Sub-Saharan Africa

Given that IT projects may take a long time to be fully institutionalized, sufficient resources are required to build the local capacity to support and sustain the project after the withdrawal of donors. Inadequate donor support often contributes to weakening rather than strengthening human resource capacity and effective system design, since it emphasizes the technology itself at the expense of the needs of the users. These factors contribute to the design and implemntation of unsustainable health information systems in developing countries. [from abstract]

District health systems in Africa depend largely on public funding. In many countries, not only are these funds insufficient, but they are also released in an untimely fashion, thereby creating serious cash flow problems for district health managers. This paper examines how the untimely release of public sector health funds in Ghana affects district health activities and the way district managers cope with the situation. [from abstract]

Rwanda is one of the pioneers of performance-based financing. Building on lessons from three donor-financed pilots, the government has assumed leadership for this approach and is scaling up a standardized model nationwide. [from author]

The regional guidelines for implementing the SDNM in the African Region are to accelerate action at country level. The guidelines also provide both a framework for WHO action to support countries in improving the quality of nursing and midwifery services, and a guide for action at national and local levels. Possible priority actions have been proposed to countries to facilitate strengthening of nursing and midwifery services at national and local levels. [from foreword]

This paper aims to discuss the challenges influencing the state of caregiving in the Kanye community home-based care programme in Botswana. [from abstract]

The Zambia Prevention, Care and Treatment Partnership began training and placing community volunteers as lay counsellors in order to complement the efforts of the health care workers in providing HIV counselling and testing services. These volunteers are trained using the standard national counselling and testing curriculum. This study was conducted to review the effectiveness of lay counsellors in addressing staff shortages and the provision of HIV counselling and testing services. [from abstract]

Recent years have seen growing awareness of the importance of human resources for health in health systems and with it an intensifying of the international and national policies in place to steer a response. This paper looks at how governments and donors in five countries: Cameroon, Indonesia, Malawi, Rwanda and Tanzania, have translated such policies into action. [from abstract]

We wanted to try to account for worker motivation as a key factor that might affect the success of an intervention to improve implementation of health worker practices in eight district hospitals in Kenya. In the absence of available tools, we therefore aimed to develop a tool that could enable a rapid measurement of motivation at baseline and at subsequent points during the 18-month intervention study. [from abstract]

This presentation provides the results of studies designed to ascertain which Ghanaian trainee health professionals are more likely to emigrate, as well as the rationale for these choices. It also attempts to identify potential areas for policy intervention in order to moderate the benefits and costs of both the long-term and short-term impact of this situation.

This presentation chronicles the emigration patterns of Ghanaian health professionals and the effects on that country's own health services. There is a specific focus on the emigration expectations of Ghanaian trainee health personnel, as well as offering suggestions for potential methods for addressing the situation.

This presentation offers the findings of a study assessing how policies in richer countries impact least-developed countries, specifically regarding skilled labour migration.

This presentation describes perspectives on the out-migration of health professionals in Africa.

In Zimbabwe, as in many parts of sub-Saharan Africa, home-based care (HBC) plays a vital role in the response to HIV as overwhelmed public health and welfare systems fail to cope with the demands of the epidemic. This document details a project designed to contribute to better understanding and evidence-based decision-making in the implementation of HBC interventions in Zimbabwe and beyond. [adapted from executive summary]

This report provides a short summary of the key discussion points from a meeting in Addis Ababa, Ethiopia on the 10th and 11th of January 2008. The meeting followed on from the launch of the WHO Guidelines on Task-Shifting and was attended by participants who are actively involved in addressing HRH. [adapted from author]

In response to the critical HRH shortages in Africa, the UK Department for International Development (DFID) and Office of the US Global Aids Coordinator (OGAC) have been in discussion with a number of African countries to develop strategies and country level actions. The aim is to demonstrate the maximum flexibility of disease specific programmes to support broad based primary care in line with countries’ health plans. This report presents a summary of the main findings from the country visit to Kenya. [from introduction]

This document details the efforts of the Christian Health Association to strengthen sub-Saharan Africa’s national health sectors by mitigating the the HR shortage. [adapted from executive summary]

A study on workplace violence within the health sector in Rwanda was conducted in 2007 in order to determine the type, impact, context, consequences and prevention strategies of workplace violence in Rwanda; to assist the Ministries of Health, Public service and Labor (MIFOTRA) as well as other stakeholders in developing a political, legal and programmatic response to improve providers’ safety, satisfaction and retention. This study also explored the characteristics of gender-based violence, including gender-based discrimination and its relation to workplace violence. [adapted from foreword]

This report details the work of the the Capacity Project assistance to the Lesotho Ministry of Health and Social Welfare to strengthen its capacity to respond to the HIV/AIDS pandemic by addressing gender segregation in nonformal caregiving through the active engagement of men as providers of community and home-based HIV/AIDS care and support. [adapted from foreword]

These guidelines target all health workers at the different levels of the health care delivery system and apply to both the formal and informal workplaces within the health sector. This document covers the basic principles that are required to ensure workplace safety and health including hazard identification, risk management, prevention and management of exposures and incidents. [from foreword]

The paper seeks to analyze the import of distance education for promotion of proficiency skills in the health sector and review ongoing professional development programmes for health workers in Ghana, and come out with strategies to offer training avenues leading to the professional growth of the individuals and economic growth of the country. [from abstract]

This toolkit is an interactive, client-friendly approach for improving counseling on family planning and prevention, detection, and treatment of sexually transmitted infections (STIs) including HIV. It includes a training of trainers guide that supervisors and others can use to train health care facility directors and service providers on how to use the BCS+ for counseling family planning clients. [from publisher]

Voluntary counseling and testing (VCT) is a cornerstone for successful implementation of prevention, care and support services among HIV negative and positive individuals. VCT is also perceived to be an effective strategy in risk reduction among sexually active young people. This study aimed to assess the acceptability of VCT and its actual uptake among young health care professional students. [adapted from abstract]

This paper evaluates the effectiveness and cost-effectiveness of alternative training strategies for increasing access to emergency obstetric care in Burkina Faso. [adapted from abstract]

This report summarizes elements of the primary health strategy and the health sector goals established by the Malawi Ministry of Health.

Before the HRH situation could be addressed, it had to be measured. While it was long apparent that HRH availability, quality, and management needed to be improved, data to determine staffing needs and guide staff training and allocation were lacking. [from author]

The study used a literature review and field research to obtain data on strategies for the retention of health workers in various institutions in Kenya.

This issue of Voices discusses the impact of the Emergency Hiring Plan developed in combination with the Capacity Project and the Kenyan Ministry of Health to increase the number of qualified professionals working in Kenya’s public health facilities. [adapted from author]

With the scarcity of African health professionals, volunteers are earmarked for an increased role in HIV/AIDS management, with a growing number of projects relying on grassroots community members to provide home nursing care to those with AIDS - as part of the wider task-shifting agenda. Yet little is known about how best to facilitate such involvement. This paper reports on community perceptions of a 3-year project which sought to train and support volunteer health workers in a rural community in South Africa. [from abstract]

This study highlights the experiences and challenges associated with decentralisation and the partial re-centralisation in relation to the recruitment and distribution of health workers. [from abstract]

This report summarizes the key problems in the health sector and their implications on human resources for health and financing of the health sector; discusses the issues on human resources for health; explores options for improving the production, deployment, retention and management of these workers; analyzes the current state of financing in the health sector; explores options for the financing of essential health services and non-EHP services; and summarizes the way forward. [adapted from introduction]