Sub-Saharan Africa

Connecting Medical Specialists in Rural Hospitals: Lessons Learned from the Telemedicine Project in Tanzania

This brief outlines a project conceived to tap the potential of telemedicine in Tanzania and to develop the relevant technology and practices. The project aimed to reduce the strain caused by a shortage of qualified personnel, contribute to training and continuous professional development; improve the quality of health services in rural areas; contribute to the establishment of a referral system; and be cost-effective.

Assessment of Human Resources for Pharmaceutical Services in Ghana

The development of a framework for human resource planning for the pharmaceutical secotr forms the basis for strengthening this sector. Thus the generation of evidence to support pharmaceutical human resources planning strategies is vital. This report is a preliminary assessment of the pharmaceutical workforce in Ghana. [from preface]

Assessment of the Pharmaceutical Human Resources in Tanzania and the Strategic Framework

Lack of comprehensive data on personnel in the pharmaceutical sector is a gap in national human resource for health policies in most developing countries. This study was undertaken in order to determine the total workforce providing pharmaceutical services in both the public and private sectors in Tanzania. [from summary]

Improving Quality of Malaria Treatment Services: Assessing Inequities in Consumers' Perceptions and Providers' Behaviour in Nigeria

Information about quality of malaria treatment services of different healthcare providers is needed to know how to improve the treatment of malaria since inappropriate service provision leads to increased burden of malaria. This study determined the technical and perceived quality of malaria treatment services of different types of providers in three urban and three rural areas in southeast Nigeria. [from abstract]

Positive Practice Environments in Uganda: Enhancing Health Worker and Health System Performance

This paper aims to explore the current key issues facing Uganda’s health human resource climate with particular attention to practice environments including recruitment, retention and productivity of its health workforce, to identify the HR solutions that are being or have been employed to address these main challenges. The paper will also help in identifying knowledge gaps for future in-depth research and recommendations for future strategies. [from introduction]

Zambia Country Case Study on Positive Practice Environments (PPE): Quality Workplaces for Quality Care

This desk review has put together a situation analysis of the professional practice environment in Zambia today, bringing out a picture of unhealthy, unproductive work environments. [from summary]

Task Shifting in Mozambique: Cross-Sectional Evaluation of Non-Physician Clinicians' Performance in HIV/AIDS Care

This article reports on a nationwide evaluation by the Mozambican Ministry of Health of the quality of care delivered by non-physician clinicians after a two-week in-service training course emphasizing antiretroviral therapy. [adapted from abstract]

Zeroing In: AIDS Donors and Africa's Health Workforce

This report focuses on AIDS donors and on how they can better use their funding to address health workforce issues. It introduces the HRH crisis, the evolving approaches of AIDS donors, how these approaches to health workforce strengthening and development have played out in practice in Mozambique, Uganda, and Zambia and makes recommendations meant to inform the ongoing deliberations of AIDS donors as they work out the implementation details of their health system strengthening commitments. [adapted from author]

Task Sharing in Zambia: HIV Service Scale-Up Compound the Human Resource Crisis

This study analyses and reports trends in HIV and non-HIV ambulatory service workloads on clinical staff in urban and rural district level facilities. [from abstract]

Health Worker Performance in the Management of Paediatric Fevers Following In-Service Training and Exposure to Job Aids in Kenya

This article evaluates an initiative launched in Kenya to improve malaria case-management through enhanced in-service training and provision of job aids. [from abstract]

Beyond Prevention: Home Management of Malaria in Kenya

Home Management of Malaria (HMM) is a strategy to improve acces to appropriate and effective malaria treatment in the community or home through early recognition of malaria symptoms and prompt treatment. To do this, volunteer members of the communities are trained to recognize fever, to administer treatment to children under five years of age when they find it, and to advise on follow-up treatment and prevention. They are monitored by a trained member of staff, such as a public health officer.

Healthy Images of Manhood: a Male Engagement Approach for Workplaces and Community Programs Integrating Gender, Family Planning and HIV/AIDS

This paper describes a project that has implemented an integrated male engagement program to address gender and family planning/reproductive health in a workplace HIV/AIDS Program. [from author]

Human Resources Development for Health: Accelerating Implementation of the Regional Strategy

This framework on how to accelerate the implementation of the regional strategy for the development of human resources for health has been prepared to provide guidance and focus on priority actions that could lead to real and positive changes in countries in the WHO African region. [adapted from summary]

Evaluation of Malawi's Emergency Human Resources Programme

This is an independent evaluation of the six-year Emergency Human Resource Programme, which was designed to address the health crisis in Malawi largely caused by an acute shortage of professional workers in the public health sector. Central to this commitment was the need to improve staffing levels and increase the production of health workers through a coherent package of financial incentives and investments in local health training institutions. [from summary]

Doubling the Number of Health Graduates in Zambia: Estimating Feasibility and Costs

To address the HRH crisis, the Ministry of Health in Zambia plans to double the annual number of health training graduates in the next five years to increase the supply of health workers. This article determined the feasibility and costs of doubling training institution output through an individual school assessment framework. [adapted from abstract]

