Sub-Saharan Africa

Improving maternal and reproductive health still remains a major challenge in most low-income countries especially in sub-Saharan Africa. The growing inequality in access to maternal health interventions is an issue of great concern. In Ghana, inadequate attention has been given to the inequality gap that exists amongst women when accessing antenatal care during pregnancy and skilled attendance at birth.

The study concludes that to address these gender gaps in ICTs in Nigeria, all hands must be on deck to change women’s attitudes towards ICT use by overcoming technophobia;women should be provided with educational and economic empowerment; government ICT policies and programs must address the needs of women;and the civil society should be part and parcel of this crusade for the betterment of women and the society at large. [from abstract]

During national scale up of Integrated Community Case Management (iCCM) in Rwanda, greater improvements in care-seeking were found in the districts where Kabeho Mwana implemented its model than in the rest of the country. Success was attributed to an emphasis on routine data review, intensive monitoring, collaborative supervision, community mobilization, and, in particular, CHW peer support groups. [from introduction]

Laboratory professionals are expected to maintain their knowledge on the most recent advances in
laboratory testing and continuing professional development (CPD) programs can address this expectation. In
developing countries, accessing CPD programs is a major challenge for laboratory personnel, partly due to their
limited availability. An assessment was conducted among clinical laboratory workforce in Botswana to identify and
prioritize CPD training needs as well as preferred modes of CPD delivery. [from abstract]

This study used a mixed methods approach with data from the Regulatory Human Resources Information System (tracks initial student enrolment through registration) and the Kenya Health Workforce Information System (tracks deployment and demographic information on licensed nurses) for the quantitative analyses and qualitative data from key informant interviews with nurse training institution educators and/or administrators. [from abstract]

Patient’s satisfaction is one indicator of healthcare quality. Few studies have examined the inpatient experiences in resource-scarce environments in sub-Saharan Africa. This paper examines patient’s satisfaction on the public medical wards at a Kenyan referral hospital, we performed a cross-sectional survey focused on patient’s satisfaction with medical information and their relationship with staffing and hospital routine. Ratings of communication with providers, efforts to protect privacy, information about costs, food, and hospital environment were also elicited. [adapted from abstract]

In countries with high maternal and newborn morbidity and mortality, reliable access to quality healthcare in rural areas is essential to save lives. Health workers who are satisfied with their jobs are more likely to remain in rural posts. Understanding what factors influence health workers’ satisfaction can help determine where resources should be focused. Although there is a growing body of research assessing health worker satisfaction in hospitals, less is known about health worker satisfaction in rural, primary health clinics.

The predominant model of public health commodity supply chains in developing countries is one dominated by a central medical store (CMS). In this model, the CMS plays the pivotal role of procurement, storage and warehousing of all health commodities before they are distributed to the next level in the supply chain. Challenges with technical and organization capacity at the CMS level has led to longstanding difficulties in creating sustainable performance improvements in several countries.

Volunteer community health workers (CHWs) form an important element of many health systems, and in Kenya these volunteers are the foundation for promoting behavior change through health education, earlier case identification, and timely referral to trained health care providers. This study examines the effectiveness of a community health worker project conducted in rural Kenya that sought to promote improved knowledge of maternal newborn health and to increase deliveries under skilled attendance. [from abstract]

Special and emergency hiring programs entail the use of processes and mechanisms that are outside of the primary, nationally institutionalized human resource frameworks. Specifically, we sought to assess whether these approaches avert some of the challenges that undercut optimal deployment, long-term retention, and the rational assignment of transfers. Do efforts outside of the “regular” system bypass the P&T challenges of the “normal” system? Why? [from introduction]

This paper presents findings from a study designed to assess the extent to which community residents and leaders participated in the skilled delivery program and the specific roles they played in its implementation and effectiveness. [from abstract]

The identification and treatment of mental disorders must be considered an urgent public health priority in low- and middle-income countries. Trained primary health workers can deliver safe and effective treatment for mental disorders as a feasible alternative to ease the scarcity of mental health specialists in developing countries. [from abstract]

IPV is important to health systems because of the wide-ranging and serious health effects experienced by exposed women, as well as the unique opportunity afforded to healthcare providers to enquire about violence. [from introduction]

Burkina Faso faces a daunting family planning (FP) challenge. While the use of any modern contraceptive method
more than tripled between 1993 and 2006, the unmet need for FP remains high, at 31.1% among married women. Long-acting methods (IUDs and implants)and permanent methods (female sterilization and vasectomy) are the most effective
of all FP methods. However, use of long-acting and permanent methods of contraception (LA/PMs) in Burkina Faso remains
low, at 13% of the overall method mix. [adapted from source]

