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Improving Quality, Increasing Access to Reproductive Health Care in African Urban Slums

JHPIEGO has been focused on improving the quality and availability of reproductive health and family planning services for slum residents, both by targeting the facility-based health care providers and the community members who access these services. This document outlines several lessons that have been learned from this experience. [adapted from author]

Men’s Reproductive Health Curriculum

This three-part curriculum is designed to provide a broad range of health care workers with the skills and sensitivity needed to work with male clients and provide men’s reproductive health services. [from author]

Decentralization of Postabortion Care in Senegal and Tanzania

In developing countries, postabortion care (PAC) programs are frequently available only in urban or regional health facilities, placing rural women at greater risk for mortality and morbidity from complications because they lack access to services. This technical brief evaluates efforts to decentralize PAC activities in Senegal and Tanzania that show PAC can be safely and successfully decentralized with services capably provided by mid-level personnel in health centers, dispensaries, and some health posts when providers are trained and supervised and equipment and supplies are available.

Decentralization and Governance in Health

This paper presents some of the basic governance issues related to decentralization and some examples of how projects and donor policies have contributed to more effective decentralization processes. [from author]

Global Atlas of the Health Workforce

The World Health Organization (WHO) has been collecting and compiling cross-nationally comparable data on health workers in all WHO Member States. The data available in the Global Atlas of the Health Workforce is the main outcome of this effort. Estimates of the stock (absolute numbers) and density (per 1000 population) of the health workforce are available here for 193 Member States. National-level data refer to the active health workforce, that is, all persons currently participating in the health labour market. [adapted from publisher]

Susan's Story: Keeping Secrets and Promoting Family Planning in Rural Kenya

This Voices discusses the experiences of nurse hired through the Emergency Hiring Plan in Kenya in providing family planning services, and the importance of confidentiality in the successful provision of these services.

Human Resources for Maternal Health: Multi-Purpose or Specialists?

In this paper we review the current situation of human resources for maternal health as well as the problems that they face. We propose seven key areas of work that must be addressed when planning for scaling up human resources for maternal health in light of MDG5, and finally we indicate some advances recently made in selected countries and the lessons learned from these experiences. [from abstract]

Human Resources for Health: Overcoming the Crisis

This article summarizes the Joint Learning Initiative report that analyzes the global workforce, which proposes mobilization and strengthening of human resources for health is central to combating health crises in some of the world’s poorest countries and for building sustainable health systems in all countries. [adapted from author]

What Sort of Stewardship and Health System Management is Needed to Tackle Health Inequity, and How Can It Be Developed and Sustained

This paper argues that stronger and values-based public sector management and leadership is essential in building health systems that better address health inequities. It identifies the particular competencies of public sector managers and reviews evidence on how these competencies can be developed. Renewing the values base of public health system managers and professionals is an important requirement. [from summary]

Task Shifting: Successes from Mozambique and Rwanda

These reports demonstratre that non-physician clinicians and nurses can take over many of the tasks in providing HIV care and treatment (including ART) in some resource-limited settings. [from author]

Task Shifting

This article defines the concept of task shifting, outlines the World Health Organization’s “Treat, Train, Retain’s” recommendations and guidelines on task shifting, gives case study examples of how task shifting can be used, defines the remaining barriers and suggests the conditions necessary for the success of task shifting.

Improving Human Resources for Health while Scaling Up ARV Access in Ethiopia and Malawi

In the space of just a few years, close to 300,000 people with HIV have been put onto ART in Ethiopia and Malawi - two of the countries most severely affected by the human resources for health crisis. But while some might suggest that such a rapid scale-up could only have come at the expense of other general health services, Ethiopia and Malawi performed this remarkable feat using HIV/AIDS funding and technical support to launch ambitious and comprehensive human resource plans to strengthen their health sectors overall. [from author]

Effectiveness of a Nurse-Led Case Management Home Care Model in Primary Health Care: a Quasi-Experimental, Controlled, Multi-Centre Study

Demand for home care services has increased considerably, along with the growing complexity of cases and variability among resources and providers. Designing services that guarantee co-ordination and integration for providers and levels of care is of paramount importance. The aim of this study is to determine the effectiveness of a new case-management based, home care delivery model which has been implemented in Andalusia (Spain). [from abstract]

Community-Based Newborn Care: Are We There Yet?

