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HIV/AIDS and the Public Sector Workforce: an Action Guide for Managers

This action guide offers practical guidance on creating or expanding HIV/AIDS workplace programs for civil services. Human resource managers, employee welfare managers, medical officers and labor representatives in government ministries and agencies can use the guide to design and develop effective and appropriate HIV/AIDS prevention, care and support programs. Public Sector Workforce is intended to be a basic reference tool. Users can select chapters to assist with specific aspects of an HIV/AIDS program.

Make Better Use of Provider Time in Public Health Clinics

Concern about increasing demand for reproductive health services has led program managers to examine the productivity and costs of existing programs. While all programs can advocate for additional funds from their governments and establish or increase prices for services to clients, often they can also use their existing resources more efficiently. Evidence from reproductive health programs across developing countries suggests that service providers are often underutilized. [author’s description]

Defining a Performance Improvement Intervention for Kenya Reproductive Health Supervisors: Results of a Performance Analysis

The competency-based approach used in JHPIEGO-supported training improves performance by ensuring that trainees go back to their worksites with the knowledge and skills required to provide FP services. Once back at the workplace, however, participants often face constraints that limit their ability to provide quality services. Factors that can affect the performance of the healthcare provider include: job expectations, performance feedback, supplies and equipment, motivation, possessing the knowledge and skills to provide services, and supervision.

Establishing Integrated Family Planning/Reproductive Health Preservice and Inservice National Clinical Training Systems in Turkey

JHPIEGO has been working since 1991 to support the development of a national integrated clinical training system used for both family planning/reproductive health (FP/RH) preservice education and inservice training in Turkey.

Institutionalization of Reproductive Health Preservice Education in the Philippines: An Evaluation of Programmatic Effort, 1987-1998

From 1987 to 1998, JHPIEGO, through its Training in Reproductive Health (TRH) Project, collaborated with the Association of Deans of Philippine Colleges of Nursing (ADPCN) and the Association of Philippine Schools of Midwifery (APSOM) to strengthen preservice nursing and midwifery education in the Philippines. Between 1987 and 1994, JHPIEGO initiated activities to strengthen family planning/reproductive health (FP/RH) and enhance trainer/faculty development in five nursing schools and five midwifery schools.

Evaluation of the Institutionalization of Family Planning/ Reproductive Health Inservice Training in Bolivia

Beginning in 1992, JHPIEGO worked in close collaboration with the Bolivia Ministry of Health (MOH) to develop an integrated family planning/reproductive health (FP/RH) training network throughout the country. The focus of the assistance was the establishment of nine national training centers (NTCs) for inservice training conducted by physician-nurse teams and located at departmental maternity hospitals in departmental capitals. By 2000, the government of Bolivia and other stakeholders had shifted the training emphasis to preservice education efforts.

Strengthening Preservice Midwifery Education in Ghana: Achievements and Phase 2 Expansion Plans

JHPIEGO and the United States Agency for International Development/Ghana, has now focused on strengthening preservice education for nurses and midwives who provide FP/reproductive health (RH) and safe motherhood services. The phased strategy will ultimately strengthen preservice classroom and clinical training components in all ten midwifery training schools (MTS) in Ghana. To clarify the needs of the training institutions and guide program planning, two needs assessments were conducted at the MTS in Kumasi and Koforidua.

Matched Case-Control Evaluation of the Knowledge and Skills of Midwives in Ghana Two Years after Graduation

JHPIEGO’s strategies for strengthening Ghanaian preservice education in family planning/reproductive health and essential maternal and neonatal care have included: developing and implementing a standardized, competency-based curriculum; improving knowledge and skills of tutors and clinical trainers/preceptors; reinforcing service delivery sites used for clinical practice; and providing schools and clinical training sites with anatomic models and supporting training materials. [adapted from author]

Malawi Health Human Resource Information Systems: Supporting the Development and Monitoring of Health Human Resource Deployment and Training Policies and Plans

WHO, World Bank, and other human resources for health experts globally have recognized the dearth of human resource data for the health sector in many developing countries. In the present assessment, JHPIEGO reviewed the availability of staff deployment and training data from routine information systems in Malawi to inform the Ministry of Health and Population (MOHP) of deficiencies that would need to be addressed in order to better inform the development and ongoing monitoring of deployment and training policies and plans.
[publisher’s description]

