Sub-Saharan Africa

This review seeks to understand the role of remittances in international nurse migration within the context of three theories of international migration: equilibrium approaches, social networks, and globalization. [from abstract]

This technical brief offers six recommendations to help national stakeholders transform evidence into policy decisions and subsequent action. Using an example from Uganda, the authors illustrate how the development and sharing of evidence can support decision-making for change in health workforce recruitment and retention policies, toward the aim of improving access to high-quality health care for the population. [from introduction]

Most African countries are facing a human resources for health (HRH) crisis, lacking the required workforce to deliver basic health care, including care for mothers and children. To address the HRH challenges, evidence-based deployment and training policies are required. However, the resources available to country-level policy makers to create such
policies are limited. To inform future HRH planning, a scoping review was conducted to identify the type, extent, and quality of evidence that exists on HRH policies for rural MNCH in Africa. [from abstract]

Electronic medical record systems are being implemented in many countries to support healthcare services. However, its adoption rate remains low, especially in developing countries due to technological, financial, and organizational factors. There is lack of solid evidence and empirical research regarding the pre implementation readiness of healthcare providers. The aim of this study is to assess health professionals?

Community health workers (CHWs) can play important roles in primary health care delivery, particularly in settings of health workforce shortages. However, little is known about CHWs’ perceptions of barriers and motivations, as well as those of the beneficiaries of CHWs.[from abstract]

This paper presents two medical schools, Makerere University College of Health Sciences and College of Medicine, University of Ibadan, which successfully implemented CBME [Competency-Based Medical Education]. The processes of curriculum revision are described and common themes are highlighted. Both schools used similar processes in developing their CBME curricula, with early and significant stakeholder involvement. [from abstract]

Despite numerous persistent challenges – including low quality of care, continuing inequalities and the substantial impact of the HIV/AIDS pandemic – Mozambique provides important lessons to other countries aiming to scale up health provision rapidly in a post-conflict setting. These particularly include the importance of focusing on distance and education as barriers to access, using innovative and low-cost human-resource policies to scale up health personnel quickly, and of moving towards more coordinated systems of aid disbursement. [from abstract]

This report synthesises findings from five country case studies from the health dimension of this project, which focus
on maternal and child health (MCH) (Mozambique,Nepal, Rwanda) and neglected tropical diseases (NTDs)(Cambodia, Sierra Leone). MCH was selected given its centrality in two of the Millennium Development Goals (MDGs) and its ability to act as a proxy for strengthened health systems.

This paper presents a review of the attempt to implement a western-oriented mental health system into
a different culture, specifically a developing country such as Uganda. It draws upon an extensive literature review
and the author’s work in Uganda to identify the lessons learned as well as the challenges of introducing a western-
oriented mental health system in a totally new cultural milieu. [from abstract]

Le CDE [Centre de Documentation Electronique] se veut un centre de partage et d’échange de connaissances et d’expériences en matière de lutte contre le VIH/sida. Vous trouverez dans cet espace toute information, documents, publications, ainsi que des outils de communication utiles développés par le CCP [ Centre des Programmes de Communication de l’Université de Johns Hopkins] et ses partenaires dans le cadre de la lutte contre le VIH/sida impliquant les jeunes en Côte d’Ivoire. [from introduction]

The use of social media is a very important avenue for reaching MSM who are not reached by peer educators in Ghana. The method should be adopted as an integral outreach approach for HIV-prevention interventions in the future.[from abstract]

From 2010 through 2013, the SHOPS project implemented a series of pilot activities to explore the feasibility of introducing private sector health education financing mechanisms. SHOPS explored private sector solutions to help meet ambitious targets from the U.S. President’s Emergency Plan for AIDS Relief for training new health care workers. This report shares the project’s work with private pre-service education financing in Malawi, Rwanda, Tanzania, and Zambia.

This paper outlines the opportunities and challenges posed by the proposed NHI [National Health Insurance] reforms in South Africa. It begins by explaining the country’s current system of health care provision including its human resource structure, functions and cost implications. It then summarizes the deficits and limitations of the current two-tiered health system and discusses what NHI is trying to achieve within this context and how it hopes to address the problems. [from summary]

The Community Health Workers (CHWs) Programme was launched in Luanda, Angola, in 2007 as an initiative of the provincial government. The aim of this study was to assess its implementation process. This is a case study with documental analysis, CHWs reports data, individual interviews and focal groups. [from abstract]

Both sexual and reproductive health (SRH) services and HIV programs in sub-Saharan Africa are typically delivered vertically, operating parallel to national health systems. The objective of this study was to map the evidence on national and international strategies for integration of SRH and HIV services in sub-Saharan Africa and to develop a research agenda for future health systems integration. [from abstract]

There is a scarcity of empirical data on institutions devoted to knowledge brokerage and their influence in Africa. Our objective was to describe two pioneering Knowledge Translation Platforms (KTPs) supporting evidence informed health policymaking (EIHSP) in Cameroon and Uganda.

