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Licensure, Accreditation, and Certification: Approaches to Health Services Quality

This monograph provides a brief overview of several aspects of quality assurance, including its cost-effectiveness and its feasibility in less developed countries. The monograph describes the dimensions of quality, the four principles of quality assurance, the QA process, and key activities in the development of a QA program.

Impact of HIV/AIDS on the Health Sector in Sub-Saharan Africa: The Issue of Human Resources

This paper reviews data, studies, and other information on HIV/AIDS impacts on human resources in sub-Saharan Africa. The purpose is to guide the development of an instrument to conduct HIV/AIDS human resource assessments in the health sector. Until now, inadequate attention has been devoted to this critical step in responding to the epidemic. Such assessments can assist policy makers and advocacy groups to shape and accelerate the implementation of national HIV/AIDS policies and programs throughout the continent. [Description from author]

Attitudes of Nursing Students of Kolkata Toward Caring for HIV/AIDS Patients

This study examines the attitudes of nursing students toward caring for HIV/AIDS patients and their knowledge and perceptions about the disease. Findings revealed a very positive outlook of the nursing students in regards to caring for HIV/AIDS patients. Although most of them expressed their willingness to take any job offer concerning caring for HIV/AIDS patients, 34.3% apprehended resistance from their family members in this regard. However, they also considered that it would be possible for them to overcome the resistance. Although 100% of the students had heard of HIV/AIDS, a number of them had misconceptions about various aspects of the disease.

Polio Eradication: Mobilizing and Managing Human Resources

This paper reviews the strategies for polio eradication, summarizes the skills and number of people required for their implementation, outlines the approach used to mobilize and manage these human resources, and discusses the impact of this approach. [from introduction]

Zambia HIV/AIDS Workforce Study: Preparing for Scale-up

This report presents the findings of a study conducted at 16 healthcare sites in Zambia offering voluntary counseling and testing (VCT), prevention of mother-to-child transmission of HIV (P-MTCT), and antiretroviral (ARV) therapy. The study period, including design, implementation, and data analysis, was April to June 2003. The purpose of the study was to assist the Government of Zambia in determining whether it will have sufficient staff to be able to scale up VCT, P-MTCT, and ARV treatment to reach its targeted numbers of clients.

Ethical Issues in Health Workforce Development

Increasing the numbers of health workers and improving their skills requires that countries confront a number of ethical dilemmas. The ethical considerations in answering five important questions on enabling health workers to deal appropriately with the circumstances in which they must work are described.

HIV/AIDS and Human Resources

We are beginning to recognize that, parallel to biological action, the HIV/AIDS pandemic also attacks the human capacity and social defence systems. By destroying the fabric of health systems, the spread and impact of the epidemic is hugely augmented. [author’s description]

Better Health Outcomes from Limited Resources: Focusing on Priority Services in Malawi

The present report deals with health financing issues in Malawi and analyzes trends in health expenditures in the 1990s, along with the prospects for improving resource mobilization, allocation and use in the health sector of that country. This review highlights the need to further prioritize the activities under the Malawi National Health Plan so that the plan will be a basis for government policy and budgetary commitments and also an instrument to marshal and orchestrate donor support to the sector. [from foreword]

Human Resources for the Control of Road Traffic Injury

The definition of the ideal numbers and distribution of human resources required for control of road traffic injury (RTI) is not as advanced as for other health problems. We can nonetheless identify functions that need to be addressed across the spectrum of injury control. [from abstract]

Uganda Leads the Way in Innovative HIV/AIDS Treatment

This news article introduces an approach to HIV/AIDS treatment that has helped Uganda scale up treatment in the midst of limited health workers. The approach, called Integrated Management of Adult and Adolescent Illness (IMAI), has been inspired by successes in Latin America, the former Soviet Union and Africa, where lay health workers who are often relatives, friends or other community volunteers have been trained to help treat tuberculosis patients in poor settings. [adapted from author]

Mauritania Health System and Implementation of the Poverty Reduction Strategy: Medium-Term Expenditure Framework (2002-04) for Improving the Efficiency and Equity of Public Health Expenditure

Provides an overview of a new budgeting approach in Mauritania, developed by the Ministry of Health on the basis of an analysis of the health problems of poor people, their difficulties in accessing health care, and the shortcomings of the health systems in serving them. The document shows how such analysis can inform the budgeting process and reorient public expenditures in the health sector. Budgeting health services in Mauritania have shifted from a line item approach towards performance based programs with specific indicators of success identified both program and region wide. [from author

Role of Wages in the Migration of Health Care Professionals from Developing Countries.

