South Asia

Rapid Assessment of Community Health Worker Knowledge Compared with Knowledge of Doctors and Nurses

This study analyzed and compared the knowledge base of trained community health workers with that of doctors and nurses in Afghanistan to determine the differences in their abilities to provide healthcare and health information to patients.

Performance-Based Reimbursement Scheme: a Final Report of a Pilot Study

The NGO Service Delivery Program (NSDP) developed a system ensuring better access of the health services to the poorest segment of the population, along with raising revenue by providing fee-for services to the better off population. The former strategy highlights a safety net policy for the poorest segment, who are identified by participatory rapid appraisal technique and handed out a health benefit card. The latter strategy helps the NGOs to revise their service charges according to local demand and other factors. This report analyzes this pilot effort and its drawbacks and makes recommendations based on lessons learned. [adapted from author]

Likely Benefit of Using Workload Indicators of Staffing Need (WISN) for Human Resources Management in the Health Sector of Bangladesh

This study demonstrates how Workload Indicators of Staffing Need (WISN) can be used as a human resources planning and management tool for improving decisions at all levels of health services about the provision, allocation and deployment of staff. [from abstract]

Skilled Birth Attendants Accepted at Home Deliveries in Bangladesh

An NSDP survey shows strong support for the use of skilled birth attendants and willingness to pay for their services. Widespread use of SBAs holds much promise in helping to meet the UN Millennium Development goal of reducing the maternal mortality rate to around 140 by 2015. The survey results, which also indicate some barriers to SBA use, have enabled the design of an appropriate pilot intervention. [from introduction]

Results from Study of Clinical Staff Turnover Suggest New HR Strategies

The NGOs that comprise the USAID-funded NGO Service Delivery Program must control costs in order to improve their cost recovery rates. Costs associatied with high staff turnover are an important variable operating expense. An NSDP study of staff turnover has produced interesting findings contributing to new staff retention strategies. [introduction]

Finding Private-Sector Support for Primary Health Care in Bangladesh

NGOs that provide basic health care to the poor must become less dependent on donor support by diversifying their funding. The NGO Service Delivery Program (NSDP), a USAID-funded health care program in Bangladesh, is working with NGOs to find corporate sponsorship. [publisher’s description]

Migration of Human Resources for Health within and out of Sri Lanka: Report and Analysis 2005

This article addresses some human resource problems amongst which migration of human capital to resourceful settings is detailed as a priority problem. Several factors have contributed to dissatisfaction and human resources, especially those with higher skills and qualifications, migrating towards more resourceful settings, both overseas and within the country. [from abstract]

Demographic Implications for Health Human Resources for Bangladesh

This paper is mainly intended to show the demographic implications for Bangladesh’s Health-human resources production in the next two decades as absolute increase in Population is still too high that the economy can cope with. [author’s description]

Survey of the Existing Health Workforce of Ministry of Health, Bangladesh

The objective of this study is to present and analyze different issues relating to the existing workforce in the health services of Bangladesh under the Ministry of Health. [from abstract]

Guidelines for Development of a Health Worker Certification System

The main objective of the Ministry of Health (MOH) certification program, which will be called the Health Worker Certification System (HWCS), is to achieve a standard level of quality provided by all health workers. To achieve this level of quality it is critical that the skills of each health worker by certified through a competency-based test. This system of testing will require that all training of health workers in the future be focused on combining knowledge acquisition with hands-on competency based skills, rather than just didactic training. Refresher training and recertification will also be required in order to ensure a basic level of quality.

Community Development and Its Impact on Health: South Asian Experience

Most South Asian governments have concentrated on emulating a Western style of healthcare service, with the result that an elite few are overmedicalised whereas the majority are neglected. However, community participation in the development of local health services could provide a solution. [abstract]

Reaching Every Child for Primary Immunization: An Experience from Parsa District, Nepal

A Village Development Committee Orientation organized to allow representatives of different organizations to discuss and identify causes of low coverage and high drop-out in their community. Special emphasis was placed on monitoring the immunization drop-out rate of each health facility. Indicators for VDCs have improved in 2003, and Parsa District is now regarded as one of the highest performing districts in the region.

Dual Job Holding by Public Sector Health Professionals in Highly Resource-Constrained Settings: Problem or Solution?

This paper examines the policy options for the regulation of dual job holding by medical professionals in highly resource-constrained settings. It draws on the limited evidence available on this topic to assess a number of regulatory options in relation to the objectives of quality of care and access to services, as well as some of the policy constraints that can undermine implementation in resource-poor settings. [from abstract]

Impact of Management Training on Family Planning and Health Services Performance in Rural Bangladesh

This study assessed the impact of management training in the performance of managers from agencies in Bangladesh delivering primary healthcare services. [from abstract]

Appraisal of the Institutional Training Arrangement for Community Health Workers in Bangladesh

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.

Ghost Doctors: Absenteeism in Bangladeshi Health Facilities

The authors report on a study in which unannounced visits were made to health clinics in Bangladesh with the intention of discovering what fraction of medical professionals were present at their assigned post. This survey represents the first attempt to quantify the extent of the problem on a nationally representative scale. [from abstract]

Multiple Public-Private Jobholding of Health Care Providers in Developing Countries: An Exploration of Theory and Evidence

This review examines the systemic and individual causes of multiple job holding (MJH) and evidence on its prevalence. MJH should be seen as resulting initially from underlying system-related causes. These include overly ambitious efforts by governments to develop and staff extensive delivery systems with insufficient resources. Governments have tried to use a combination of low wages, incentives, exhortations to public service, and regulation to develop these systems.

Implementing IMCI in a Developing Country: Estimating the Need for Additional Health Workers in Bangladesh

This study estimates the personnel cost implications of implementing the newly proposed Integrated Management of Childhood Illness (IMCI) algorithm in the first level health care facilities in rural Bangladesh. Policy makers need to know the additional resource requirements for IMCI before its actual implementation so that appropriate levels and combinations of personnel and drugs can be allocated. [abstract]

Attitudes of Nursing Students of Kolkata Toward Caring for HIV/AIDS Patients

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.

Plumbing the Brain Drain

The departure of a large proportion of the most competent and innovative individuals from developing nations slows the achievement of the critical mass needed to generate the enabling context in which knowledge creation occurs. To favourably modify the movement and distribution of global talent, developing countries must implement bold and creative strategies that are backed by national policies.