One challenge that community health workers face when they provide hormonal contraceptives to new clients is ruling out pregnancy. A randomized controlled trial in Madagascar found that offering the health workers pregnancy tests to distribute for free increases their number of new contraceptive clients. [from introduction]

South Africa has a dual health system, namely, the public health sector that includes government health institutions, serving mostly the lower income population and the private health sector that serves those who can afford care from their own income. The public sector is responsible for 82 percent of the population and only accounts for 40 percent of the government health expenditure. The purpose of this study was to evaluate job satisfaction levels among nursing staff within a public hospital in Southern Gauteng. [adapted from abstract]

The study explored the effects of motivation and job satisfaction on turnover intention and how motivation and satisfaction can be improved by district health managers in order to increase retention of health workers. [from abstract]

In 2012, Pathfinder conducted a study to explore whether CHWs who are intended to promote family planning as part of an integrated package of services do communicate with beneficiaries about family planning, and what actions women take based on these messages. The study also explored whether CHWs are reaching the poor, marginalized and vulnerable, and examined the costs of implementing the CHW component of the SCIP project. [from executive summary]

Recent analysis by the SHOPS project shows that the private health sector could help country governments sustain national HIV responses. SHOPS used national health accounts data to track how HIV funds flow through the health systems in Côte d’Ivoire, Kenya, Malawi, and Namibia, and identified ways that donors and the government can better work with the private health sector. [from introduction]

Health care is labor intensive and managers strive to identify a mix of staff that can safely deliver a range of services using available resources. In many developing countries,primary-level workers, auxiliary staff, and community health workers (CHWs) are being trained to assume roles and perform functions traditionally reserved for mid- or high-level cadres of health workers as a means of optimizing the number and capacity of available providers.

The official report for the 9th International Conference on ICT for Development, Education & Training, which took place from May 28 to 30, 2014 in Kampala, Uganda. [adapted from publisher]

This paper explores how e-learning is situated in the drive towards realization of MDGs [Millennium Development Goals] in the African continent.

The Nursing Education Partnership Initiative (NEPI) was established in 2011 by the U.S. President’s Emergency Plan for AIDS Relief in response to key capacity-building challenges facing preservice nursing and midwifery education in Sub-Saharan Africa. NEPI has formed partnerships with governments and key stakeholders in Ethiopia, Democratic Republic of Congo, Lesotho, Malawi, and Zambia and supports 19 nursing and midwifery education institutions and 1 nursing council.

This paper examines the various models, challenges, and evaluative efforts of community-based education (CBE) programs at Medical Education Partnership Initiative (MEPI) schools and makes recommendations to strengthen those programs in the African context. [from abstract]

From 1990 to 2011, contraceptive use in Ethiopia increased nine fold and the total fertility rate fell from 7.0 to 4.8. What are the main elements of this success? We posit that the four most significant factors are: political will, generous donor support, non-governmental and public–private partnerships, and the government’s establishment of a network of health extension workers. In this study, we look at these factors and how their interaction increased the proportion of women having both the desire to use and ability to access contraceptives. [adapted from abstract]

The Ugandan Government has an ambitious goal to reduce unmet need for family planning (FP) from its current 34% to 10% over the next 10 years. This brief shares experiences and lessons from capacity building for Family Planning at the national and district levels in Uganda.[adapted from introduction]

Knowledge of the relation between health-system factors and child mortality could help to inform health policy in low-income and middle-income countries. We aimed to quantify modifiable health-system factors and their relation with provincial-level heterogeneity in under-5, infant, and neonatal mortality over time in Mozambique. [from abstract]

With this aim, the study looks at the development of policies on human resources for health (HRH) in Sierra Leone over the decade after the conflict (2002–2012). [from abstract]

This study examines the delivery of health services by faith-based organizations (FBOs) as a possible alternative to privatization in Uganda, where these not-for-profit health providers have been servicing communities since the second half of the 19th century. Their facilities focus on primary care and operate in rural, under-serviced areas, charging affordable user fees, while also treating those who cannot pay. [from executive summary]

This study investigated factors influencing motivation and retention of HCWs at primary health care facilities in three different settings in Kenya - the remote area of Turkana, the relatively accessible region of Machakos, and the disadvantaged informal urban settlement of Kibera in Nairobi. [from abstract]