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Thailand’s Unsung Heroes

The success of primary health care programmes in Thailand over the past three decades can be attributed not only to medical advances but to the role of community health volunteers. Buddhist monks and their temples have been strongly involved in health promotion and education, particularly in remote, rural communities. [from introduction]

Zambia's Health-Worker Crisis

This article is an overview of the major HRH issues facing the health system in Zambia, including out-migration, an outdated medical-training infrastructure, faulty government management, and the effects of HIV/AIDS.

Should Active Recruitment of Health Workers from Sub-Saharan Africa be Viewed as a Crime?

This editorial describes the widespread recruitment of health workers from sub-Saharan Africa to developed nations by recruiting agencies. The authors describe international efforts to criminalize this practice and express concern at the continued practice of recruitment.

Indian Public-Private Partnership for Skilled Birth-Attendance

This article describes the efforts of the Indian government to decrease maternal mortality by improving birthing conditions. The scheme created a partnership with the private sector and an NGO to provide free birth care to poor families through contracts with private obstetricians practicing in rural areas. The authors conclude that public-private partnerships can rapidly scale up the availability of human resources for skilled birth-attendance and emergency obstetric care to the poor in a very short time. [adapted from author]

Africa's Neglected Surgical Workforce Crisis

This article outlines the challenges facing the surgical workforce in Africa. Funding priorities in Africa typically favor infectious diseases, and surgery and perioperative care have been neglected, even though essential surgical care at district hospitals is more cost effective than some other highly prioritized interventions, such as antiretroviral therapy for HIV. There is a need to integrate surgical and anesthetic training programs so health personnel, particularly in rural areas, can treat the full range of diseases appropriate to that level of care. [adapted from author]

Salaries and Incomes of Health Workers in Sub-Saharan Africa

This article investigates pay structures for health workers in the public sector in sub-Saharan Africa; the adequacy of incomes for health workers; the management of public- and private-sector pay; and the fiscal and macroeconomic factors that impinge on pay policy for the public sector. The study finds that pay and income of health workers varies widely, whether between countries, by comparison with cost of living, or between the public and private sectors. To optimize the distribution and mix of health workers, policy interventions are needed. Fiscal constraints to increased salaries might need to be overcome in many countries, and non-financial incentives improved. [adapted from summary]

Regional Goals for Human Resources for Health 2007 - 2015

This document outlines the issues for human resources for health in the Americas and what the Pan American Health Organization resolves should be done to address them.

Rehabilitation Under Fire: Health Care in Iraq 2003-2007

This report describes how the war in Iraq and its aftermath continue to have a disastrous impact on the physical and mental health of the Iraqi people, and the urgent measures needed to improve health and health services. It assesses the current state of the health system, including the impact of insecurity, and the workforce, supplies, medicines and equipment it lacks. It also looks at health information and health policy in Iraq. The report ends with conclusions and recommendations, exploring what needs to happen now in Iraq and what lessons can be learned. [adapted from author]

How Private Health Care Can Help Africa

To understand how the private health sector might better complement Africa’s public health systems, we studied the health care sectors of 45 sub-Saharan African countries. The findings suggest opportunities for private enterprise to help improve the region’s woefully poor health outcomes.

Assessment of the Additional Duties Hours Allowance (ADHA) Scheme: Final Report

The original purpose of the ADHA scheme was to compensate doctors for hours worked beyond the standard 40 hours per week or 160 hours per month. This study investigated how the scheme impacted a number of human resources (HR) factors associated with health worker recruitment, deployment, retention and performance - specifically, how the significantly higher income levels resulting from the ADHA scheme influenced job satisfaction, motivation, workplace climate and the relationship between clinical and administrative staff, as well as productivity. The study provides a detailed chronology of the ADHA scheme and explores lessons learned from the way in which the GOG implemented and administered the scheme.

Recruiting and Retaining Health Workers in Ethiopia

This presentation was given at the First Forum on Human Resources for Health in Kampala. It covers the imbalance in physician deployment in Ethiopia and the lottery system for ensuring coverage in rural areas.

Block Granting, Perfomance Based Incentives and Fiscal Space Issue: the New Generation of HRH Reforms in Rwanda

This presentation was given at the First Forum on Human Resources for Health in Kampala. It reviews a study of how Rwanda, faced with constrained fiscal conditions, has implemented innovative reforms to create fiscal space for human resources and to make these resources more responsive to needs through an analysis of budget documents and policy and regulation changes and key informant interviews. [adapted from author]

Uganda Health Workforce Study: Satisfaction and Intent to Stay Among Health Workers in Public and PNFP Facilities

This presentation was given at the First Forum on Human Resources for Health in Kampala. It describes a study to identify the level of satisfaction and intent to stay among health workers and effort to develop strategies to improve retention. [adapted from author]

Financial Incentives and Mobility of the Health Workforce in Burkina Faso

This presentation was given at the First Forum on Human Resources for Health in Kampala. It describes a study done to analyze health worker perceptions of renumeration and determine the factors that affect the mobility of the health workforce in Burkina Faso

