Sub-Saharan Africa

This presentation discusses the various aspects of private providers as they pertain to contracting for health services. [from presentation]

The researchers conclude that given the HRH crisis, ART delivery models requiring much less doctor time need to be developed. Overall, there is a need to shift tasks from medical doctors to nurses and from nurses to community health workers. In particular, the patients themselves need to play an important role in the delivery of ART. The outcomes of the various scenarios are predicted. [from author]

In South Africa, first-contact primary care is delivered by nurses in small clinics and larger community health centres (CHC). CHCs also employ doctors, who often work in isolation from the nurses, with poor differentiation of roles and little effective teamwork or communication. Worcester CHC, a typical public sector CHC in rural South Africa, decided to explore how to create more successful practice teams of doctors and nurses.

Community-based education (CBE) was developed thirty years ago in response to the maldistribution of physicians and subsequent inequity of health care services across geographical areas in developed and developing countries. Several medical schools in Nigeria report adopting CBE. This study seeks to identify and describe the CBE programs in accredited Nigerian medical schools and to report students’ assessments of the knowledge and skills gained during their community-based educational experience. [from abstract]

There is a gross shortage of nurses, yet there is a need to provide quality care and defend patient care. Widening scope of practice is not new to all categories of nurses and given the Occupational Specific Dispensation for nurses there is a need to critically engage with these issues.

In what areas do the HIV/AIDS donor programs interact with key operational parts of health systems? To answer it, and to better inform the ongoing discussion of AIDS and health systems, the report investigates and compares the donors’ interactions in three countries (Mozambique, Uganda, and Zambia) with three components of health systems: the health information system, the supply chain system for essential medicines, and human resources for health. [from summary] Chapter 4 is dedicated to the HRH aspects of this issue.

Malawi is one of the poorest nations in the world, with some of the worst health worker to population ratios. Most health services are provided by clinical officers, medical assistants and enrolled nurses. The government has taken action to address the staffing shortfall, estimated at 15,000. [from author]

This report details the findings of the Forum on Engaging the Private Sector in Child Health held in Uganda in 2005. It discusses the potential of private providers and the private sector as a resource for improving community health outcomes. [from executive summary]

Task shifting should not be viewed as a panacea for the human resources challenges facing sub-Saharan Africa. Rather, it must be part of an overall strategy that includes measures to increase, retain, and sustain health staff. [from author]

Swaziland has taken the lead in caring for overburdened health workers with the opening of the first Wellness Centre in Manzini for them and their families. This article reports on this innovative response to the deepening crisis in human resources for health in sub-Saharan Africa. [adapted from author]

In 2001 the Faculty of Medicine of the University of Gezira (FMUG) introduced the Integrated Management of Childhood Illness (IMCI) strategy into its medical curriculum. The emphasis was on pre-service training that addresses standard case management and the IMCI community component. This report presents the experience of FMUG in integrating such a training package into the medical curriculum. It explains the rationale for introducing the IMCI community component and the guiding principles for doing so.

This case study evaluates a project in Kenya that concentrates on HIV and AIDS care and prevention through support and training of community volunteers to provide PLHA with HBC, widespread and diverse efforts to promote behavior change and raise awareness about HIV and AIDS, improving access to VCT, as well as capacity building efforts and direct material assistance for OVC and PLHA. [adapted from introduction]

Scaling up the implementation of new health care interventions can be challenging and demand intensive training or retraining of health workers. This paper reports on the results of testing the effectiveness of two different kinds of face-to-face facilitation used in conjunction with a well-designed educational package in the scaling up of kangaroo mother care. [from abstract]

The Tanzanian health system is currently undergoing major reforms. As part of this, a study was commissioned into the delivery of services and care at the Muhimbili National Hospital. One of the main components of this comprehensive study was to measure the extent to which workers in the hospital were satisfied with the tasks they performed and to identify factors associated with low motivation in the workplace. [from abstract]

This paper looks at the HRH crisis as experienced by the Uganda Catholic Medical Bureau network giving the trend, examining the reasons, the destinations of attritional cases and what the network is trying to do to improve human resource stability. [from abstract]

This report describes the second phase of a study that developed and tested an integrated program of counselor job aids, mother take-home materials, and counselor training in a healthcare site providing counseling for the prevention of mother-to-child transmission of HIV (PMTCT) in Moshi District in the Kilimanjaro Region of Tanzania. [from executive summary]

This mid-term evaluation report focuses on Capacity Project support to the Government of Kenya’s Emergency Hiring Plan. It assesses the main achievements, challenges and impact on service delivery and health systems improvement, from the plan’s inception through the November 2007 mid-point. The report outlines all aspects of the approach used, providing clear recommendations on how the Ministry of Health may strengthen its existing human resource systems on the basis of lessons learned, and provides additional insights to the process, which may be useful for informing similar country contexts.

The Private Sector Partnerships-One (PSP-One) project fielded an assessment team to document the state of operations for the Biruh Tesfa network, identify strategies to improve network sustainability, and determine local organizations that could have a role in network management and support. In addition the team was asked to explore opportunities to integrate HIV services into the Biruh Tesfa network. [from abstract]

This document is the result of an assessment of the private sector in Nigeria for the provision of reproductive health and family planning products and services. [from abstract]

The article presents a successful application in Mozambique of a leadership development program created by Management Sciences for Health. [from abstract]

Two crises dominate the health sectors of sub-Saharan African countries: those of human resources and of HIV. There is considerable variation in the extent to which these two phenomena affect sub-Saharan countries, with a few facing extreme levels of both. This paper reviews the continent-wide situation with respect to this double burden before considering the case of Malawi in more detail. [from abstract]

Sub-Saharan Africa is the epicenter of the HIV/AIDS epidemic. An assessment of health-care worker availability in the region against health system needs for that area reveals stark gaps. This article details the contributing reasons for health-care worker shortages, as well as the effect of these shortages on antiretroviral therapy (ART) for HIV-infected patients. [from abstract]

This article focuses on professional nurses in a study of patterns of planning, recruitment, training and task allocation associated with an expanding antiretroviral program in the districts of Free State. [from abstract]

Malawi’s health human resources initiatives since the late 1990s provide a good example of a comprehensive national scale-up plan for the health workforce. Its Emergency Human Resources Plan has shown modest but promising results. Health worker attrition remains high and tutor supply low, but training capacity has been substantially expanded and Malawi is expected to begin meeting training output targets in 2008. [from introduction]

Ghana addresses its serious health workforce shortage and consequent issues with health service delivery through a new human resources strategic plan developed to guide scale-up from 2007 to 2011. [from abstract]

This study was conducted to identify determinants, benchmarks and indicators of the costs and benefits and distributional impact of the migration of human resources for health on health services in Kenya and to make policy proposals for intervention. [from abstract]

This article describes the experience of the Family Life Education Programme, a reproductive health program that provides community-based health services through 40 clinics in five districts of Uganda, in improving retention and performance by using the Human Resource Management Rapid Assessment Tool. [adapted from abstract]

This document evaluates the expected change in the reproductive preferences of women due to the presence of volunteers and community health workers providing health service delivery in the communities through the Community Health and Family Planning project. In the communities where there is intervention, women seem to show that their fertility preferences are generally shifting towards small family sizes although the fertility levels are still high. [adapted from author]

The purpose of this study was to identify and recommend strategies for tackling the underlying issues in the human resources for health (HRH) management process in Uganda with an eye towards addressing the HRH crisis. [from executive summary]

The overall objective of this study was to analyse the challenges which family caregivers encountered in home-based care when they tried to access medical treatment for home-based AIDS patients in the context of confidentiality and limited medical care. [from abstract]