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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 introductory presentation on migration and other health workforce issues in a global economy was offered during a dialogue hosted by the WHO and OECD.

This review surveys trends in physician supply in the United States from 1980 to the present. It discusses the composition of the physician workforce; changes in the inflows and outflows of the physician workforce; and how international migration, retirement, part-time practice and alternative employment have impacted the physician workforce. Finally, the paper considers implications of physician shortages and the recruitment of physicians from abroad. [adapted from summary]

The United States has the largest professional nurse workforce in the world but does not produce enough nurses to meet its growing demand. The U.S. is now the world’s major importer of nurses, but the shortage is too large to be solved by recruitment abroad without depleting world nursing resources. The national shortage could be largely addressed by investments in expanding nursing school capacity. [adapted from summary]

Most healthcare in the UK is delivered through the National Health Service (NHS). Shortages of skilled staff led to policy changes including international recruitment of health professionals. Subsequent changes in the UK migration policy have impacted international recruitment, leading to a significant reduction in the inflow of international clinicians to the NHS. [adapted from summary]

Italy’s aging population is placing a strain on the public health system. Care for the aged has increasingly been delegated to informal immigrant workers. However, international migration will not be sufficient to solve Italy’s health care professional needs. [adapted from summary]

This OECD report examines the role played by immigrant health workers in the Canadian health workforce, as well as the interactions between migration policies and education and health workforce management policies. [adapted from introduction]

Health worker retention is critical for health system performance and a key problem is how best to motivate and retain health workers. The authors undertook a systematic review to consolidate existing evidence on the impact of financial and non-financial incentives on motivation and retention. [from abstract]

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]

The recruitment of health care practitioners from developing to developed countries is an important topic in global health ethics. This paper examines the emergence of the debate over what is now popularly called the “Brain Drain” – the migration of physicians from developing to developed countries and between industrialized nations. [adapted from abstract]

Health professionals face the duality of the professional and the organizational systems, each of which has its own distinct values, principles and expectations. This study presents organizational and professional commitment concepts and their relations in the context of the health sector. [adapted from introduction]

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 suggests that India’s maternal mortality rate is so high due to political, administrative and managerial issues such as the lack of exclusive midwifery training and professional midwives. [adapted from author]

Well-functioning health information systems are required to ensure the production, analysis, dissemination and use of reliable and timely essential human resources for health (HRH) information needed for workforce planning, management and evaluation. This project aims to produce a set of indicators and domains with definitions and associated fact-sheets to establish a minimum data set to record, share, analyse and apply HRH data.

The theory of planned behaviour states that attitudinal variables such as job satisfaction only have an indirect effect on retention whereas intentions have a direct effect. This study tests for the direct and indirect effects of job satisfaction of nurses during the 3 years after qualification. [adapted from abstract]

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]

Shortages and maldistibution of physicians in northern Ontario, Canada, have been a longstanding issue. This study seeks to document, in a chronological manner, the introduction of programs intended to help solve the problem by the provincial government over a 35-year period and to examine several aspects of policy implementation, using these programmes as a case study. [from abstract]

This paper analyzes China’s current health workforce in terms of quantity, quality, and distribution. Unlike most countries, China has more doctors than nurses. Doctor density in urban areas was more than twice that in rural areas, with nurse density showing more than a three-fold difference. Over the past decade there has been a massive expansion of medical education, with an excess in the production of health workers over absorption into the health workforce.

This report looks at how the landscape of human resources for health (HRH) has evolved and current key challenges. It looks at the complexities of HRH planning and management in the current environment and how various jurisdictions are finding innovative ways to collect and use HHR information. It also talk abouts education and training, workplace environment, distribution and migration, and provides updated data and information on supply-side trends for health professions. [adapted from author]


There is also a reference guide that provides aggregate, supply-based trend information.

Epidemiological data indicate elevated psychosocial health risks for physicians, e. g., burnout, depression, marital disturbances, alcohol and substance abuse, and suicide. The purpose of this study was to identify psychosocial health resources and risk factors in profession-related behaviour and experience patterns of medical students and physicians that may serve as a basis for appropriate health promoting interventions. [from abstract]

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]

This issue offers an overview of the core factors contributing to the success of family planning programs. Family planning professionals around the world helped to identify these 10 crucial program elements. This report highlights program experiences, best practices, and evidence-based guidance derived from nearly six decades of experience in international family planning. [adapted from author]

Sections of the report that address HRH include “High-Performing Staff” (p. 16).

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]

The 2008 World Health Report revisits the vision of primary health care as a set of values and principles for guiding the development of health systems. It represents an opportunity to identify major avenues for health systems reform in the areas of universal coverage, service delivery, public policy and leadership. [adapted from publisher]

This toolkit provides practical advice to anyone involved in, or who is interested in becoming involved in, performance-based contracting of health services with nonstate providers in the context of developing countries. It addresses many of the issues that may be encountered and provides input from experienced contracting professionals, many of whom contributed to the development of this toolkit. [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]

Research has identified that skilled nurses working in rural and remote locations are crucial for the provision of maternity care to rural parturient women. This study considered the experiences of rural nurses and their contributions to maternity care in rural and remote settings and in the small towns where women might be referred for care surrounding childbirth. [from introduction]

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]