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Paying Primary Health Care Centers for Performance in Rwanda

Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. [from abstract]

Key Determinants of Migration among Health Professionals in Ghana

The focus of this study is to assess the level of migration expectation among health care professionals and to determine some of the factors which have pushed - and are likely to continue to push - them to seek employment outside Ghana. [from introduction]

Medicine in Australia: Balancing Employement and Life (MABEL) Longitudinal Survey: Protocol and Baseline Data for a Prospective Cohort Study of Australian Doctors' Workforce Participation

While there is considerable research on medical workforce supply trends, there is little research examining the determinants of labour supply decisions for the medical workforce. The MABEL study investigates workforce participation patterns and their determinants using a longitudinal survey of Australian doctors. It aims to generate evidence to support developing effective policy responses to workforce issues such as shortages and maldistribution. This paper describes the study protocol and baseline cohort, including an analysis of response rates and response bias. [from abstract]

Strategy to Improve Skills in Pharmaceutical Supply Management in East Africa: the Regional Technical Resource Collaboration for Pharmaceutical Management

This article evaluates a training initiative that has been established to help address the problem of skills shortage in pharmaceutical management in East Africa. [adapted from abstract]

Challenges Facing the Tanzanian Health Workforce in the Era of HIV/AIDS

The need for documenting how the AIDS epidemic is affecting the health care personnel has long been recognized. In the specific case of Tanzania which already has a Health Sector HIV/AIDS Strategy it is imperative to have information on how the health system and the health personnel who are expected to spearhead the implementation of that strategy are being affected. This can guide preventive and remedial measures to ensure that the capacity of the system and its personnel for the effective implementation of the Strategy is not unduly compromised. [from author]

Wrong Schools or Wrong Students? The Potential Role of Medical Education in Regional Imbalances of the Health Workforce in the United Republic of Tanzania

This paper reviews available research evidence that links medical students’ characteristics with human resource imbalances and the contribution of medical schools in perpetuating an inequitable distribution of the health workforce. [from abstract]

Validation of Community Health Workers' Assessment of Neonatal Illness in Rural Bangladesh

Improving neonatal health and survival requires cost-effective interventions at the community level, as well as linkages between the community and the health-care system within the continuum of care for the treatment of severe illness. The primary purpose of this study was to evaluate the performance of CHWs in recognizing signs and symptoms of neonatal illness during routine household surveillance in rural Bangladesh. [from introduction]

Human Resource and Funding Constraints for Essential Surgery in District Hospitals in Africa: A Retrospective Cross-Sectional Survey

While constrained health budgets and health worker shortages have been blamed for the low rates of surgery, there has been little empirical data on the providers of surgery and cost of surgical services in Africa. This study described the range of providers of surgical care and anesthesia and estimated the resources dedicated to surgery at district hospitals in three African countries. [from abstract]

Task Shifting Routine Inpatient Pediatric HIV Testing Improves Program Outcomes in Urban Malawi: A Retrospective Observational Study

This study evaluated two models of routine HIV testing of hospitalized children in a high HIV-prevalence resource-constrained African setting. Both models incorporated task shifting, or the allocation of tasks to the least-costly, capable health worker. [from abstract]

Malawi: Distribution of DMPA at the Community Level: Lessons Learned

In 2008, Malawi piloted the distribution of depo-medroxy progesterone acetate (DMPA), an injectable contraceptive, to the community by Health Surveillance Assistants. This report presents lessons learned during the initial implementation, from gaining stakeholder buy-in to curriculum development, and the initial three months after the training and implementation roll-out. [from abstract]

Evaluation Study on the Relevance and Effectiveness of Training Activities in Northern Uganda

This study focused on a trained health workforce in Northern Uganda. The retention of specifically-trained staff 12-15 months after attending training was examined, as was the relevance and usefulness of the training as perceived by the health workers. [from abstract]

Improving Health Workforce Recruitment and Retention in Rural and Remote Regions of Nigeria

This article posits that out-migration of health workers is not a critical contributor to health workforce shortages in Nigeria’s rural and remote areas and that more important factors include: contraction of government health spending as a percentage of GDP despite deteriorating health conditions, public health management systems that operate by default rather than by design, spartan living conditions outside urban areas, inadequate training of appropriate cadres of health staff, limited facilities and medications for effective delivery of clinical services, and burnout of overworked and unde

Impact of the Economic Recession on Nurses and Nursing in Iceland

This article describes human resources in nursing and the role and status of nurses within the health care system. It also deals with government measures and the foreseeable impact on nursing and health care services. [adapted from introduction]

Incentive Payments to General Practitioners Aimed at Increasing Opportunistic Testing of Young Women for Chlamydia: a Pilot Cluster Randomised Controlled Trial

Financial incentives have been used for many years internationally to improve quality of care in general practice. The aim of this pilot study was to determine if offering general practitioners a small incentive payment per test would increase chlamydia testing in women aged 16 to 24 years, attending general practice. [from abstract]

New Pardigm Old Thinking: The Case for Emergency Obstetric Care in the Prevention of Maternal Mortality in Nigeria

This study assessed the knowledge of maternity unit operatives at the primary and secondary levels of care about the concept of emergency obstetric care and investigated the contents of antenatal care counseling services they delivered to clients. It also described the operatives’ preferred strategies and practices for promoting safe motherhood and averting maternal mortality in south-west Nigeria. [from abstract]

Cost and Cost-Effectiveness of Smear-Positive Tuberculosis Treatment by Health Extension Workers in Southern Ethiopia: A Community Randomized Trial

