Sub-Saharan Africa

Lack of access to quality reproductive health services is the main contributor to the high maternal mortality and morbidity in sub-Saharan Africa. This is partly due to a shortage of qualified and experienced health care providers. However this article explores conscientious objection amongst the available few as a hitherto undocumented potential factor influencing access to health care. [from abstract]

This article addresses health workers’ experiences with the open performance review and appraisal system (OPRAS) in Tanzania, expectations towards pay for performance, and how lessons learned from OPRAS can assist in the implementation of pay for performance. The broader aim is to generate knowledge on health workers’ motivation in low-income contexts. [adapted from abstract]

In a district hospital in conflict-torn Somalia, the authors assessed the impact of introducing telemedicine on the quality of paediatric care, and the added value as perceived by local clinicians. [from abstract]

In this study the authors examine the relationship between health worker incomes and their satisfaction and motivation. [from abstract]

This study investigated the reasons for the poor performance of the district health executives reported by provincial health managers in the Midlands province of Zimbabwe. [adapted from abstract]

There is growing interest in expanding testing coverage through the implementation of innovative models such as home-based HIV counselling and testing (HBHCT) by trained lay counsellors. With the aim of informing scale up, this paper discusses client characteristics and acceptability of an HBHCT intervention implemented in rural South Africa. [from abstract]

The goal of this assessment was to evaluate the routine health Information system in Taraba state to identify the strengths, weaknesses, threats, and opportunities of the health management information system unit in the state and its local government areas with a view to identifying risks that pose a threat to the implementation of software upgrades. [adapted from publisher]

The goal of this assessment was to evaluate the routine health Information system in Imo state to identify the strengths, weaknesses, threats, and opportunities of the health management information system unit in the state and its local government areas with a view to identifying risks that pose a threat to the implementation of software upgrades. [adapted from publisher]

The goal of this assessment was to evaluate the routine health Information system in Oyo state to identify the strengths, weaknesses, threats, and opportunities of the health management information system unit in the state and its local government areas with a view to identifying risks that pose a threat to the implementation of software upgrades. [adapted from publisher]

The goal of this assessment was to evaluate the routine health Information system in Niger state to identify the strengths, weaknesses, threats, and opportunities of the health management information system unit in the state and its local government areas with a view to identifying risks that pose a threat to the implementation of software upgrades. [adapted from publisher]

The goal of this assessment was to evaluate the routine health Information system in Delta state to identify the strengths, weaknesses, threats, and opportunities of the health management information system unit in the state and its local government areas with a view to identifying risks that pose a threat to the implementation of software upgrades. [adapted from publisher]

The goal of this assessment was to evaluate the routine health Information system in Kebbi state to identify the strengths, weaknesses, threats, and opportunities of the health management information system unit in the state and its local government areas with a view to identifying risks that pose a threat to the implementation of software upgrades. [adapted from publisher]

Community-directed treatment with ivermectin (CDTi) and community-directed interventions (CDI) are participatory approaches to strengthen health care at community level. This study aimed at assessing primary health care in two rural Malawian districts without CDTi experience with a view to explore the relevance of the CDI approach. [adapted from abstract]

This article describes an exploratory study that asked: what is understood by the term motivation; what encourages and discourages providers of maternal and newborn care in rural areas; and which factors influence their performance and job satisfaction. [adapted from author]

Shifting the role of counseling to less skilled workers may improve efficiency and coverage of health services, but evidence is needed on the impact of substitution on quality of care. This research explored the influence of delegating maternal and newborn counseling responsibilities to clinic-based lay nurse aides on the quality of counseling provided as part of a task shifting initiative to expand their role. [from abstract]

This study evaluated the cost-effectiveness of down-referring stable antiretroviral therapy (ART) patients from a doctor-managed, hospital-based ART clinic to a nurse-managed primary health care facility in Johannesburg, South Africa. [from abstract]

This report summarizes key findings of a stakeholder-driven participatory productivity improvement process. The results of the study also shed light on which interventions may be most appropriate and effective for improving productivity within the Zambian context, and could be implemented on a wider scale within the country. [from summary]

Qualified doctors in Malawi continue to leave the public sector in order to work or train abroad. This study explored the postgraduate plans of current medical students, and the extent to which this is influenced by their background. [adapted from abstract]

The study aims to compare two task-shifting approaches to the dispensing of anti-retroviral therapy (ART): indirectly supervised pharmacist’s assistants and nurse-based pharmaceutical care models against the standard of care which involves a pharmacist dispensing ART. [adapted from abstract]

Through research on health leadership in low-income settings, including sub-Saharan Africa, with attention to historical, political and sociocultural context, this study sought to characterize the experiences of individuals in key health-care leadership roles in sub-Saharan Africa. [adapted from abstract]

The aim of this study was to explore the factors influencing the career plans of medical students and recent graduates with regard to four policy-relevant aspects: emigration outside Malawi; working at district level; private sector employment and postgraduate specialisation. [from abstract]

This paper describes task-shifting taking place in health centers and district hospitals in Mozambique and Zambia to identify the perceived causes and factors facilitating or impeding task-shifting, and to determine both the positive and negative consequences of task-shifting for the service users, for the services and for health workers. [adapted from abstract]

This brief oulines an initiative to implement a pre-service training strategy for pharmacists, pharmacy technicians and nurses thatis expected to strengthen in-country capacity to manage national supply chains and ensure uninterrupted access to essential health commodities. [adapted from author]

This brief describes an intervention on training pre-service trainers that has helped provide graduating biomedical students with supply chain skills and reduce long-term in-service training costs. [adapted from author]

This survey of the Senegalese supply chain workforce was conducted using the “Human Resources Capacity for Public Health Supply Chain Management Assessment Guide” and evaluates the supply chain organization and personnel distribution, champion systems, policies and plans, workforce development, workforce efficiency, and professionalization efforts in the public health supply chain. [adapted from author]

This extensive report gathered evidence and research to see if technology could be harnessed in transformative ways to address critical gaps in community health worker (CHW) training in Sub-Saharan Africa. It covers: the importance of CHW, current approaches to CHW training, emerging evidence and opportunities. [adapted from author]

The aim of this study is to determine factors associated with the acceptance and uptake of voluntary HIV testing among healthcare workers in a public hospital in KwaZulu-Natal. [from abstract]

Interns are a vulnerable group of healthcare workers, cited as having the highest incidence of accidental needle-stick injuries and splashes with blood or body fluids. This study compared the incidence of occupational exposure between first- and second-year interns in South Africa to estabilsh the severity of the problem. [adapted from abstract]

This paper discusses the ethical and legal constraints on a healthcare worker who has been occupationally exposed to possible HIV infection in circumstances where the patient will not/is not in a position to give consent to be tested to establish his/her HIV status, which is a prerequisite for the healthworker to receive postexposure prophylaxis in South Africa. [adapted from abstract]

This descriptive cross-sectional study was conducted among private sector doctors who manage HIV and AIDS patients in KwaZulu-Natal to collect data on private sector doctors’ HIV testing practices.