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This research report has been published to illustrate the situation of workplace violence in the health sector in Thailand as well as contributing factors to, the consequences, and management of that violence. [from preface]

These studies measure and characterize the problem of violence against health professionals in the workplace in selected settings in Portugal. They answer questions such as: Who are the most affected health professionals? What types of violence are most frequent? In what circumstances do episodes of violence happen? What are the institutional procedures? What are the consequences for the victims, the Institutions and the perpetrators? What is the positioning of the NHS managers, the professional councils the unions and the professional associations about this problem? [author’s description]

This report results from a research project on violence against health care providers in selected health care units in Maputo city. The main objective of this work was to analyse the level of violence which existed in the hospitals of Maputo city, identifying the factors and forms of struggle or prevention of these events. [from introduction]

This case study evaluates workplace violence in the health sector of Lebanon. Information for the study came from focus group discussions, in-depth interviews and a questionnaire.

This case study examines the problem of workplace violence in the health sector of Bulgaria through consulting, examination and content analysis of the information and research available as well as conducting 6 focus groups and a confidential sociological survey. [adapted from author]

The objective of the country case studies consists in showing country-specific evidence and practical solutions concerning workplace violence in the health sector. By summarising existing information and analysing newly obtained information the study aims to identify risk factors as well as best practices of anti-violence interventions in the given socio-cultural context. This work will serve as a basis for the formulation of guidelines for prevention and coping strategies targeting issues of workplace violence in the health sector. [author’s description]

This research study gathered baseline information about occupational violence in the health care industry in Australia, to identify the contexts in which violence most commonly occurs, and to provide guidance on high-risk sites and commonly reported patterns of violent incidents. [adapted from author]

The present study reviews and analyses major known national guidelines and strategies for prevention and management of workplace violence. The purpose is to get a detailed picture of strategies recommended, a better knowledge on existing guidance for employers and employees. Another objective is to obtain information on the implementation processes and the impact of the reviewed guidelines. Identification of good practices as well as gaps shall serve as a basis for lessons learnt for the development of future guidance materials.

This IUD assessment tool provides performance standards for IUD provision based on type of visit-new client or revisit. It may be used as part of a programmatic performance improvement initiative, by the site or individual providers to self-assess or by external evaluators to assess achievement of the standards. Often, performance standards are used to affect change at multiple sites. [author’s description]

While the scale of the [health worker shortage] crisis is huge, solutions do exist. Many countries and communities around the world have begun to develop and implement innovative initiatives to sustain and build the health workforce. Several such examples are highlighted here. They address such issues as retention in rural areas, AIDS treatment for health workers, and the deployment of paraprofessionals to extend health care access deeper into communities. Many of these examples focus on rural areas, which typically have only a fraction of the number of health workers as urban areas due to more difficult living conditions, social and professional isolation, and weaker health infrastructure. [publisher’s description]

The objective of this article was to compare the cost-effectiveness of the tuberculosis programm run by the Bangladesh Rural Advancement Committee, which uses community health workers (CHWs), with that of the government program which does not use CHWs. [adapted from author]

The Public Private Partnership in Health (PPPH) is an element of Uganda’s Health Sector Strategic Plan II. The private sector includes not-for-profit providers, for-profit providers called private health practitioners (PHPs), and traditional and complementary medicine providers. A representative sample of facilities was selected and surveyed to provide in-depth information on PHP facilities, which could be extrapolated to the national database. The survey collected information from 359 facilities on facility ownership, human resources, staff employment in other facilities, infrastructure and equipment, health services provided including in-depth information on HIV/AIDS services, drug availability, health management information systems, financial management procedures, and registration and organizational affiliation.

Home-based care (HBC) for HIV/AIDS is increasingly looked to as a more accessible and affordable alternative to more costly inpatient care, both for patients who are unable to travel to or pay for inpatient care as well as for governments that must fund inpatient facilities. Partners for Health Reformplus estimated the cost of HBC for HIV in Rwanda, based on a sample of eight programs offering care in early 2004. The sample comprised facility- and community-based programs. Both types of program implement the medical care recommended in the Ministry of Health guidelines for HBC. [from abstract]

There is a growing acknowledgment of the importance of the continuum of care and support services to people living with HIV/AIDS outside of health facilities. Greater reliance on communities to provide care and support to people living with HIV/AIDS as well as non-complex maintenance and adherence support for treatment of those who are under antiretroviral treatment is seen as a way to alleviate the burden placed on traditional health systems in countries highly affected by HIV/AIDS. This report presents findings from the field-test of the Partners for Health Reformplus guidelines developed for costing home-based care (HBC) programs, with cases drawn from nine HBC programs in Uganda.

This paper describes the specific policy measures that the Zimbabwean government has recently implemented to try to improve health sector performance, and promote higher levels of motivation amongst public sector health care workers. The overall reform package is to include financial reforms (user fees and social insurance), strengthening of health management, liberalization and regulation of the private health sector, decentralization, and contracting out. Unfortunately, the process of reform implementation in Zimbabwe and the government’s poor communication with workers, combined with a conflict between local cultures and the measures being implemented, has undermined the potentially positive effect of reforms on health worker motivation.

