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Nurses are expected to empower their clients, but they cannot do so if they themselves feel powerless. They must become empowered before they can empower others. This paper is an attempt to clarify the concept of power in nursing. It also presents a model describing the factors affecting nurse empowerment. [from abstract]

This paper addresses the problem of wastage of the qualified labor force, which takes place both during the education process and when trained personnel try to find jobs in the local market. Reducing wastage at both the educational and labor levels should improve the capacity of social investment, thereby increasing the capacity of the health system as a whole to provide services, particularly to those populations who are most in need. [from abstract]

The problem of training human resources in health is a real concern in public health in Central Africa. What can be changed in order to train more competent health professionals? This is of utmost importance in primary health care.

This brief report describes four different accreditation programs in South Africa: one is nationwide and addresses hospitals; the second accredits privately financed healthcare programs; the third is a provincial program accrediting all public healthcare facilities, and the fourth assesses clinics providing adolescent reproductive health. This operations research study interviewed stakeholders of the South Africa healthcare system to elicit their views of the best possible options for South Africa and of the strengths and weaknesses of the four existing programs. [author’s description]

Whilst the issue of international migration of health workers is sometimes presented as a one-way linear ‘brain drain,’ the dynamics of international mobility, migration and recruitment of health workers are complex.

The Chinese government has found it impossible to maintain uniform pay levels, particularly in the face of a radical devolution of its own financial management. Health workers have increasingly resorted to informal methods of earning an income. The government considers this to be unprofessional behavior and has used a combination of moral pressure and loss of professional privileges to discourage it.

The goal of this article is to evaluate the current status of human resources quality, availability and distribution in Northern Tanzania in order to provide emergency obstetric care services to specific districts in this area. It also discusses the usefulness of distribution indicators for describing equity in the decision-making process. [from abstract]

In an effort to understand the flows of funds throughout the health system, the Government of Rwanda (GoR) conducted, for the second time, a National Health Accounts (NHA) estimation. NHA is an internationally recognized tool for measuring health expenditures in a comprehensive manner — one that includes the public, private and donor sectors. By doing so, NHA offers a financial perspective on who is paying for health care, who is managing health care funds and their allocation, and where the funds are going — by type of provider and service. In short, NHA aims to inform policymakers on resource flows for the entire health system so as to assist in making good policy decisions and averting potentially adverse ones.

This report attempts to provide a comprehensive assessment of health outcomes and of the health sector performance in targeting the poor. The report is guided by the Poverty Reduction Strategy Framework on health, nutrition and population and poverty. It also uses the frameworks on accountability and service provision from the World Development Report 2004: Making Services Work for Poor People. The report builds upon a vast literature on the health sector in Uganda and uses available data from surveys and the health information system for its analysis. It provides an in depth examination of inequalities in health outcomes, health behavior and practices and of health system performance and financing from the equity perspective.

This research sheds light on the nature, design and provision of institutional services for providing training to the premier community health service providers in the public sector in Bangladesh. Virtually no major study exists on the training of the FWVs in the country. The methodology of the research mainly consists of a personal interview and questionnaire survey, covering the concerned trainers and officials of the major public health administration and training institutions of the country, including the National Institute of Population Research and Training, the Family Planning Directorate and the Family Welfare Visitors’ Training Institute.

This document intends to provide a policy and strategic framework for management of health information, use of information in planning and management of health services and monitoring health sector performance. [from preface]

This study was carried out in order to determine factors that may facilitate the poor retention of registered nurses in the Malawian public health sector.

This paper illustrates that the way human resources for health (HRH) are trained and deployed in Africa does not enhance productivity and that countries are unable to realize the full potential expected from the working life of their health workers.

The Community-based Health Planning and Services (CHPS) Initiative has employed strategies tested in the successful Navrongo experiment to guide national health reforms that mobilize volunteerism, resources and cultural institutions for supporting community-based primary health care. This paper reviews the development of the CHPS initiative, describes the processes of implementation and relates the initiative to the principles of scaling up organizational change which it embraces.

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.

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]

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]

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]

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.

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]

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.

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]

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]

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

This document summarizes the human resources management situation in the region, its determinants, and the projects for its development. To promote improvements in the human resources management function as part of the sectoral changes under way at the national and regional level, the Pan American Health Organization is proposing a series of strategies, actions, and operational tools through the Observatory of Human Resources in Health Sector Reform initiative. [adapted from author]

An initial investment of an estimated $2.0 billion in 2006, rising to an estimated $7.7 billion annually by 2010, is needed from African governments and the collective donor community to double sub-Saharan Africa’s health workforce while increasing its effectiveness, thus making significant progress towards developing the workforces required for countries in sub-Saharan Africa to achieve national and global health goals. [author’s description]

This paper summarizes the key issues confronting human resources (HR) in the health sector in sub-Saharan Africa and the role that HIV/AIDS has played in exacerbating this crisis. Section I reviews the causes and consequences of this crisis. Section II focuses on the effects of the HIV/AIDS epidemic on the crisis. Section III analyzes the constraints faced by recent health initiatives in addressing HR issues. Finally, Section IV provides recommendations on how donors and other partners can address HR issues in a more intensive, sustained, and concerted manner. [summary]

This report is aimed at policy makers both in developing country governments and in international agencies. It was a key input to the second meeting of the High Level Forum on the Health Millennium Development Goals held in Abuja in December 2004. It was written to raise awareness of a looming crisis in human resources for health confronting most countries in sub-Saharan Africa, and to help serve as a catalyst for action to avert this crisis.

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]

The purpose of this paper is to advocate for and guide planners in the collection and use of appropriate information to develop and manage the health workforce in a manner that enables health systems to respond to the service demands created or worsened by HIV/AIDS. The paper also intends to guide the development of tools for assessing impacts of HIV/AIDS on the health sector. Such tools can assist policymakers, planners, and advocacy groups to shape and accelerate the implementation of national HIV/AIDS policies and programs throughout the continent. [Description from author]