Sub-Saharan Africa

The principles and practices outlined in this document are based on the author’s experience with creating a health worker clinical mentorship program for pediatric HIV care in Uganda as part of the continuum of education required to create competent health-care providers. [adapted from author]

The need to strengthen health-care worker capacity was identified by the Botswana Ministry of Health and confirmed by a training needs assessment conducted in 2001. In response, Botswana embarked on the first phase of a national antiretroviral training program, which this document outlines. [adapted from author]

This article shares experiences and insights gained, primarily in Zambia but also in Malawi, from the implementation of the “Caring for Caregivers” projects in Zambia and Malawi. [from author]

A birth attendant training program that has been shown in a multinational trial to reduce stillbirth and perinatal mortality rates among neonates weighing at least 1.5 kilograms - most of them born outside of hospitals, also reduced mortality among infants of all weights born in Zambian clinics. [from author]

This study examined whether a pictorial set of job aids could improve the quality of maternal and newborn care counseling by skilled providers and whether similar performance levels could be achieved by clinic-based lay providers as part of a task shifting initiative to expand their role. [from author]

As part of the collaborative to improve the efficiency of HIV service delivery, the authors conducted a baseline assessment of HIV/AIDS provider productivity, efficiency, and engagement in Uganda. [adapted from author]

This brief outlines a collaborative to improve health worker performance and improve the quality and efficiency of maternal care services by building the capacity of local management and health workers to implement sustainable improvements in maternal care provided in Tahoua. [adapted from author]

This report discusses and analyzes labor market dynamics and outcomes (including unemployment, worker shortages, and urban-rural imbalances of categories of health workers) from a labor economics perspective to address undesirable outcomes (including urban-rural HRH imbalances) more effectively. [adapted from summary]

The purpose of this paper is to describe and analyze the professional expectations of medical students during the 2007-2008 academic year at the public medical schools of Angola, Guinea-Bissau and Mozambique, and to identify their social and geographical origins, their professional expectations and difficulties relating to their education and professional future. [from abstract]

The aim of this study was to determine the use of different types of HIV testing services and to investigate perceptions and experiences of these services with a particular emphasis on the provider initiated testing in three selected districts in Kenya, Tanzania, and, Zambia.

This paper uses a forecasting model to estimate the need for, supply of, and shortage of doctors, nurses, and midwives in thirty-nine African countries for 2015, the target date of the United Nations Millennium Development Goals. [from abstract]

This presentation outlines an intervention that introduced PDAs or Smartphones for data collection in Nigeria to improve the supervision, assessment and creation of action plans for quality improvement in facilities where tuberculosis (TB) is diagnosed and treated. [adapted from author]

This case study provides a discussion on the key issues in the development of the nursing workforce in Mauritius. [from introduction]

This study aimed to assess the impact of a task shifting intervention in an ARV clinic in reducing the patients’ waiting time in the clinic. [adapted from author]

This study used the Maslach Burnout Inventory to evaluate the degree of burnout among junior doctors at Red Cross War Memorial Children’s Hospital and the influence on the retention of valuable skills in the hospital. [from author]

This paper reflects an initial review of aid effectiveness in relation to human resources for health. It asks whether the recent aid effectiveness agenda, as expressed in commitments made to the Paris Declaration, is responding appropriately to the specific needs of HRH and countries’ efforts to strengthen and scale up human resources. [from author]

This study aimed to evaluate the influence of educational factors on the choice of rural or urban sites of practice of health professionals in South Africa. [from abstract]

The Collaboration for Health Equity through Education and Research was formed in 2003 to examine strategies that would increase the production of health professionals who choose to practise in rural and under-served areas in South Africa. This article aimed to identify how each faculty is preparing its students for service in rural or under-served areas. [from abstract]

This editorial explores what health sciences training institutions achieved in the past 50 years to address the health care priorities of South Africans who are most in need. [adapted from author]

This article outlines a mobile health information pilot project in South Africa that provides nurses with instant access to a clinical library and treatment guidelines to improve their performance and positively impact patient care. [adapted from author]

This study investigated the readiness of the public health sector to provide malaria casemanagement in Somalia, a country where there has been no functioning central government for almost two decades. [from abstract]

This presentation for the 2008 AIDS Conference outlines the issues in providing HIV treatement with an HRH shortage, task shifiting to lay providers and community health workers (CHWs), trends in lay workers in sub-Saharan Africa, and lessons learned for successful task shifting.

This presentation is an overview of the Ethiopian experience in strengthening human resources for health as a strategic approach to integrate services and improve productivity for family planning. [from publisher]

This paper presents a randomized feld experiment on community-based monitoring of public primary health care providers in Uganda. Through two rounds of village meetings, localized NGOs encouraged communities to be more involved with the state of health service provision and strengthened their capacity to hold their local health providers to account for performance. A year after the intervention, treatment communities are more involved in monitoring the provider; health workers appear to exert higher effort to serve the community; and there was a positive impact on child health.

This chapter of “Developing Pathways and Partnerships” outlines the dimensions of and describes the characteristics of FBO HIV/AIDS initiatives, utilizing where possible evidence from published studies. It explains why FBO initiatives remain poorly understood and receive insufficient support from government sectors and development organizations. It concludes with lessons learned in mainstreaming FBO HIV/AIDS initiatives, suggesting ways in which external agencies can strengthen faith-based HIV/AIDS initiatives and help them align with accepted best practices and public-health strategies.

This supplement to “Sexual and Reproductive Health: Core Competencies in Primary Care” presents of the results of a survey to identify what sexual and reproductive health provision is offered in primary health care, the delivery points and which health workers are providing it especially relevant to the African Region. [adapted from introduction]

Through public-private partnerships, the government of Rwanda can make more efficient use of public resources by targeting and meeting the needs of specific populations and thus help ensure family planning services and products will be available to all Rwandans in the long term. This report aims to inform stakeholders working to strengthen family planning through multisectoral partnerships about Rwanda’s family market.

The focus of this brief is on examining how the lack of availability of trained personnel can constrain the ability of the government of Uganda to meet its strategic goals in scaling up antiretroviral treatment (ART). It utilizes a capacity module tool that estimates human resource requirements for HIV interventions. [from author]

This study documented women’s experiences of accessing ART and prevention of mother-to-child HIV transmission (PMTCT) program. In-depth interviews identified considerable weaknesses within operational HIV service delivery including: shortage in staff and supplies, lack of healthworker knowledge, stigma, and inadequacy of data and information systems for monitoring and evaluation. The analysis suggests that there is great scope for health system change, much of which centers on health personnel capacity and performance. [adapted from author]

While per diems appear to have been originally used to compensate for the loss of time and income caused by such participation, today they have become political instruments that taint research and intervention activities. The author believes per diems are contributing to expected failure of Africa to meet the Milliennium Development Goals by 2015 because they reduce the potential effectiveness of interventions and dilute health sector resources. [from author]