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This policy brief explores the major challenges facing Kenya in the implementation of their Integrated Management of Childhood Illness strategy and looks at why it is failing to fulfill its potential to improve health care and reduce child mortality. [adapted from introduction]

This report discusses ways and means of improving the capacities of nurses and midwives and building consensus on a regional agenda to strengthen the contribution of nursing and midwifery services to rapidly scale up health services delivery and health outcomes in the African region. [adapted from introduction]

The health worker shortage in sub-Saharan Africa derives from many causes, yet the dynamics of entry into and exit from the health workforce in many of these countries remain poorly understood. This limits the capacity of national governments and their international development partners to design and implement appropriate intervention programmes. This paper provides some of this information through the first systematic estimates of health worker inflow and outflow in selected sub-Saharan African countries. [adapted from introduction]

This study involves the development and evaluation of training materials for provider-initiated HIV counseling and testing, HIV prevention and integrated primary HIV care and support for use by health care workers involved in the care of patients with TB at the primary health care clinic level in the Democratic Republic of Congo. [adapted from abstract]

This article reports on research that assessed international and national best practice in the selection of students for graduate entry medical courses in order to investigate correlations between medical student selection procedures and exposure to rural medical practice during medical training with choice of careers in rural medicine. Central to the study was the issue of the medical workforce shortage in Australia’s rural communities. [from introduction]

This study aims to undertake a national assessment of existing district management structures, competencies and current training programmes in order to inform a national strategy and plan to strengthen district management capacity to ensure effective delivery of primary health care in South Africa. [from introduction]

Tanzania is implementing the Integrated Management of Childhood Illness (IMCI), developed by the WHO and UNICEF to improve the management of child health at the primary care level in order to reduce child mortality in low and middle income countries. Workers in health facilities are trained in a structured IMCI case management course. IMCI also advocates the strengthening of the health system to facilitate practice of the skills acquired by health workers, as well as calling for improvement of household and community practices related to child health. [from executive summary]

Medical doctors and nurses in Bangladesh are concentrated in urban secondary and tertiary hospitals, while 70% of the population lives in rural areas. This situation has created a major challenge for the national health system, particularly for reducing the high maternal mortality rate, with fewer than 20% of births being attended by a skilled birth attendant. The Declaration of Safe Motherhood was desgined to address this issue, supportetd by a number of national programs and strategies. [from summary]

Ethiopia suffers from an acute shortage of health workers at every level, and rural areas in which 85% of the population live have been particularly chronically under-served. The Ministry of Health chose to focus on community level provision, initiating the Health Extension Programme in 2004. This is outlined in the current Health Sector Development Plan, which focuses on both human resource development and the construction and rehabilitation of facilities. [adapted from introduction]

Currently, a wide variety of community health workers are active in many antiretroviral treatment delivery sites. This article investigates whether present community health worker programmes for antiretroviral treatment are taking into account the lessons learnt from past experiences with community health worker programmes in primary health care and to what extent they are seizing the new antiretroviral treatment-specific opportunities. [from abstract]

This commentary outlines strategies the authors have found successful in aligning health education and training with local health needs in ways that demonstrate socially accountable outcomes for Vancouver Island, Canada. [adapted from abstract]

A Health Management Information System (HMIS) can be a powerful tool to make health care delivery more effective and far more efficient. This paper describes how an HMIS can also be used for organisational development and reports on the experiences of the HMIS programme of the Uganda Catholic Medical Bureau (UCMB) in Uganda. [from abstract]

This study explores the experience of conflict as perceived by Iranian hospital nurses in Tehran, Islamic Republic of Iran. Although conflict-control approaches have been extensively researched throughout the world, no research-based data are available on the perception of conflict and effective resolutions among hospital nurses in Iran. [adapted from abstract]

Rural township health centres and urban community health centres play a crucial role in the delivery of primary health care in China. The limited availability and low qualifications of human resources in health are among the main challenges facing lower-level health facilities. This paper aims to analyse the mobility of health workers in township and community health centres. [from abstract]

Governments in developing countries are challenged to meet the health needs of their populations because of financial constraints, limited human resources, and weak health infrastructure. The private sector can help expand access to and quality of reproductive health services through its resources, expertise, and infrastructure.

