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The following guidelines have been developed by a working group of practitioners drawn from clinics, hospitals, congregations and communities. They are intended for use by practitioners from the congregation, community, clinic, and other partners in local responses which are incorporating ART. [Description from preface]

Health systems in industrialized countries are having success with new approaches for evaluating and improving care delivered by clinicians in ambulatory care settings. Described herein is a program which awards recognition to individual physicians or physician groups who deliver high-quality, cost-effective care. [from author’s description]

A brief description of why strengthening human resources informations systems (HRIS) is important, what constitutes an HRIS, and what The Capacity Project has accomplished and learned in this area.

In response to the under-representation of female peer educators in the Geração BIZ Program (GBP), an adolescent sexual and reproductive health program in Mozambique, an operational research study was used to test new strategies for improving recruitment, participation, and retention of female peer educators. The study tested an intervention model to increase the involvement and performance of girls in the GBP.

Evidence Update is a two-page summary of a Cochrane Review of healthcare interventions relevant to people in low-income and middle income-countries. This issue reviews whether lay health workers improve health care delivery and health care outcomes.

The lack of human resources for health (HRH) is increasingly being recognized as a major bottleneck to scaling up antiretroviral treatment (ART), particularly in sub-Saharan Africa, whose societies and health systems are hardest hit by HIV/AIDS. In this case study of Swaziland, we describe the current HRH situation in the public sector. We identify major factors that contribute to the crisis, describe policy initiatives to tackle it and base on these a number of projections for the future. Finally, we suggest some areas for further research that may contribute to tackling the HRH crisis in Swaziland.

The objective of this paper is to offer a better understanding of the determinants of geographical imbalances in the distribution of health personnel, and to identify and assess the strategies developed to correct them.

The relationship between poor conditions of employment and work of nursing personnel and shortages is complex. Consequences may include: increased patient morbidity and mortality; greater levels of violence in the workplace; reduced occupational safety and health for remaining personnel; high levels of job dissatisfaction with intention to quit; and unsustainable patterns of health worker migration from developing countries.The Nursing Personnel Convention articulates the kinds of provisions needed to address many of the identified problems. It must be implemented in the greatest number of countries in order to set decent standards of work, boost the professional and political profile of nursing personnel, and provide incentive for nursing personnel to remain in their jobs.

There are substantial differences in the working lives of women and men and this affects their occupational safety and health (OSH). The Community strategy on health and safety at work has mainstreaming, or integrating, gender into occupational safety and health activities as an objective. To support this, the Agency has produced a report examining gender differences in workplace injury and illness, gaps in knowledge and the implications for improving risk prevention. This factsheet summarizes the main findings. [adapted from publisher’s description]

The aim of this report is not only to give a clear overview of gender differences in safety and health at work and how they arise, but also to provide information about what this means for prevention and how a gender-sensitive approach can be taken in occupational safety and health. [from preface]

This report is the outcome of a seminar held in Brussels on 15th June 2004. The aims of the seminar were firstly to share information on gender and occupational safety and health (OSH) issues, including a gender-sensitive approach in OSH and how gender can be mainstreamed into OSH, and secondly to facilitate discussion and debate among EU and national authorities, social partners and experts on how to take forward gender issues in OSH. It includes proposals for taking forward gender issues in OSH. [Publisher’s description]

Imbalance in the cadre mix, number, distribution, and quality of health personnel are major concerns for health planners and policy makers. Many methods were developed and used to project future supply and requirement for health personnel. This paper modified the population-to-physician ratio method, by taking into account the specific characteristics of the Thai health care system, and of the future economic scenarios to project requirements of Thai physicians over the next twenty-five years. [from abstract]

Most human resources for health in developing countries are produced by highly subsidized public institutes. Due to inequity in basic education most health science students are from wealthier urban families. They tend to remain in urban areas after graduation, creating inequitable distribution of health personnel. At the same time the public education institutes are subject to strong bureaucratic inefficiency and usually no systematic quality control system. This paper analyses this situation in Thailand. [adapted from abstract]

Human Resource Development (HRD)is a very important yet very difficult component for effective health care delivery, especially in the public sector. Bureaucratic barriers, discontinuity, ineffective leadership, and lack of systematic approaches are major reasons for failures. A package of HRD strategies were introduced into Yasothon Hospital. This paper describes the detail of the implementation and evaluation of the results. [from abstract]

The objective of this study is to present and analyze different issues relating to the existing workforce in the health services of Bangladesh under the Ministry of Health. [from abstract]

