Sub-Saharan Africa

We reviewed published literature that outlines the principles of quality assurance in higher education from various institutions worldwide. Using this information, we designed a handbook that outlines the quality assurance principles in a simple and practical way. This was intended to enable institutions, even in developing countries, to adapt these principles in accordance with their local resource capacity. We subsequently pilot-tested this handbook at one of the sites in Ghana. [from abstract]

To help build the health workforce in Uganda, the Capacity Project is assisting the Ministry of Health to strengthen its human resources management and ability to gather and use accurate data for strategic planning. Drawing on key policy questions developed by the Health Workforce Advisory Board, the Capacity Project installed a certification and licensing information system at the four health professional councils and a human resources management system at the Ministry of Health.

While the recruitement of rural doctors is steadily rising, there is concern about their long-term retention. In response, an orientation course for recently established rural doctors was set up in 2003, based on a training needs assessment. This paper draws lessons from this experience, focusing on processes and mechanisms operating in the relation between training and retention in rural practice. [adapted from author]

After a curriculum review, Makerere University’s longstanding traditional curriculum was converted to a problem based learning curriculum with a focus on Community Based Education and Service (COBES). As a component of COBES, radiography, medical, nursing, dentistry and pharmacy students are sent to community health facilities where they are expected to participate in community services and other primary healthcare activities.

There is increasing consensus that training programmes should focus on know-how instead of know-all. IntraHealth International’s Learning for performance: a guide and toolkit for health worker training and education programs offers a step-by-step, customizable approach designed to develop the right skills linked to job responsibilities. Using Learning for Performance yields more efficient training that focuses on what is essential for health workers to do their jobs and on effective learning methods.

The theme of this edition is primary health care in South Africa. It includes national and international perpescitves on primary health care and focuses on areas such as policy and legislation, infectious diseases, maternal and child health and human resources. Chapter 11 discusses strengthening human resources for primary care. [adapted from summary]

This presentation on the emergency HR program in Malawi was offered during a dialogue hosted by the WHO and OECD.

This document discusses the in-country ownership of health initiatives from the Health Sector Strategic Plan focusing on critical areas such as retention, recruitment and occupational safety.

This paper investigates the impact of the framework and strategies to retain critical health professionals (CHPs) that the Zimbabwean government has put in place, particularly regarding non-financial incentives, in the face of continuing high out-migration. [from summary]

This document summarizes a project to design, implement and compare two models of integrating CT for HIV within FP services in 23 health facilities in Kenya in terms of their feasibility, acceptability, cost and effect on the voluntary use of CT, as well as the quality of FP services. [adapted from summary]

This article profiles three leaders from Afghanistan, South Africa, and Southern Sudan who have made a significant difference in those countries’ HR situations. By taking a comprehensive approach and working in partnership with stakeholders, these leaders demonstrate that strengthening health workforce planning, management, and training can have a positive effect on the performance of the health sector. [from author]

Tanzania’s government has developed various policies and guidelines to address the HIV/AIDS pandemic, including a five-year commitment to provide anti-retroviral therapy to 500,000 Tanzanians. This program faces many HRH-related challenges and constraints. This report discusses the implementation of a home-based care model to support older caregivers for Tanzanians living with HIV/AIDS. [adapted from report]

Irrational drug use is contributed by many factors including care providers giving wrong drug information to patients. Dispensing staff in private pharmacy shops play a significant role in pharmaceutical management and provision of relevant information to clinicians and patients, enhancing the improvement of rational medicine use. This report offers an evaluation/staff assessment of pharmacist knowledge in a situation where they function as health workers in dispensing and prescribing medications. [adapted from introduction]

Increased interest in parasite-based malaria diagnosis has led to increased use of rapid diagnostic tests (RDTs), particularly in rural settings. The scarcity of health facilities and trained personnel in many sub-Saharan African countries means that limiting RDT use to such facilities would exclude a significant proportion of febrile cases. Use of RDTs by volunteer community health workers (CHWs) is one alternative, but most sub-Saharan African countries prohibit CHWs from handling blood, and little is known about CHW ability to use RDTs safely and effectively. [adapted from introduction]