COPE for Child Health in Kenya and Guinea: an Analysis of Service Quality

This report presents the results of a longitudinal, quasi-experimental study evaluating the introduction and use of COPE and the resulting changes in service quality in two countries, Kenya and Guinea. At the end of a 15-month period, providers’ attitudes, providers’ ability to solve problems, service quality, and client satisfaction were assessed at eight intervention sites and at eight matched control sites, using both qualitative and quantitative methods. [author’s description]

Estimating the Need for Family Planning/Reproductive Health Service Providers in Malawi

Using the training needs projection methods in the Spectrum Policy Modeling System software module ProTrain, this report estimates the numbers of family planning/reproductive health service providers needed to reach total fertility rate and contraceptive prevalence goals for Malawi from 2001-2007. [adapted from publisher]

COPE Handbook: a Process for Improving Quality in Health Services, Revised Edition

COPE, which stands for “client-oriented, provider-efficient” services, is a process that helps health care staff continuously improve the quality and efficiency of services provided at their facility and make services more responsive to clients’ needs. COPE provides staff with practical, easy-to-use tools to identify problems and develop solutions using local resources, and it encourages all levels of staff and supervisors to work together as a team and to involve clients in assessing services. Through COPE, staff develop a customer focus, learning to define quality in concrete terms by putting themselves in their clients’ shoes.

Establishing a Nursing Student Learning Center for Women's Reproductive Health in Nepal

The goal of this paper is to describe the establishment of a self-sustaining Student Learning Center (SLC) employing humanistic anatomical models to aid in the teaching of family planning and reproductive health clinical skills to nursing students in Nepal.

Performance Improvement: Developing a Strategy for Reproductive Health Services

During the past several years there has been a global trend in business and industry to move from training to performance improvement. This paper presents a review of selected performance improvement and training literature that has been helpful to JHPIEGO in identifying issues related to this trend and in shaping our performance improvement strategy. [author’s description]

Measuring Provider Performance: Challenges and Definitions

While the need to measure performance in the field of family planning and reproductive health care FP/RH) is widely recognized, there is no consensus on a standard definition of the term. Consequently, when organizations and projects describe or measure performance, particularly in the context of health worker or program evaluations, the term may be used in ambiguous and confusing or even contradictory ways. [author’s description]

Performance and Quality Improvement Process to Improve Infection Prevention: Malawi Case Study

The Malawi Ministry of Health and Population (MOHP) sought the assistance of JHPIEGO to implement a performance and quality improvement (PQI) initiative in infection prevention (IP), as one intervention in response to concerns of healthcare workers and potential healthcare workers regarding the existing risks of exposure to infection with major communicable diseases, especially HIV/AIDS, at the country’s hospitals and other health facilities.

Facilitative Supervision Handbook

The handbook includes descriptions of the facilitative approach to supervision and the roles and characteristics of facilitative supervisors in involving staff in the QI process, leading staff through change, creating a nonthreatening environment, and helping staff use data for decision making. [publisher’s description]

Making it Happen: Using Distance Learning to Improve Reproductive Health Provider Performance

This publication is for training managers, trainers of health providers, decision-makers, and those who fund and support training actvities. It examines distance learning as an effective training approach for reproductive health providers in developing countries. In addition to describing the components of distance learning, this publication will provide illustrative examples for training health workers, outline steps for starting a distance learning program and suggest additional resources. It will help readers plan and implement effective distance learning. [author’s description]

High-Performing Reproductive Healthcare Facilities in Kenya: Why They Exceed Expectations

This report summarizes findings from Phase 2 of a two-phase case study to determine why certain reproductive healthcare facilities in low-resource settings perform better than others. The study examined the characteristics, behaviors, and coping strategies of high-performing reproductive healthcare facilities in Kenya, exploring elements of resilience and factors influencing performance.