A roundtable discussion of the following questions: 1) Why attempt HRH planning? 2) What should be the objectives for HRH planning? 3) Why has HRH planning had limited success in the past? 4) Will these reasons for limited success continue in the future? 5) Even if HRH planning might be useful, why wouldn’t market forces be a better guide to policy? 6) If both HRH planning and market forces have their use, when should we choose one and when the other? [From author]

This paper analyzes the present situation of general practitioners in the Thai health care system and the conditions under which their contribution could be strengthened. [from abstract]

Developing countries that have to cope with pressures to reform their bureaucracies have to contend with increasing health worker benefits and salaries that are often intended to retain these health workers in government service. In the Philippines, national and local efforts in health have been forced to focus on guaranteeing some of these benefits, and local governments are feeling the financial limitations of their local funds. [from abstract]

This study explores the details of the process leading to the equivalence determination of qualifications and degrees for the education and training of the health professions in Thailand. [from abstract]

This paper examines the use of human resource indicators to support management-led initiatives to improve health service efficiency and effectiveness. [from abstract]

The Royal College of Nursing (RCN) commissioned this report into the experiences of internationally recruited nurses (IRNs) working in the UK. The study explores the motivations and experiences of IRNs in order to understand why overseas nurses come to work in the UK, what experiences they undergo and whether they plan to stay in the UK, return to their countries of origin or go to another country to work after a short period. [from executive summary]

With globalisation trends, the emigration of highly skilled persons from developing countries has significantly increased. The implication of this movement of skilled labour (termed as “the brain drain”) has emerged as an important issue of international debate in recent years. The objective of the paper is to look at different possible policy responses which can minimize its adverse effects, and which can promote the sharing of gains between source and host countries. The paper focuses on three policy approaches: retention, return and circulation of skills. It argues that the best strategy to deal with the problem of loss of skilled labour is one based on the concept of circulation of skills, which yields mutual benefits for both sending and host countries.

This publication provides an overview of some of the key challenges for policy-makers in addressing the linkages between migration, health and human rights.The first section explains why we are addressing the issue of migration and health and what is meant by doing this through a human rights framework. It then explores some of the terminology used. The second section links the reasons why people migrate with the health and human rights implications of moving on the populations left behind. The third section considers the health implications for those on the move both in the context of public health as well as in relation to the health of the individual.

The study found that about half of the deliveries in Malawi are not assisted by a skilled attendant. It seems that there is a severe and long standing problem with retaining midwives. Therefore, close monitoring of the retention problem is advisable. The research found that the two main forms of losses are that the midwives die or they go abroad. Possible ways of mitigating the loss through emigration could be to continue efforts in enforcing codes of practice on international recruitment in recipient countries.

The numbers of health professionals joining the brain drain has reached a peak in recent years in apparent response to huge demands emanating from the developed countries. The brain drain of professionals, combined with the health crisis, threatens the entire development process in Africa. The crisis in health intensifies with the advent of the HIV/AIDS crisis. The loss of health workers simply serves to worsen a dire situation.

The brain-drain may not be stoppable, but it may be manageable. There is a great deal more that developed countries should be doing to support collapsing health systems in poorer countries and improving incentives for health staff to stay. [From author]

A human rights framework provides a formal and explicit way to examine the different social, political and economic problems that both give rise to, and result from, international migration, in particular inequality. It also allows clear and explicit articulation of where the obligation to do something about these human rights impacts lies under international human rights law, together with migration of health workers; and ensures that any improvements in the right to health are achieved without any express limitation of any other rights, including freedom of movement and rights in work.

This paper should be read in association with its companion paper on migration and human rights (Bueno de Mesquita and Gordon 2005). Our aims are conceptual and agenda-setting. In essence, we argue that current policy responses to migration of health professionals from low income developing countries underestimate the pressures and misidentify the reasons for rising migration, overestimate the impact of recruitment policies on migration flows while ignoring unintended side effects, and mis specify the ethical dilemmas involved.

This workbook has been designed to help you produce a workforce plan. The workbook is set out as the draft of workforce plan for Department of Health of a mythical small island country, Planania. Your task is to make changes in the content of this draft so as to produce a draft plan for your health authority. Although the workbook was designed for use at national level in small countries, it has been used in preparing workforce plans for health systems serving populations of several million people. It can be used for planning at district, regional or national level.

This rapid-assessment guide is designed to help users arrive at a global overview of a country’s HRH situation. The guide is designed to help users assess current HRH constraints and challenges to “scaling up” health interventions. HRH main issues include: Policy, regulation and planning; Management and performance improvement; Labour market; Education, training and research; HRH and priority health programmes; and Monitoring and evaluation. [author’s description]