Human Resources Retention Scheme: Qualitative and Quantitative Experience from Zambia

This presentation was given at the First Forum on Human Resources for Health in Kampala. It discusses the Zambia Health Workers Retention Scheme, an incentive program targeting key health worker cadres primarily in rural district to decrease attrition rates of critical service providers. [adapted from author]

Trends, Magnitude, and Reasons of Nurse Migration out of Lebanon

This presentation was given at the First Forum on Human Resources for Health in Kampala. It outlines HRH in the eastern Mediterranean region, trends in international nurse migration, and the Lebanese context. [adapted from author]

Philippine HRH Master Plan (2005-2030)

This presentation was given at the First Forum on Human Resources for Health in Kampala. It outlines the Philippine’s HRH Master Plan to develop and install HHRMD systems that will support Philippine health sector reforms to improve health outcomes. [adapted from author]

Recruitment and Placement of Foreign Health Care Professionals to Work in the Public Sector Health Care in South Africa: Assessment

This presentation was given at the First Forum on Human Resources for Health in Kampala. It details a study done to assess the feasibility and interest among stakeholders in the Netherlands, UK and US in facilitating recruitment and placement of foreign health care professionals to work in public sector health care in South Africa. [adapted from author]

Migration to the UK Voices of Ghanaian Nurses: Preliminary Descriptive Findings

This presentation was given at the First Forum on Human Resources for Health in Kampala. It outlines the micro-economics of health worker behaviour and discusses a study done to evaluate migration in Ghana.

Curriculum Innovations at Faculty of Medicine, Makerere University

This presentation was given at the First Forum on Human Resources for Health in Kampala. It discusses the key features of the Problem-Based Learning/Community-Based Education and Service innovations to the health curricula at Makerere University, why they implemented these improvements and the benefits they have seen from the program.

Scaling Up Health Worker Numbers in a Post Conflict Setting

This presentation was given at the First Forum on Human Resources for Health in Kampala. It discusses training Clinical Officers, a cadre of mid-level health professionals, as a method of filling the health worker gap in a post-conflict area.

Educating and Training Health Workforce to Consolidate a Universal Health System

This presentation was given at the First Forum on Human Resources for Health in Kampala. It discusses educational strategies for training health workers to scale up service delivery in Brazil.

Estimated Financial and Human Resources Requirements for the Treatment of Malaria in Malawi

The main aim of the study was to estimate how much clinician-time that malaria exacts on Malawi’s Ministry of Health resources. It estimates the proportion of finances that anti-malarial medications exact on the country’s health budget and determines whether the Malawi public health sector had adequate human resources to provide treatment. [adapted from author]

It's Like Giving Birth to the Sick Person for the Second Time: Family Caregivers' Perspectives on Providing Care

The general aim of this paper is to add to the limited research on family caregivers, and specifically to enable a better understanding of the actual experience of providing care for ill adults within the home in the context of HIV/AIDS, using qualitative research findings from a KwaZulu-Natal study. [from author]

Key Factors Influencing High-Performing Healthcare Sites in Low-Resource Settings

This study focused on the positive traits and strategies exhibited by high-performing facilities to determine how to improve performance at average and low-performing sites. [from author]

Medical Dialogue: How to Kick-Start a Joint AIDS Response by Health Workers and Traditional Healers

This publication provides information on the medical dialogue, a method formulated to address the recommendation for collaboration between biomedical practitioners and traditional healers and the integration of traditional medicine into public health care to respond to AIDS. [adapted from author]

Strengthening Management in Low-Income Countries: Lessons from Uganda: a Case Study on Management of Health Services Delivery

In an initiative to collate experiences on management development in low resource settings, WHO carried out case studies to explore management development approaches and how these impacted managerial and service delivery performance. [adapted from author]

Crisis in Human Resources for Health Care and the Potential of a Retired Workforce: Case Study of the Independent Midwifery Sector in Tanzania

This article examines one new element of non-government provision in Tanzania: small-scale independent midwifery practices. Because of their location and emphasis on personalized care, small-scale independent practices run by retired midwives could potentially increase rates of skilled attendance at delivery at peripheral level. [from author]

Attracting Psychiatrists to a Rural Area 10 Years On

In rural areas across Australia the recruitment and retention of adequate numbers of medical specialists, including psychiatrists, has been a long outstanding problem. Latrobe Regional Hospital reached a major crisis in 1994, with only one psychiatrist and a large number of vacancies. This led to a focus on the recruitment and retention of psychiatrists in order to improve this essential element of the workforce. [from abstract]

You Have to Face Your Mistakes in the Street: the Contextual Keys that Shape Health Service Access and Health Workers' Experiences in Rural Areas

Rural healthcare provision is limited in many areas because of workforce recruitment and retention issues. Pharmacists and social workers are examples of allied health professionals who play vital roles in the provision of rural health care. Personal factors including an individual’s fit with a local community and their professional role were explored to determine the way they affect access to rural health care. [from abstract]