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During the 1990s in Kenya, nurse midwives, a new group of private-sector service providers, were licensed to operate private clinics close to communities. The private nurse midwives operate private clinics, nursing and maternity homes primarily in densely populated peri-urban areas, rural trading centers and towns. The networks described in this report emerged out of the need for a sustainable supervision system and a continuing education program for the private nurse midwives. [from introduction]

This presentation discusses the midwifery gap in Pakistan and the strategies they are using to address it.

Despite ample evidence that HIV has entered the general population, most HIV awareness programs in India continue to neglect rural areas. Low HIV awareness and high stigma, fueled by low literacy, seasonal migration, gender inequity, spatial dispersion, and cultural taboos pose extra challenges to implement much-needed HIV education programs in rural areas. This paper describes a peer education model developed to educate and empower low-literacy communities in the rural district of Perambalur in India. [from abstract]

Modernizing the way health care professionals are educated and engaged in their vital work requires a collaborative and coordinated approach among many players. The Health Council convened the summit on health human resources to focus on practical, short-term solutions. This report attempts to capture the lively discussion and encouraging examples of innovation brought forward at that forum, organized into four theme areas: education and training, scopes of practice, workplace practices and planning. [adapted from author]

This survey is the first attempt to examine the preparedness of the health
system to implement guidelines for HIV testing in clinical settings, and to provide comprehensive AIDS management. This includes availing HIV testing in clinical settings to both adult and pediatric patients, and providing treatment for HIV disease. The survey also examines the working environment in health care facilities, with an emphasis on HIV infection control and access to post-exposure prophylaxis for health workers themselves. [from foreword]

This paper examines the employment preferences of public sector registered nurses working in Malawi and identifies the range and relative importance of the factors that affect their motivation. The research was designed in the light of the Malawi government’s programme to address the shortage of health workers, which is based on salary top-ups as a means of increasing employee motivation and reducing high rates of attrition. This policy has been adopted despite relatively little quantitative exploration into the employment preferences of health workers in developing countries.

Knowing that quality is never an accident, always the result of high intention, sincere effort, intelligent direction and skillful execution, and that it represents the wise choice of many alternatives, this abbreviated version of the Policy attempts to provide the strategic direction health facilities and officials need to follow to assure quality in health care and continuous improvement in the care that is being provided. Health care personnel are encouraged to use this copy of the Policy to focus their intentions and guide their efforts. [from foreword].

This report summarizes the results of the first year of the two-year project entitled International Recruitment of Nurses to the United States: Toward a Consensus on Ethical Standards of Practice. It examines the structure and basic practices of the U.S. based international nurse recruitment industry. The purpose of the project is to facilitate consensus among stakeholders on how to reduce the harm and increase the benefits of international nurse recruitment for source countries and for migrant nurses themselves. [from author]

The Canadian health care system is one of the places where push comes to pull in terms of attracting health care professionals from sub-Saharan Africa. The authors call this the perverse subsidy: the costs of training these professionals are paid for by poorer people in poorer countries. The pull to Canada is equally a push from Africa. Reflections on a pilot study on a labour mobility issue that is equally a question of conscience. [from author]

This study evaluated biases in guideline untilization of evidence-based practice concerning contraception perscription. It was found that in India, Peru, and Rwanda, health care providers underutilize evidence-based practice guidelines as they prescribe contraceptives. This article ends with recommendations for providers to most effectively utilize evidence-based practice. [adapted from abstract]

This presentation describes the benefits and challenges of structured on-the-job training with evidence from a case study of Nepal.

Telemedicine is viewed as a new way of offering medical services. It is seen as a means of overcoming the growing shortage of health practitioners in developing countries. The aim of this paper is to highlight the need for the formulation of guidelines for the ethical practice of telemedicine in South Africa. [from abstract]

Within the Southern African prevention of mother to child transmission (PMTCT) programmes, counsellors talk with pregnant mothers about a number of interrelated decisions and behaviour changes. Current counselling has been characterised as ineffective in eliciting behaviour change and as adopting a predominantly informational and directive approach. Motivational interviewing (MI) was chosen as a more appropriate approach to guide mothers in these difficult decisions, as it is designed for conversations about behaviour change. MI has not previously been attempted in this context. This paper reflects on how MI can be incorporated successfully into PMTCT counselling and what lessons can be learnt regarding how to conduct training with counsellors.

Clinical skills and the ability to perform procedures is a vital part of general medicine. Teaching these skills to aspiring doctors is a complex task and it starts with a good theoretical preparation and some practical experience at university. On graduating from university, each doctor is faced with the task of transforming theoretical knowledge into the practical, procedural skills of a competent professional. This study aims to assess the perceptions of intern doctors working in regional hospitals in the Western Cape of their skills training both at undergraduate level and during the intern year.