Several countries are increasingly relying on immigration as a means of coping with domestic shortages of health care professionals. This trend has led to concerns that in many of the source countries—especially within Africa—the outflow of health care professionals is adversely affecting the health care system. This paper examines the role of wages in the migration decision and discusses the likely effect of wage increases in source countries in slowing migration flows. [from abstract]

Private Sector, Human Resources and Health Franchising in Africa

In much of the developing world, private health care providers and pharmacies are the most important sources of medicine and medical care and yet these providers are frequently not considered in planning for public health. This paper presents the available evidence, by socioeconomic status, on which strata of society benefit from publicly provided care and which strata use private health care. [from abstract]

Role of Traditional Birth Attendants in Preventing Perinatal Transmission of HIV

Every year a million women infected with HIV deliver babies without professional help. This article suggests that traditional birth attendants could be involved in preventing perinatal transmission of HIV by offering services such as HIV testing and counseling and short courses of antiretroviral drugs. [publisher’s description]

Intervention Complexity: A Conceptual Framework to Inform Priority-Setting in Health

This article proposes a conceptual framework for the analysis of human resources for health interventions according to their degree of technical complexity; this complements the notion of institutional capacity in considering the feasibility of implementing an intervention.

Vertical-Horizontal Synergy of the Health Workforce

An editorial by Gijs Elzinga in an issue of the Bulletin of the World Health Organization dedicated to the theme of Human Resources for Health. Elzinga discusses the importance of effective interplay between the goals of vertical programs and the horizontal health care system within which vertical programs are implemented.

Health Care on the Frontlines: Survey Evidence on Public and Private Providers in Uganda

The report presents findings from a baseline survey of 155 primary health care facilities (dispensaries, with and without maternity units) that was carried out in Uganda in the latter part of 2000. The analysis compares service delivery performance in three ownership categories: government, private for-profit, and private nonprofit. Among the topics it explores at the facility level are staffing, availability of drugs and other inputs, remuneration, outputs, and financing. The findings are highly relevant for public policy in Uganda and in other countries in Africa that are undertaking civil service reform and promoting private-public partnerships in health care.

Responding to HIV/AIDS in Africa: A Comparative Analysis of Responses to the Abuja Declaration in Kenya, Malawi, Nigeria and Zimbabwe

The challenge of tackling HIV/AIDS was taken up by African Heads of State at their summit in Abuja in 2001. This led to the Abuja Declaration, the primary goal of which is to reverse the accelerating rate of HIV infection, TB and other related infectious diseases.

This report is based on research carried out by ActionAid International in Kenya, Malawi, Nigeria and Zimbabwe and provides a comparative analysis of the achievements and challenges faced by these four African countries in relation to the Declaration. [Adapted from author]

Human Resources in the Health Sector: An International Perspective

This paper, aimed primarily at DFID advisers and health sector analysts, will attempt to map out selected issues relating to the planning and management of human resources by combining an international perspective with issues and trends emerging from individual countries. HR issues and challenges have been grouped into four broad objectives that poor countries, donors and advisers will need to address simultaneously over the next decade and beyond.

Policy Brief Two: Rehabilitating the Workforce: The Key to Scaling up MNCH (World Health Report 2005: Making Every Mother and Child Count)

This policy brief from the World Health Report 2005 argues that it will not be possible to effectively scale up Maternal, Newborn and Child Health (MNCH) care without confronting the global health workforce crisis. It highlights how lack of managerial autonomy, gender discrimination and violence in the workplace, dwindling salaries, poor working conditions and some donor interventions have all contributed to a lack of productivity, as well as the rural to urban, public to private and poor to rich country brain drain and migration. The brief argues the need to plan the expansion of the workforce while implementing corrective measures to rehabilitate productivity and morale.