In this study, we aimed to determine the cost and cost-effectiveness of involving health extension workers in tuberculosis treatment in Southern Ethiopia. This paper presents an ancillary cost-effectiveness analysis of data from a randomized control trial. [adapted from introduction]

Developing Counseling skills through Pre-Recorded Videos and Role Play: a Pre- and Post-Intervention Study in a Pakistani Medical School

Interactive methods like role play, recorded video scenarios and objective structured clinical exam are being regularly used to teach and assess communication skills of medical students in the western world. In developing countries however, they are still in the preliminary phases of execution in most institutes. Our study was conducted in a naive under resourced setup to assess the impact of such teaching methodologies on the counseling skills of medical students. [from abstract]

Evaluating Different Dimensions of Programme Effectiveness for Private Medicine Retailer Malaria Control Interventions in Kenya

This study presents evaluation findings of two different programs targeting private medicine retailers for malaria control in Kenya. Key components of this evaluation were measurement of program performance, including coverage, knowledge, practices, and utilization based on spatial analysis. [from abstract]

Impact of Provider-Initiated (Opt-Out) HIV Testing and Counseling of Patients with Sexually Transmitted Infection in Cape Town, South Africa: a Controlled Trial

This study evaluated whether the provider-initiated HIV testing and counseling approach increased HIV testing amongst patients with a new episode of sexually transmitted infection, as compared to standard voluntary counseling and testing at the primary care level in South Africa, a high prevalence and low resource setting. [from abstract]

Antiretroviral Treatment Outcomes from a Nurse-Driven, Community-Supported HIV/AIDS Treatment Programme in Rural Lesotho: Observational Cohort Assessment at Two Years

This successful program highlights how improving HIV care strengthened the primary health care system and validates several critical areas for task shifting that are being considered by other countries in the region, including nurse-driven ART for adults and children, and lay counsellor supported testing and counselling, adherence and case management. [from abstract]

Effect of a Peer-Educational Intervention on Provider Knowledge and Reported Performance in Family Planning Services: a Cluster Randomized Trial

This study evaluated the effect of an educational program including peer discussions on the providers’ knowledge and reported performance in family planning services. [from abstract]

Realist Evaluation of the Management of a Well-Performing Regional Hospital in Ghana

This article uses the realist evaluation method to determine the effect of human resource management on hospital performance using a regional facility in Ghana.

Implementation of the Learning for Performance Approach at the Gao Nursing School in Mali: Final Report

This report documents the efficiency of the Learning for Performance approach in the implementation of new pre-service reproductive health/family planning and child health training modules aimed at local health technicians working in Northern Mali. [adapted from introduction]

Implementation of the Learning for Performance Approach in Rwanda: Final Report

The Capacity Project used the Learning for Performance (LFP) approach to develop the family planning (FP), HIV/AIDS and gender components included in the competency-based A1 nursing and midwifery pre-service curricula. LFP was also used to adapt the Rwanda national FP curriculum to an on-the-job training approach. This study documents the implementation of the and the lessons learned from its application in preservice education and in-service training in Rwanda. [from summary]

Final Feasibility Evaluation for No-Scalpel Vasectomy in Rwanda

In direct response to the country’s human resources for health needs, the Capacity Project helped to develop the capacity of the district hospital clinical workforce to expand access to a full range of quality family planning methods through a pilot vasectomy in-service training program for physicians and nurses at two district hospitals. [adapted from introduction]

Evaluation of a Rapid Workforce Expansion Strategy: the Kenya Emergency Hiring Plan

This evaluation presents the results of a Kenyan emergency hiring plan (EHP) to quickly hire, train and deploy workers to high-need areas. The report presents the tracked hiring, training and deployment of all new hires compared to identified gaps. It also contains facility statistics and new hire and coworker feedback in a sample of ten facilities at baseline and every six months for period of three years. [adapted from summary]

Evaluation of the Capacity Project's Human Resources Information Systems (HRIS) Strengthening Process in Swaziland, Uganda and Rwanda

The Capacity Project worked to strengthen HRIS in several low-resource countries to assist decision-makers and human resources managers in identifying and responding to critical gaps in HRH. The findings and recommendations in this report cover the Capacity Project’s implementation of HRIS in Swaziland, Rwanda and Uganda. [from summary]

Task Shifting for Scale-up of HIV Care: Evaluation of Nurse-Centered Antiretroviral Treatment at Rural Health Centers in Rwanda

In September 2005, a pilot program of nurse-centered antiretroviral treatment (ART) prescription was launched in three rural primary health centers in Rwanda. We retrospectively evaluated the feasibility and effectiveness of this task-shifting model using descriptive data. [from abstract]

Role of Nonphysician Clinicians in the Rapid Expansion of HIV Care in Mozambique

In Mozambique, a country with a high HIV burden and a staggering workforce deficit, the Ministry of Health looked to past experience in workforce expansion to rapidly build ART delivery capacity, including reliance on existing nonphysician clinicians (NPC) to prescribe ART and dramatically increasing the output of NPC training. [from abstract]

Job Requirements Compared to Medical School Education: Differences between Graduates from Problem-Based Learning and Convential Curricula

Problem-based learning (PBL) has been suggested as a key educational method of knowledge acquisition to improve medical education. This study sought to evaluate the differences in medical school education between graduates from PBL-based and conventional curricula and to what extent these curricula fit job requirements. [from abstract]