The first study of the Australian hospital pharmacy workforce (public and private hospitals) was undertaken in 2001. Data from this study provided a baseline and were used to estimate the future demand for hospital pharmacists. This article summarizes an update of this survey done in 2003. [adapted from author]

The health and well-being of the health workforce and the quality of the healthcare work environment has a profound impact on the effectiveness and efficiency of healthcare services. This resource identifies priority actions that are known to improve the workplace and that can be implemented quickly and efficiently. The actions focus on both system wide and organizational performance improvement on specific areas relating to quality work life. [from executive summary]

Following health sector reform, Ethiopia started training new categories of health workers. This study addresses students’ perspectives regarding their training and career plans. This study suggests that the current training programs have serious inadequacies that need to be addressed. [from abstract]

The objective of this study was to assess whether traditional birth attendants, drug-shop vendors, community reproductive-health workers, or adolescent peer mobilizers could administer intermittent preventive treatment (IPTp) for malaria with sulfadoxine-pyrimethamine to pregnant women. The study concludes that the use of the guideline with adequate training significantly improved correctness of malaria treatment with chloroquine at home. Adoption of this mode of intervention is recommended to improve compliance with drug use at home. The applicability for deploying artemisinin-based combination therapy at the community level needs to be investigated.

Many Nigerian children with malaria are treated at home. Treatments are mostly incorrect, due to caregivers’ poor knowledge of appropriate and correct dose of drugs. A comparative study was carried out in two rural health districts in southwest Nigeria to determine the effectiveness of a guideline targeted at caregivers, in the treatment of febrile children using chloroquine. [from abstract]

The purpose of this study was to assess physicians’ knowledge, attitude and global comfort in caring for patients with AIDS (PWA), to determine the sociodemographic variables that could influence physicians and to identify any relationship between their knowledge, attitude and comfort. The study reinforced the need for an ongoing education focused on experiential learning and professional socialization in order to influence physicians’ attitude and enhance their feeling of comfort when caring for PWA. [adapted from abstract]

This article describes an intervention for training traditional birth attendants and integrating them into an improved health care system, which was proven to be achievable and effective in reducing perinatal mortality. This model could result in large improvements in perinatal and maternal health in developing countries. [adapted from abstract]

In the rural areas of sub-Saharan Africa, the majority of young children affected by malaria have no access to formal health services. Home treatment through mothers of febrile children supported by mother groups and local health workers has the potential to reduce malaria morbidity and mortality. [from author]

This article describes the experience of Guatemalan students at Cuba’s Latin American Medical School. The students’ education emphasizes health problems and diseases characterizing the epidemiological situation in their home country and in-depth courses in disaster management, as well as clinical experience in Guatemala. [adapted from author]

This article describes the efforts within the Cuban medical system to collaborate with health authorities around the globe to develop medical education programs to train such urgently-needed professionals with curricula formulated to meet international standards and local health needs. Special emphasis is placed on the assistance that Cuba provided to Gambia in establishing a medical school in that country. [from author]

This article describes the Cuban medical education system. The role of Cuban physicians internationally is discussed, as well as the placement of international students in Cuban medical schools.

The world’s 1,691 medical schools and 5,492 nursing schools are not producing enough graduates to cover the massive global deficit of doctors, nurses, and midwives. One scaling-up initiative addressing these critical shortages is Cuba’s Latin American Medical School. This article describes those efforts. [adapted from introduction]

The Institute of Medicine’s Academy of Science has recommended that medical schools incorporate information on CAM (complementary and alternative medicine) into required medical school curricula so that graduates will be able to competently advise their patients in the use of CAM. The report states a need to study models of systems that integrate CAM and allopathic medicine. The authors present Cuba’s health care system as one such model and describe how CAM (or natural and traditional medicine) is integrated into all levels of clinical care and medical education in Cuba. The authors conclude that there is much to learn from the Cuban experience to inform U.S.

This report details the impact of Pathfinder Interational’s community-based approach to reproductive health and family planning in Ethiopia.

This article discusses the development of a decision framework to assist policymakers in choosing and designing effective incentive systems. The researchers identified several models that have proven to be effective in changing or enabling a health provider’s performance.

This brief reports on a project through Cambodia’s Ministry of Health which contracted health services to NGOs. Contracting NGOs to manage the primary health care system was found to be an effective means to increase service coverage and achieve a more pro-poor distribution of services in rural areas of Cambodia. [adapted from introduction]