This version of Voices discusses the Capacity Project’s work with the Ministry of Health in Southern Sudan to strengthen its ability to plan for and manage the health workforce. [adapted from author]

The main objective of this study was to assess the role of traditional birth attendants and the quality of their services in contributing to the reduction of maternal deaths in Malawi. [from abstract]

There has been little research on HIV incidence or prevalence among hospital staff worldwide, and even less on modes of transmission among those infected. Recent evidence from South Africa suggests that HIV prevalence among health care personnel may not differ greatly from the general population. This evaluation study describes the significant effect of HIV morbidity and mortality among the workers in Zambia’s health care system. [adapted from introduction]

JHPIEGO has been focused on improving the quality and availability of reproductive health and family planning services for slum residents, both by targeting the facility-based health care providers and the community members who access these services. This document outlines several lessons that have been learned from this experience. [adapted from author]

In developing countries, postabortion care (PAC) programs are frequently available only in urban or regional health facilities, placing rural women at greater risk for mortality and morbidity from complications because they lack access to services. This technical brief evaluates efforts to decentralize PAC activities in Senegal and Tanzania that show PAC can be safely and successfully decentralized with services capably provided by mid-level personnel in health centers, dispensaries, and some health posts when providers are trained and supervised and equipment and supplies are available.

This Voices discusses the experiences of nurse hired through the Emergency Hiring Plan in Kenya in providing family planning services, and the importance of confidentiality in the successful provision of these services.

These reports demonstratre that non-physician clinicians and nurses can take over many of the tasks in providing HIV care and treatment (including ART) in some resource-limited settings. [from author]

In the space of just a few years, close to 300,000 people with HIV have been put onto ART in Ethiopia and Malawi - two of the countries most severely affected by the human resources for health crisis. But while some might suggest that such a rapid scale-up could only have come at the expense of other general health services, Ethiopia and Malawi performed this remarkable feat using HIV/AIDS funding and technical support to launch ambitious and comprehensive human resource plans to strengthen their health sectors overall. [from author]

This article compares the quality, quantity and distribution of tuberculosis physicians, laboratory staff, community health workers and nurses in Nigeria and Kyrgyzstan, and highlights implications for (re)training tuberculosis workers in developing countries. [from abstract]

Despite a pool of unemployed health staff available in Kenya, staffing levels at most facilities were only 50%, and maldistribution of staff left many people without access to antiretroviral therapy. Because in the current system it takes one to two years to fill vacant positions, even when funding is available, an emergency approach was needed to fast-track the hiring and deployment process. A stakeholder group was formed to bring together leaders from several sectors to design and implement a fast-track hiring and deployment model that would mobilize 830 additional health workers.

Prior to implementing male circumcision as a public health measure against the spread of HIV, the feasibility, safety and costs of the procedure within target countries should be evaluated to understand what measures need to be taken to ensure access to safe, affordable voluntary circumcision services. The aims of this study were to assess variation and safety of male circumcision practices, as well as resource and training needs related to the procedure, in a community that has been practicing circumcision traditionally for many generations. [from introduction]

Thousands of community workers are helping Ethiopia to deliver primary health-care services to people living in rural areas. However, critics say that the training these workers receive is not adequate for them to attend many of the health problems they encounter. [from introduction]

This article describes the achievements of 11 Sudanese-Canadian physicians who completed medical training and returned to Southern Sudan to practice. Few internationally educated physicians are prepared to return to a homeland as challenging as Southern Sudan; this goes against the globally entrenched flow of physicians migrating from developing to developed countries. [from introduction]

This report describes three health system developments introduced by the Rwandan government that are improving these barriers to care

Most children undergoing surgery in Kenya are anaesthetised by clinical officers or anaesthetists with minimal training in paediatric anaesthesia. This article details the statistics of how this personnel shortage impacts anaesthesia delivery. [from introduction]

This presentation discusses the current climate and prospects for health partnerships between the private and public sectors in Africa. [from presentation]