Managing Reproductive Health Services with a Gender Perspective

The roles that women and men play should guide the ways in which clinic staff assess their clients’ needs and provide care. This edition of The Manager shows how awareness of gender issues can improve the design, mangement, and delivery of health services, and takes you step by step through the process of assessing the influence of gender on organizational management. [editor’s description]

Performance Improvement

The Performance Improvement approach gives organizations the tools they need to find out which essential components of good performance are missing, and then match interventions to root causes, closing the gaps between the performance they are experiencing and the performance they desire.


This document is in English, French and Spanish.

Facilitative Supervision: a Vital Link in Quality Reproductive Health Service Delivery

AVSC defines facilitative supervision as an approach to supervision that emphasizes mentoring, joint problem solving, and two-way communication between the supervisor and those being supervised. This definition recognizes that supervisors play an essential role as intermediaries who can facilitate the implementation of institutional goals and who can facilitate local-level problem solving and quality improvement.

Health Worker Motivation in Africa: the Role of Non-Financial Incentives and Human Resource Management Tools

There is a serious human resource crisis in the health sector in developing countries, particularly in Africa. One of the challenges is the low motivation of health workers. Experience and the evidence suggest that any comprehensive strategy to maximize health worker motivation in a developing country context has to involve a mix of financial and non-financial incentives. This study assesses the role of non-financial incentives for motivation in two cases, in Benin and Kenya. [abstract]

Meeting the Need: Strengthening Family Planning Programs

This report is designed as a general resource to help family planning program managers strengthen their programs and meet growing family planning needs…It offers a broad overview of key programmatic considerations. Each subsection includes a list of practical specialized resources and hands-on tools that can support program managers desiring to bring about programmatic change…

Determinants of Health Worker Motivation in Tblisi, Georgia: a 360 Degree Assessment in Two Hospitals

This paper represents the second phase of a larger study examining health worker motivation in two hospitals in Tbilisi, Georgia. The overall objective of the 360 degree assessment was to begin to identify the major organizational, situational, and individual factors associated with health worker motivation, and to better understand how major constituencies (i.e., managers, supervisors, workers, and patients) perceive the hospital/work environment. Specific objectives of this study component were to: assess congruence between managers, supervisors and workers on perceptions of hospital goals; compare perceptions of hospital and worker characteristics among types of workers (physician, nurse, other) and levels of respondents (managers, supervisors, workers, patients); and identify possible factors for stimulating good performance and possible interventions for enhancing motivation.

Addressing the Human Resource in Health Crisis: Empowering the Private Not for Profit Health Training Institutions to Play Their Role

This presentation was part of the International Conference on Global Health session, “Answering the Call: Innovations in Human Resources by African Faith-Based Organizations.” From the perspective of the Uganda Catholic Medical Bureau experience, the presentation discusses why the private not-for-profit sector is important in service provision and training; why nurses are in the midst of the human resource crisis; obastacles to increasing the training capacity; and what the PNFP health training institutions are doing to address their weaknesses. [adapted from author]

Adherence to Antiretroviral Therapy in a Home-Based AIDS Care Programme in Rural Uganda

Poverty and limited health services in rural Africa present barriers to adherence to antiretroviral therapy that necessitate innovative options other than facility-based methods for delivery and monitoring of such therapy. We assessed adherence to antiretroviral therapy in a cohort of HIV-infected people in a home-based AIDS care programme that provides the therapy and other AIDS care, prevention, and support services in rural Uganda. [author’s description]

Private Sector Response to HIV and AIDS in Lesotho

This study attempted to determine the feasibility of a private sector led long-term intervention to reduce the HIV-infection rate among apparel workers and to provide care and support for those already infected. [author’s description]

Health Worker Flight from Sub-Saharan Africa: Patterns, Implications & Mitigating Strategies

This presentation was given at the second annual AAMC Physician Workforce Research Conference, “2020 Vision: Focusing on the Future.” It discusses out migration and brain drain from sub-Saharan Africa and gives an overview of the issues related to this problem, particularly in respect to a project done in Uganda.

Note: This resource is no longer available online

Determining Staffing Levels and Mix of UCMB Affiliated Hospitals

The main objectives of this study in Uganda Catholic Medical Bureau (UCMB) affiliated hospitals were to: assess the
quality of services delivered in accordance to the
available standards; compute staffing requirements for
the hospitals; and set standard workloads for each
type of staff cadre. [from introduction]