The Mothers’ Support Group empowers mothers and mother-to-be to access peer-based support and make linkages to services such as family planning, infant-feeding, counseling, nutriotional guidance, antiretroviral therapy, prevention of mother-to-child transmission and health institutional delivery. [from author]

This paper reports on the first international attempt to investigate the migration intentions of pharmacy students and identify migration factors and their relationships. [from abstract]

Traditionally, faith-based health organisations have been important health care providers in many remote and other under-serviced areas. Currently, these facilities bear the brunt of the competition for scarce human resources. It is important for faith-based organisations to learn from recent experiences and from the creative ways in which colleagues seek to retain their health workers and improve quality of human resource management. [from preface]

Insufficient attention has been paid to understanding what determines the performance of health workers and how they make labor market choices. This paper reports on findings from focus group discussions with both health workers and users of health services in Ethiopia. We describe performance problems identified by both health users and health workers participating in the focus group discussions including absenteeism and shirking, pilfering drugs and materials, informal health care provision and illicit charging, and corruption.

This report assesses progress on the Millennium Development Goals 4 and 5 on child mortality and maternal health and proposes best strategies for reaching them. Chapeter 3 (p.81) discusses the impact of skilled attendance and emergency obstetric care on maternal and child survival rates, and chapter 4 (p.119) outlines the broader importance of health workforce management to maternal and child health. [adapted from author]

This toolkit provides a package of HRIS procedures and tools to HRH stakeholders, HR information system managers and software developers to facilitate applying the HRIS strengthening processes and iHRIS software developed by the Capacity Project. The toolkit collects briefs, forms, case studies, resources and other materials to assist with all five steps of the HRIS strengthening process: introduction, building HRIS leadership, assessing and improving existing systems, developing software solutions, using data to make decisions, and ensuring sustainability. [from author]

The issue of participation by medical providers from wealthy countries in short-term medical volunteer work in resource-poor countries has been reaised as being potentially harmful to recipient communities. This exploratory study examines the perception of short-term medical volunteer work in Guatemala from the perspective of members of recipient communities affected by or participating in these programs. [adapted from sbstract]

Retention continues to be a serious challenge in the human resources for health crisis. There is increasingly widespread commitment to initiatives to attract and retain skilled workers, especially in rural areas. The purpose of this brief is to update and document some contributions made from 2005 to 2008 in the area of worker retention. [from author]

In the face of medical workforce shortages, governments are looking to displace doctors with alternative health care providers like nurse practitioners, physician assistants, and other health professionals such as psychologists and pharmacists to relieve bottlenecks in health care delivery. Displacing doctors in this way, or role or task substitution as it is also termed, has been actively pursued in the United Kingdom and United States. How should the medical profession react to these developments? [from author]

This study undertook an in-depth exploration of the unintended consequences of pay-for-performance programs In England and California. The authors interviewed primary care physicians in California and England and compared unintended consequences in each setting. [adapted from abstract]

Health facility assessments are being increasingly used to measure and monitor indicators of health workforce performance, but the global evidence base remains weak. The World Health Organization coordinated a series of facility-based surveys using a common approach in six countries: Chad, Cote d’Ivoire, Jamaica, Mozambique, Sri Lanka and Zimbabwe. The objectives were to inform the development and monitoring of human resources for health policy within the countries; and to test and validate the use of standardized facility-based human resources assessment tools across different contexts.

This presentation covers the state of the health workforce in Ethiopia and defines the crisis in health worker coverage including numerous charts and staistics that track the decline in the number of doctors.

East African countries have in the recent past experienced a tremendous increase in the volume of antiretroviral drugs. Capacity to manage these medicines in the region remains limited. Makerere University established a network of academic institutions to build capacity for pharmaceutical management in the East African region. The initiative includes institutions from Uganda, Tanzania, Kenya and Rwanda and aims to improve access to safe, effective and quality-assured medicines for the treatment of HIV/AIDS, TB and Malaria through spearheading in-country capacity.

The Ministry of Health and Medical Education in the Islamic Republic of Iran has undertaken a reform of its health system, in which-lower level managers are given new roles and responsibilities in a decentralized system. To support these efforts, a series of courses for health managers and trainers was developed. A total of seven short training courses were implemented, and a detailed evaluation of the courses was undertaken to guide future development of the training programs. [adapted from abstract]

This paper will use India as a lens to examine the broader issues surrounding human resources and public health. It will explore some of the HR strategies employed in a variety of settings with mixed results. Finally, it will look at several very contrasting approaches employed by two Indian states, Tamil Nadu and Gujarat, in dealing with human resource shortages as they struggle to reduce maternal mortality. [from author]