critical challenges, and mobilizing them to learn and take effective action. What about those leaders in our midst, those people who enable groups to make progress at the local and district levels. This presentation is a report of findings about “everyday leaders,” those who lead others everyday, in difficult conditions. [adapted from speaker notes]

Family planning and other health care organizations in developing countries increasingly must do more with the same resources, and sometimes with fewer. Reorganizing work processes offers one common-sense way to help staff members at all levels cope with growing demands. [author’s description]

A potentially effective strategy for bringing early, appropriate and low cost treatment of malaria closer to the home is through the use of community health workers. The objective of this study was to determine peoples’ stated and actual preferences for different strategies for improving the timeliness and appropriateness of treatment of malaria before and after the implementation of a community health workers strategy in their community. [from abstract]

Human resources for health are non-existent in many parts of the world and the outer islands of Marshall Islands in Micronesia are prime examples. While the more populated islands with hospital facilities are often successful in recruiting qualified health professionals from overseas, the outer islands generally have very limited health resources, and are thus less successful. In an attempt to provide reasonable health services to these islands, indigenous people were trained as Health Assistants (HA) to service their local communities.

The medical brain drain has been described as rich countries looting doctors and nurses from developing countries undermining their health systems and public health. However this brain-drain might also be seen as a success in the training and export of health professionals and the benefits this provides. This paper illustrates the arguments and possible policy options by focusing on the situation in one of the poorest countries in the world, Malawi. [author’s description]

This review of the South African Health Information System (HIS) maps essential health-related information, discusses the District Health Information System, details the current status of the HIS and the challenges the HIS faces.

This Manual is designed to be a quick-and-easy, user-friendly reference for the development of health management information systems (HMIS), with the focus on applications. It serves as a primer on HMIS development and provides a general overview of the basic principles, as well as the fundamental steps and issues involved in the different activities to be undertaken. It aims simply to provide the basic elements on HMIS development for people who do not have the time or the need to read deeply on the subject.

Public health decision-making is critically dependent on the timely availability of sound data. The role of health information systems is to generate, analyse and disseminate such data. In practice, health information systems rarely function systematically. This article discusses some of the historical problems inherent in these systems and describes the Health Metrics Network, a global collaboration intended to help bring solutions to the countries most in need. [adapted from abstract]

The HIPC/PRSP process is intended to be a major instrument for achieving improved service delivery for poor people Crucially, improved service delivery depends on having the right professional, technical and other human resources in the right place at the right time. This review examined for 6 African countries, the country based poverty reduction strategy paper (PRSP) documentation and the associated World Bank/IMF HIPC documentation for human resources for health content. These documents were supplemented with other relevant country documents such as health strategies.

This rapid literature review was undertaken to assess how well human resources for education are covered in the Poverty Reduction Strategy Papers (PRSPs) or linked documents of selected countries in the major change programmes embarked upon by government. The PRSPs and PRSP Progress Reports from six countries were selected for detailed analysis, namely Nicaragua, Albania, Tanzania, Zambia, Cambodia and Madagascar.

This course in Training Methods and Continuing Education for Health Workers identifies the role of training and continuing education as an important component of health service and personnel management. Participants will be guided through the steps of planning training and continuing education activities for a range of health workers from managers to village volunteers. The course draws on real life examples from community-directed onchocerciasis control, village health worker programs, and patent medicine vendor training programs, to name a few. [publisher’s description]

This paper provides a brief overview of some programs and issues related to the use of technology and distance education to train community health workers in frontier areas. Issues include the use of consistent definitions, the appropriate technology format for the learner and access to that technology, cultural competency /proficiency of faculty, support for faculty and students, and the assurance of quality. [from executive summary]

In Albania, the PHRplus Project developed and tested a series of tools designed to introduce family medicine concepts and strengthen primary health care (PHC) services. PHC facility managers will find the toolkits useful reference materials when developing strategies and tools to improve quality of care and monitor and evaluate PHC strengthening efforts. This series comprises three toolkits: PHC Service Delivery Toolkit; PHC Quality Improvement (QI) Toolkit; and PHC Health Information Systems (HIS) Toolkit. [from abstract]

This issue of The Manager considers strategy and process for managing a leadership transition. It describes how current leaders, staff members, and boards of directors can engage their organization in navigating the uncertainties of a search for a new leader. It explores ways to prepare for future transitions by developing leadership talents within the organization. [editor’s description]

This issue is accompanied by a case study, “Better Health: Plans for Leadership Transition.”

This issue of The Manager shows how health managers, though faced with multiple challenges of decentralization, can redefine their roles and responsibilities to better support both the people they serve and the staff at management levels closest to the population. It shows how health managers can adopt leadership practices to carry out their new roles and ultimately make decentralization work. [editor’s description]

This issue of The Manager will help managers at all levels understand the principles of local-level performance assessment and improvement. It also presents the concept of essential public health functions as a useful policy framework for decentalizing service management while maintaining and improving the coverage and quality of services. [editor’s description]

This issue of The Manager focuses mainly on leading changes in practices that improve health, rather than on overall strategic and structural change. The issue can help health managers work with a team as change agents to address community and organizational challenges that require a change in clinical or management practices.

Nurses have assumed management positions in many health institutions. To properly accomplish the demands of this role, it is important that they be competent in both management and leadership. For appropriate performance, knowledge of management and supervision styles is a priority. Therefore, the goal of this investigation is to identify the nurse manager’s knowledge regarding management and leadership.

The objective of this study was to examine associations between management training of physician executives and their leadership styles, as well as effectiveness in achieving disease management goals. [author’s description]

Today, shifting demographics and values require new models of leadership. A significant percentage of those entering family medicine are female. Male and female physicians alike are expressing greater interest in balancing work with other important parts of their lives. Models of leadership are shifting from top-down to side-by-side. Even the doctor-patient relationship is transforming, with an emphasis on collaboration and shared decision making. [adapted from author’s description]

This short documentary film chronicles the four year journey, initially funded by USAID’s Office of Population, that the governorate of Aswan, Egypt embarked upon to develop greater leadership within all levels of its health care staff. The video shows an innovative process that develops leaders at all levels, including the front lines of health care, to identify challenges and work in teams to overcome obstacles and achieve service improvements.

As the complexity of the challenges facing the public health workforce has increased, many have argued that insufficient resources have been devoted to the preparation of the workforce, including its leaders. Here we describe the growth of national advocacy for public health leadership and workforce development.

This publication is an effort to respond to the different needs for capacity building in management and implementation of health programmes and delivery of essential services. It reflects the thinking acquired from experience working with health sector reforms being implemented in the African Region. The District Health Management Training modules cover the principles that are applicable across the Region and are meant to guide and strengthen the management capacity of district health management teams. [author’s description]

This case study describes how healthcare providers in Nicaragua worked together to improve the quality of obstetric care at their health centers and posts. They began by measuring the extent to which staff performed according to standards. Once aware of the quality gaps, they formed QI teams and used rapid team problem solving to implement quality improvements so that healthcare providers could perform according to obstetric standards. Continuous monitoring shows their success in meeting the standards and improving health outcomes. [author’s description]

This cost analysis is based on QAP research on the effectiveness of two interventions (self-assessment and peer review) in sustaining or increasing the effectiveness of interpersonal communications training that midwives had taken. The research had measured the effectiveness of the interventions in terms of the number of utterances midwives made during family planning consultations, and this case study followed on, measuring the cost of each intervention in terms of the number of utterances generated.