Whole-system interventions are those that entail system wide changes in goals, service delivery arrangements and relationships between actors, requiring approaches to implementation that go beyond projects or programmes. Drawing on concepts from complexity theory, this paper describes the catalysts to implementation of a whole-system intervention in the North West Province of South Africa.

We explore whether social exclusion determines enrolment of older people in Senegal’s Plan Sesame and Ghana’s NHIS. Social exclusion affects older people’s uptake of social health protection (SHP) programs in both Senegal and Ghana. Reducing financial barriers is not enough to achieve universal coverage.Efforts to cover older people at risk of social exclusion should be increased. Sociocultural, political and economic dimensions should be considered while designing SHP schemes. [from abstract]

The use of community health workers to administer prompt treatments is gaining popularity in most sub-Saharan African countries. Their performance is a key challenge because it varies considerably, depending on the context, while being closely associated with the effectiveness of case management strategies. What determines community health workers’ performance is still under debate. Based on a realist perspective, a systematic review recently hypothesized that several mechanisms are associated with good performance and successful community interventions.

Nurses are essential to the health care delivery system especially to meet the health related millennium development goals. However, despite the significant shortage of nurses in Ethiopia, research in the country regarding nurses’ intent to stay in their profession is lacking. This study assessed intent to stay in the nursing profession and associated factors among nurses working in referral hospitals, Amhara Regional State, Ethiopia. [from abstract]

Definitions of advanced nursing practice abound, yet little has been published concerning the context for advanced nursing in sub-Saharan Africa. This study set out to explore the existence of, and potential for, advanced nursing practice in Kenya. [from abstract]

At the end of the one year of intervention, the results showed a significant reduction in sexually transmitted infections in the group that was eligible for the $20 payments every four months,but no such reduction was found for the group receiving the $10 payments. The effects were stronger among the lower socioeconomic and higher risks groups. The results of a post-intervention follow-up survey conducted one year after discontinuing the intervention indicate a sustained effect among males, but not among females. [from abstract]

Healthcare systems worldwide are changing and the use of complementary, alternative and traditional medicine (CAM) form part of this transformation. South Africa has a large number of CAM practitioners, but they are not included in the official healthcare system. The aim of this study was to determine the perception and usage of CAM among the academic and administrative staff of the University of the Free State (UFS) in Bloemfontein, South Africa. [from abstract]

The aim of this study was to analyse the existing databases on health workforce in
Botswana in order to quantify the human resources for health.

The focus of this study is to better understand how social workers and related professionals are
trained and educated—both formally and informally—to engage in social work practice, especially as it is related to child protection, in the West and Central Africa region. [from executive summary]

Social care and support services include such areas as the protection of children from violence and exploitation, care for chronically sick or disabled children and adults, support in dealing with the social difficulties of those affected by conflicts and disasters and responses to gender based violence. The aim of this paper is to make proposals for a unified coherent strategic framework which clarifies the vision, nature, scope and rationale for social care and support services. [from introduction]

Immediate and exclusive initiation of breastfeeding after delivery have been associated with better neonatal survival and child health and are recommended by the WHO. We report impact on early infant feeding practices from the PROMISE-EBF trial. [from abstract]

The Road map, which was developed with the appreciable contribution of critical stakeholders such as ministries of health, education, public services and finance as well as universities and training institutions regulators, professional bodies, civil society and nongovernmental organizations, defines strategic directions and priority interventions to be implemented in the period 2012–2025. [from introduction]

The Partnership for Reviving Routine Immunization in Northern Nigeria - Maternal, Newborn and Child Health initiative supports efforts by the government of Nigeria to bridge primary health care (PHC) policies and services at three levels of government: federal, state and local. The paper suggests that understandings informed by complexity theory and complex adaptive systems have been helpful in shaping policy and programme design across these levels. [from abstract]

The 2013/14 District Health Barometer (DHB) provides an overview of the delivery of primary health care (PHC) in the
public health sector across the provinces and districts in South Africa. The DHB is widely known for providing data to inform the development of District Health Plans and the National Department of Health’s Annual Performance Plan; as such, the publication has been used extensively for strategic planning and district monitoring.