Preservice Education Family Planning Reference Guide

This guide was developed to assist preservice health institutions in Malawi in creating, updating, or adapting the family planning content of their curricula and individual courses. Included in this document are materials that institutions and individual tutors can use to develop technically accurate and pedagogically sound lessons on family planning. [adapted from introduction]

Profile and Professional Expectations of Medical Students in Mozambique: a Longitudinal Study

This paper compares the socioeconomic profile of medical students registered at the Faculty of Medicine of Universidade Eduardo Mondlane, Maputo, for the years 1998/99 and 2007/08 to describe the medical students’ social and geographical origins, expectations and perceived difficulties regarding their education and professional future. [adapted from abstract]

Gender-Related Power Differences, Beliefs and Reactions Towards People Living with HIV/AIDS: an Urban Study in Nigeria

This research examend HIV-related stigma in Nigeria focusing on how power differences based on gender perpetuate the stigmatization of people living with HIV/AIDS and how these gender differences affect the care that they receive in health care institutions. [adapted from abstract]

Non-Financial Incentives for Voluntary Community Health Workers: a Qualitative Study

Through in-depth interviews and focus group discussions, this study explores the potential efficacy of non-financial incentives (NFI) proposed by the L10k project, an Ethiopian health extension project. The results of the study outline factors motivating voluntary community health workers, indicate other NFI mechanisms for consideration, and suggest programmatic recommendations. [adapated from publisher]

Health Workforce Responses to Global Health Initiatives Funding: a Comparison of Malawi and Zambia

Shortages of health workers are obstacles to utilising global health initiative (GHI) funds effectively in Africa. This paper reports and analyses two countries’ health workforce responses during a period of large increases in GHI funds. [from abstract]

Nurse Led, Primary Care Based Antiretroviral Treatment Versus Hospital Care: a Controlled Prospective Study in Swaziland

Antiretroviral treatment services delivered in hospital settings in Africa increasingly lack capacity to meet demand and are difficult to access by patients. This article evaluates the effectiveness of nurse-led primary care based antiretroviral treatment by comparison with usual hospital care in a typical rural sub Saharan African setting. [from abstract]

Field Epidemiology Training Programmes in Africa: Where Are the Graduates?

There is currently limited published evidence of health-related training programmes in Africa that have produced graduates, who remain and work in their countries after graduation. However, anecdotal evidence suggests that the majority of graduates of field epidemiology training programmes in Africa stay on to work in their home countries, many as valuable resources to overstretched health systems. [from abstract]

Costing the Scaling-Up of Human Resources for Health: Lessons from Mozambique and Guinea Bissau

This paper reports on two separate experiences of human resources development plans costing in Mozambique and Guinea Bissau to provide insight into the practice of costing exercises in information-poor settings and contribute to the existing debate on HRH costing methodologies. [adapted from abstract]

Meeting Human Resources for Health Staffing Goals by 2018: a Quatitatvie Analysis of Policy Options in Zambia

The MOH has developed a human resources for health strategic plan to address the health workforce crisis through improved training, hiring, and retention. This study used a model to forecast the size of the public sector health workforce in Zambia over the next ten years to identify a combination of interventions that would expand the workforce to meet staffing targets. [adapted from abstract]

Network-Based Social Capital and Capacity-Building Programs: an Example from Ethiopia

This study assessed the social networks in a Master of Hospital and Healthcare Administration program. The authors’ conclusions suggest that intentional social network development may be an important opportunity for capacity-building programs as healthcare systems improve their ability to manage resources and tackle emerging problems. [adapted from introduction]

Nurse Versus Doctor Mangement of HIV-Infected Patients Receiving Antiretroviral Therapy (CUORA-SA): a Randomised Non-Inferiority Trial

Expanded access to combination antiretroviral therapy (ART) in resource-poor settings is dependent on task shifting from doctors to other health-care providers. We compared outcomes of nurse versus doctor management of ART care for HIV-infected patients. [from summary]

Use of RDTs to Improve Malaria Diagnosis and Fever Case Management at Primary Health Care Facilities in Uganda

This study evaluated the effect of malaria rapid diagnostic tests on health workers anti-malarial drug prescriptions among outpatients at low level health care facilities within different malaria epidemiological settings in Uganda. [from abstract]

Scaling Up Integration: Development and Results of a Participatory Assessment of HIV/TB Services, South Africa

In South Africa the need to integrate HIV, TB and STI programmes has been recognised at a policy and organisation level; the challenge is now one of translating policies into relevant actions and monitoring implementation to ensure that the anticipated benefits of integration are achieved. This research set out to determine how middle level managers could be empowered to monitor the implementation of an effective, integrated HIV/TB/STI service. [from abstract]

Community Acceptability of Use of Rapid Diagnostic Tests for Malaria by Community Health Workers in Uganda

This study assessed community acceptability of the use of rapid diagnostic tests by Ugandan community health workers, locally referred to as community medicine distributors. [from abstract]

Home-Based Voluntary HIV Counselling and Testing Found Highly Acceptable and to Reduce Inequalities

Low uptake of voluntary HIV counselling and testing (VCT) in sub-Saharan Africa is raising acceptability concerns which might be associated with ways by which it is offered. This study investigated the acceptability of home-based delivery of counselling and HIV testing in urban and rural populations in Zambia where VCT has been offered mostly from local clinics. [from abstract]