This paper reports the experiences of primary care reform in the Zhezkazgan region of Kazakhstan. After the collapse of the Soviet regime, Kazakhstan undertook a radical program of reform to restructure the health sector, making primary care the centerpiece of their health reform agenda. The reforms included the creation of independent family group practices financed on a capitation basis directly from the Ministry of Health, allowing free choice of primary care providers through open enrollment, and creating a non-governmental primary care physician association. This program has had remarkable success in improving motivation among primary health care workers.

A potentially effective strategy for bringing early, appropriate and low cost treatment of malaria closer to the home is through the use of community health workers. The objective of this study was to determine peoples’ stated and actual preferences for different strategies for improving the timeliness and appropriateness of treatment of malaria before and after the implementation of a community health workers strategy in their community. [from abstract]

Human resources for health are non-existent in many parts of the world and the outer islands of Marshall Islands in Micronesia are prime examples. While the more populated islands with hospital facilities are often successful in recruiting qualified health professionals from overseas, the outer islands generally have very limited health resources, and are thus less successful. In an attempt to provide reasonable health services to these islands, indigenous people were trained as Health Assistants (HA) to service their local communities.

The medical brain drain has been described as rich countries looting doctors and nurses from developing countries undermining their health systems and public health. However this brain-drain might also be seen as a success in the training and export of health professionals and the benefits this provides. This paper illustrates the arguments and possible policy options by focusing on the situation in one of the poorest countries in the world, Malawi. [author’s description]

This review of the South African Health Information System (HIS) maps essential health-related information, discusses the District Health Information System, details the current status of the HIS and the challenges the HIS faces.

The HIPC/PRSP process is intended to be a major instrument for achieving improved service delivery for poor people Crucially, improved service delivery depends on having the right professional, technical and other human resources in the right place at the right time. This review examined for 6 African countries, the country based poverty reduction strategy paper (PRSP) documentation and the associated World Bank/IMF HIPC documentation for human resources for health content. These documents were supplemented with other relevant country documents such as health strategies.

This paper provides a brief overview of some programs and issues related to the use of technology and distance education to train community health workers in frontier areas. Issues include the use of consistent definitions, the appropriate technology format for the learner and access to that technology, cultural competency /proficiency of faculty, support for faculty and students, and the assurance of quality. [from executive summary]

In Albania, the PHRplus Project developed and tested a series of tools designed to introduce family medicine concepts and strengthen primary health care (PHC) services. PHC facility managers will find the toolkits useful reference materials when developing strategies and tools to improve quality of care and monitor and evaluate PHC strengthening efforts. This series comprises three toolkits: PHC Service Delivery Toolkit; PHC Quality Improvement (QI) Toolkit; and PHC Health Information Systems (HIS) Toolkit. [from abstract]

Nurses have assumed management positions in many health institutions. To properly accomplish the demands of this role, it is important that they be competent in both management and leadership. For appropriate performance, knowledge of management and supervision styles is a priority. Therefore, the goal of this investigation is to identify the nurse manager’s knowledge regarding management and leadership.

The objective of this study was to examine associations between management training of physician executives and their leadership styles, as well as effectiveness in achieving disease management goals. [author’s description]

This short documentary film chronicles the four year journey, initially funded by USAID’s Office of Population, that the governorate of Aswan, Egypt embarked upon to develop greater leadership within all levels of its health care staff. The video shows an innovative process that develops leaders at all levels, including the front lines of health care, to identify challenges and work in teams to overcome obstacles and achieve service improvements.

This case study describes how healthcare providers in Nicaragua worked together to improve the quality of obstetric care at their health centers and posts. They began by measuring the extent to which staff performed according to standards. Once aware of the quality gaps, they formed QI teams and used rapid team problem solving to implement quality improvements so that healthcare providers could perform according to obstetric standards. Continuous monitoring shows their success in meeting the standards and improving health outcomes. [author’s description]

This cost analysis is based on QAP research on the effectiveness of two interventions (self-assessment and peer review) in sustaining or increasing the effectiveness of interpersonal communications training that midwives had taken. The research had measured the effectiveness of the interventions in terms of the number of utterances midwives made during family planning consultations, and this case study followed on, measuring the cost of each intervention in terms of the number of utterances generated.

This case study describes how five Integrated Management of Childhood Illness (IMCI) trainers and supervisors conducted an assessment of provider knowledge and skill to carry out IMCI at 38 facilities in two districts in Kenya. [author’s description]

This report was developed to outline broad strategy, create a common vision for developing a new core health information system, and describe specific technical development tasks in detail. The new information system must be designed from the top down based on information demand. This should focus development on clear data collection and processing priorities, eliminate collection of unused data, and produce an efficient and relevant system.