Sub-Saharan Africa

This report reviews the literature, published and unpublished, available on HRH in Mozambique. It also carries out some secondary data analysis and presents data from interviews and focus group discussions with key informers and stakeholders. The study of the human resources situation in Mozambique followed a frame of reference that addressed key issues related to the context, professional policies, labour market, management of human resources, and performance and coping. [from executive summary]

Nurses provide the bulk of primary care services in South Africa. Post-apartheid health legislation envisions the provision of comprehensive primary services at all public clinics, which implies the need for a cadre of primary care nurses able to render such services. The objective of this study was to identify core competencies of clinic nurses and develop an evaluation tool for primary care nursing in South Africa. [from abstract]

The overall objective of community-based medical education (CBME) is to produce highly qualified doctors in sufficient numbers to meet the health needs of the nation at community and hospital levels. In the current program, medical students undertake an eight-week residential posting in their final year. The objective of this study was to assess the communities’ awareness, perception and participation in the CBME program. [adapted from introduction]

The focus of McKinsey’s research effort is on the HRH constraint, faced by many developing countries, in absorbing development aid and scaling up urgently needed health programs. HRH in this context is defined as the health workers at the front line of healthcare service delivery. The field work necessary to diagnose the problem and identify possible solutions has been initiated in Tanzania. We believe these findings, accounting for certain differences, will be broadly applicable to several developing countries. [from author]

In much of sub-Saharan Africa, a significant portion of the population lives in rural areas, leaving many women with limited access to clinic-based family planning services. Thus CBD of contraceptives remains an important service delivery mechanism in this region. The primary aim of this study was to assess the safety, quality, and feasibility of Depo-Provera provision by community reproductive health workers.

In Tanzania, the PHRplus project developed and tested a set of training materials and tools designed to strengthen the Integrated Disease Surveillance and Response (IDSR) system. All of the tools were implemented in twelve project districts in eight regions of the country. The tools can be adapted for use in other countries and include job aids for district training of trainers, facility training of trainers, district and facility level IDSR training materials and other supporting training tools. [adapted from publisher]

The MCH clinic workers in Somalia receive formal and in-service training to perform their professional duties. Their competence in the field was never examined. This study assessed their competencies in detecting malnourished children 5 years and below in Beledweyne. [from abstract]

Family Medicine training and assessment is becoming more formalized and developed in South Africa. Assessment of competency in relation to clinical skills can involve observation in the clinical setting, but is more usually assessed in an examination. Summative assessment of family physician’s clinical skills now usually includes an Objective Structured Clinical Examination (OSCE). Standardisation of the OSCE is required to define the pass mark above which a candidate performs at the level expected of a family physician. [from abstract]

This paper discusses global, regional and national perspectives of traditional medicine development and efforts that have been directed towards bridging the gap between traditional health practitioners and scientists/biomedical heath practitioners in contemporary health research in Tanzania. [from abstract]

This HRH policy document addresses the production and utilization of Human Resources within the Ministry of Health and Sanitation in Sierra Leone. It also responds to the contemporary challenges and developments including the exodus of human resources and advancement in technology. This policy intends to regulate and direct planning, production, management, utilization and monitoring of HR within the health sector. [from foreword]

The shortfall of health personnel continues to represent one of the major constraints to the development of health services and access to basic health care in Sierra Leone. The plan contains an analysis of the current situation with a focus on the distribution of Health Personnel, the current stock, wastage, outputs from training schools, dropout rates and human resources policies currently obtained in the Ministry of Health and Sanitation. It also projects future requirements based on the recommended establishment. [from preface]

This report summarizes the findings and conclusions of [a baseline study and a three-day stakeholder workshop on productivity]. Specifically, we present the baseline study findings, identify areas where current productivity falls short of desired levels, consider the root causes of identified productivity gaps and offer practical recommendations for feasible management interventions to improve productivity. We conclude with a short-term action plan for moving forward with implementation activities. [from introduction]

This report provides an overview of the public health situation across the 46 Member States of the African Region of the World Health Organization. The report charts progress made to date in fighting disease and promoting health in the African Region. It reviews the success stories and looks at areas where more efforts are needed to improve people’s health. [author’s description] Chapter 6 includes a discussion of the human resources for health crisis and approaches to filling the gap as well as health information systems.

