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This issue outlines the connections between work climate, employee motivation, and performance. It describes how managers can assess the climate in their work group and shows how they can use the results to make changes in leadership and management practices that will motivate their group to do the best work possible and improve results. [editor’s description]

This paper provides an overview of evidence of the effects of incentives on the performance and motivation of independent health professionals and health workers.

Using preliminary research results from 15 case studies conducted the world over we examine the prerequisites for successful introduction of performance management systems which are appropriate for developing country situations. The key message and conclusion is that it is important to measure and value staff performance, but that this requires levels of organisational management and an external policy environment that are seldom in place in a developing context.

For a health district to function, referral from health centres to district hospitals is critical. In many developing countries referral systems perform well below expectations. Niger is not an exception in this matter. Beyond obvious problems of cost and access this study shows to what extent the behaviour of the health worker in its interaction with the patient can be a barrier of its own. [from abstract]

This paper examines the issues relating to self-assessment, such as the different types of self-assessment, its uses, and its validity. It also reviews the literature (largely from developed countries) that informs our knowledge of self-assessment. The paper makes recommendations for future research and concludes that while much remains to be done to assure that self-assessment has the impact it promises, it may also be less costly and easier to implement than alternatives. [from author]

This issue introduces Training Impact Evaluation (TIE), a process designed to help managers identify and strengthen the links between training and staff performance. The issue describes the benefits of conducting a Training Impact Evaluation using a team approach and takes you step-by-step through the TIE process. The issue also offers practical suggestions for collecting, analyzing, and interpreting data on trainee performance in the workplace. It concludes with suggestions for ways that managers can use the information to make recommendations to decision makers, to improve training courses, or to seek management solutions to performance problems.

Over the last five years, international development organizations began to modify and adapt the conventional Performance Improvement Model for use in low-resource settings. This model outlines the five key factors believed to influence performance outcomes: job expectations, performance feedback, environment and tools, motivation and incentives, and knowledge and skills. This study presents a unique exploration of how the factors affect the performance of primary reproductive health providers (nurse-midwives) in two regions of Armenia. [from abstract]

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.

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]

Considered an introduction to the Performance Improvement Approach in low resource settings. Stages, Steps and Tools presents an easy-to-use guide for finding the root causes of performance problems and then selecting and implementing interventions to fix those deficits. A set of tools can be used independently or in conjunction with other interventions to improve the quality and accessibility of health care services. [