Stopping the Migration of Ghana's Health Workers

Ghana’s health sector has lost many health care workers, including those migrating to other countries. Strategies aimed at keeping personnel have had varied results. This article briefly reviews these strategies. [adapted from author]

HIV/AIDS, Equity and Health Sector Personnel in Southern Africa

This paper discusses the implications for health personnel of the HIV epidemic, and health sector responses to it, in southern Africa, using Malawi as a case study. Published and grey literature has been consulted to assess the situation and its implications for equity. [author’s description]

Guidelines for Implementing Supportive Supervision: A Step-by-Step Guide with Tools for Immunization

This resource guide assists program managers in planning and implementing supervision systems in healthcare settings. Emphasis is placed on clear job expectations, leadership, and communication.

How Can We Achieve and Maintain High-Quality Performance of Health Workers in Low-Resource Settings?

In low and middle income countries, health workers are essential for the delivery of health interventions. However, inadequate health-worker performance is a very widespread problem. We present an overview of issues and evidence about the determinants of performance and strategies for improving it. [authors’ description]

Healers Abroad: Americans Responding to the Human Resource Crisis in HIV/AIDS

This report explores potential strategies for mobilizing U.S. health personnel and technical experts to assist in the battle against HIV/AIDS in 15 African, Caribbean, and Southeast Asian countries highly affected by the disease. Commissioned by the U.S. Department of State as part of a historic global health initiative—the President’s Emergency Plan for AIDS Relief (PEPFAR)—the report presents the results of a study conducted by the Institute of Medicine’s Committee on the Options for Overseas Placement of U.S. Health Professionals. [Description from author]

Note: Online book

Costs of HIV/AIDS Among Professional Staff in the Zambian Public Health Sector

Despite their high level of training and medical knowledge, health professionals remain a population that is vulnerable to HIV/AIDS. AIDS-related mortality has been recognized as a significant factor in the loss of trained health staff in high prevalence countries, but little empirical research has been done to quantify the damage. In this study, we applied a case/comparison methodology to estimate the costs of HIV infection in the professional workforce at three Zambian healthcare institutions: Lusaka District Health Management Team, University Teaching Hospital (the national tertiary care hospital) and Kasama District Hospital and Health Management Team. Deaths or medical retirements among professional staff were analyzed wherever the complete personnel records were available, with the exclusion of cases resulting from violence, accident or disease of sudden onset. 108 cases were identified over a three-year period ending in October 2003. Each case was matched with two comparisons of similar age, sex and professional training. Data were collected for both cases and comparisons on absenteeism, compensation and medical care and reimbursement. Data were also collected on death and retirement benefits paid, or owed, to the cases. [author’s description]

Action Plan to Prevent Brain Drain: Building Equitable Health Systems in Africa

The causes of brain drain are complex and interrelated, involving social, political, and economic factors. The necessary responses will therefore be varied and cover an array of areas. Drawing on growing interest and scholarship, Physicians for Human Rights (PHR) proposes this plan of action for addressing brain drain and the unequal distribution of health personnel within countries, recommending actions by high-income countries, African governments, WHO, international financial institutions, private businesses, and others. [author’s description]

Data on the Migration of Health-Care Workers: Sources, Uses and Challenges

Most statistics on the migration of health-care workers are neither complete nor fully comparable, and they are often underused, limited, because they often give only a broad description of the phenomena, and are not as timely as required. This paper presents information on the uses of statistics and those who use them, the strengths and limitations of the main data sources, and other challenges that need to be met to obtain good evidence on the migration of health workers. This paper also proposes methods to improve the collection, analysis, sharing, and use of statistics on the migration of health workers.

Working Together to Tackle the Crisis in Human Resources for Health

The paper summarizes the rapidly accumulating evidence and growing recognition of the HRH crisis, especially in sub-Saharan Africa. The nature of the crisis is briefly outlined, drawing attention to escalating activities, demand and momentum emerging from Africa and other countries calling for appropriate and effective global and regional support. There are clear needs for quality technical work, stronger regional cooperation, harmonization of health systems and global initiatives, and for sound fiscal and migration policies.

Selecting Partners: Practical Considerations for Forming Partnerships

This handbook, developed for the Consultative Group on International Agricultural Research, describes the nature of successful partnerships: their characteristics, their benefits, their challenges, and provides practical guidance to leaders, managers, and professionals in agricultural research who are using or considering partnerships as a way to achieve greater results. While geared toward the agricultural sector, the material has wide applicability to other sectors.