The Ministry of Health Manpower Development Centre in Uganda has been carrying out training of health workers as part of their continuing education using both distance education and conventional methods since 1989. It was important, therefore, to develop a comprehensive documentation of the distance learning programmes in order to show the effectiveness and potential of distance education in upgrading medical personnel as compared to other approaches. [from author]

Health workers attending overseas universities may be less likely to return home. One response is to improve course provision and professional updating opportunities in-country. Leeds Metropolitan University, with funding from the Commonwealth Scholarships Commission under their distance learning initiative, runs a tailor-made MSc Public Health (Environmental Health and Health Promotion) in Zambia, for nurse tutors, clinical officers and environmental health workers. Using locally relevant curricula, with community-based, student centred, problem-solving approaches, retention may be improved. This paper will discuss how the course is delivered in Zambia, how the partnership developed such as to enable effective delivery of the course, and how sustainable learning can be achieved in a developing country in partnership with a UK University. [from abstract]

This study set out to characterise the nature and extent of discriminatory practices and attitudes in the health sector, and indicate possible contributing factors and intervention strategies. [from author]

This edition covers topics such as: migration of skilled health workers, investing in human resources for health, strengthening human resources for health in Africa, and the economic cost of health professionals brain drain in the African region. [author’s description]

Since the late 1990s, Malawi’s public health services have appeared to be heading for collapse due to declining staffing levels. The government launched the Essential Health Package in 2004 to help improve the health of the population, which includes scaling-up HIV and AIDS-related services. The biggest challenge facing the initiative is improving human resource levels. [adapted from author]

Despite the usefulness of voluntary counselling and testing centres implemented in Africa, their limited capacity does not allow for vast testing of the general population. Therefore, in order to increase the number of individuals tested for HIV with the aim of enhancing the scaling up, we developed a strategy based on bringing the healthcare package much closer to the people, by using mobile HIV testing units. We herein report the Cameroon experience of mobile HIV testing unit strategy, demonstrating its effectiveness in reaching a great number of individuals, including those without usual access to HIV testing facilities. [abstract]

This study explored the distribution of public sector health workers [in Zimbabwe] to show how its pattern impacts on equity objectives in health care delivery. [from executive summary]

Experience has shown that governments have different kinds of HRH policies, strategies and plans even when they are within the overall context of national health policies and strategies. This document provides guidance on the process with proposals of content for three basic HRH documents: situation analysis, policy, and strategic plan. [from foreword]

The purpose of this human resource for health (HRH) plan is to provide guidance for the staffing of the health services and the training of health service personnel to the year 2020. It analyzes main issues and dimensions in HRH and proposes strategies to meet the targets for the wellbeing of the population as defined in the vision 2020 for Rwanda The plan provides staffing targets for each of the major categories of health personnel.

By measuring the ability and actual practice of a sample of clinicians in Tanzania and examining the terms of employment for these clinicians, we show that both ability and motivation are important to quality.

This presentation is from PSP-One’s GHC Expert Panel - Expanding Health Service Access, Quality, and Equity in Developing Countries: The Role of the Private Sector. It presents franchise models for delivering family planning and reproductive health services by the private sector.

The paper investigates the magnitude of migration of health professionals from Zimbabwe, the causes of such movements and the associated impacts on health care delivery. International migration of health professionals has led to staff shortages and the situation is worse in public compared to private health institutions. The quality of care given to patients has also declined. The research calls for the adoption of an integrated approach in solving the concerns of health professions. [abstract]

This paper was commissioned to identify and review reports, documents and data relating to nursing workforce dynamics in sub-Saharan Africa with the objective of analyzing, synthesizing, and presenting key information on nurse migration in the region. It reviews trends and impact of nurse migration derived from previously published work by various groups and reports to the High Level Forum on the millennium development goals on the human resources crisis. [from abstract]

This document introduces a competency-based curriculum for nurses and midwives in Rwanda developed by the Capacity Project.

This meeting discussed the role of medical schools in the process of development and implementation for national health policies and plans, the need for medical education reforms to respond to national health challenges within the context of global and regional health strategies, the way forward for enhancing the capacity of medical schools to produce adequate human resources for health, and the formulation of recommendations for regular institutional evaluation. [adapted from executive summary]

The starting point for this online database was a comprehensive health workforce survey conducted by the WHO Regional Office for Africa in collaboration with WHO department of human resources for health in Geneva in 2004/2005. All 46 member states of the African Region have contributed to this data collection. The data base presented here is the best available information base on the health workforce in the African Region to date and it will be continuously updated. Data is provided for 23 different types of health care cadres, both as total numbers and densities per 1000 population.

The Health Service Extension Programme (HSEP) is an innovative approach to addressing the shortfall in health human resources in Ethiopia. It has developed a new cadre of Health Extension Workers (HEWs), who are charged with providing the health and hygiene promotion and some treatment services, which together constitute the bedrock of Ethiopia’s community health system. This study seeks to explore the experience of the HSEP from the perspective of the community who received the service. [from abstract]