The evidence base for strategies and interventions for newborn care in community settings has substantially improved, with a range of interventions that can be potentially packaged for delivery at different times during pregnancy, childbirth, and after birth, through various health-care providers. More recently, efficacy trials in representative rural settings have added to the evidence base. Such studies used innovative approaches with community health workers and varied preventive and treatment interventions. [from author]

12 Steps for Creating a Culture of Retention: a Workbook for Home and Community-Based Long-Term Care Providers

All long-term care agencies struggle to find and keep sufficient, reliable, and skilled staff capable of meeting client needs and providing great quality care. This workbook offers 12 concrete steps to guide agencies in developing excellent recruitment, selection and retention practices

Training of Front-Line Health Workers for Tuberculosis Control: Lessons from Nigeria and Kyrgyzstan

This article compares the quality, quantity and distribution of tuberculosis physicians, laboratory staff, community health workers and nurses in Nigeria and Kyrgyzstan, and highlights implications for (re)training tuberculosis workers in developing countries. [from abstract]

Healthy Timing and Spacing of Pregnancy: a Trainer's Reference Guide

This guide is a resource for trainers in developing in-service training for facility-based healthcare providers and community health workers (CHWs) who already have some basic experience with and understanding of RH/FP. This is not a training manual, but a reference guide which can be used and adapted by trainers based on whether or not trainees are facility-based or community-based. [from author]

Right to Health and Health Workforce Planning: a Guide for Government Officials, NGOs, Health Workers and Development Partners

The purpose of this guide is to explain why it is necessary to ground health workforce planning in human rights, and how to develop a plan that does just that. [from summary]

Task Shifting in Health Care in Resource-Poor Countries

There is good evidence and compelling logic to support the principle of task shifting

Incentives for Retaining and Motivating Health Workers in Pacific and Asian Countries

The objectives of this paper are to highlight the situation of health workers in Pacific and Asian countries to gain a better understanding of the contributing factors to health worker motivation, dissatisfaction and migration; examine the regional and global evidence on initiatives to retain a competent and motivated health workforce, especially in rural and remote areas; and suggest ways to address the shortages of health workers in Pacific and Asian countries by using incentives. [from abstract]

Guidelines for Practitioners of Community-Based Worker Systems

The purpose of these guidelines is to assist practitioners and implementing partners to run Community-Based Worker (CBW) systems more effectively, maximising impacts for clients of the service, empowering communities, empowering the CBWs themselves, and assisting governments to ensure that services are provided at scale to enhance livelihoods. The guidelines focus on how to run the CBW system rather than technicalities around HIV/AIDS or natural resources issues. [from introduction]

Health Worker Recruitment and Deployment Process in Kenya: an Emergency Hiring Program

Despite a pool of unemployed health staff available in Kenya, staffing levels at most facilities were only 50%, and maldistribution of staff left many people without access to antiretroviral therapy. Because in the current system it takes one to two years to fill vacant positions, even when funding is available, an emergency approach was needed to fast-track the hiring and deployment process. A stakeholder group was formed to bring together leaders from several sectors to design and implement a fast-track hiring and deployment model that would mobilize 830 additional health workers.

Health Workforce in Bangladesh: Who Constitutes the Healthcare System?

The report aims to document the present health workforce in the country in order to find out their strengths and weaknesses and put forward recommendations for improvement. It lays special emphasis on the profile and density of healthcare providers, quality of services provided by selected groups of providers, training, and production and future challenges for healthcare providers. [adapted from author]

Strengthening Management Capacity

Managers are an essential component of the health workforce. Good management is essential for quality service delivery and achieving desired health outcomes. This resource details a balanced, strategic approach to strengthening management capacity. [from introduction]

Emergency Preparedness and Public Health Systems: Lessons for Developing Countries

Improving the capacity of developing countries to respond to emerging diseases and especially influenza pandemics is essential to reduce both transmission around the globe and the human toll of outbreaks in the developing world. Investing in this capacity in developing countries is thus increasingly seen as a shared concern within the global community. [from introduction]

Male Circumcision for HIV Prevention: a Prospective Study of Complications in Clinical and Traditional Settings in Bungoma, Kenya

Prior to implementing male circumcision as a public health measure against the spread of HIV, the feasibility, safety and costs of the procedure within target countries should be evaluated to understand what measures need to be taken to ensure access to safe, affordable voluntary circumcision services. The aims of this study were to assess variation and safety of male circumcision practices, as well as resource and training needs related to the procedure, in a community that has been practicing circumcision traditionally for many generations. [from introduction]

Extension Workers Drive Ethiopia's Primary Health Care

Thousands of community workers are helping Ethiopia to deliver primary health-care services to people living in rural areas. However, critics say that the training these workers receive is not adequate for them to attend many of the health problems they encounter. [from introduction]

Sudanese Physicians' Reintegration Program

This article describes the achievements of 11 Sudanese-Canadian physicians who completed medical training and returned to Southern Sudan to practice. Few internationally educated physicians are prepared to return to a homeland as challenging as Southern Sudan; this goes against the globally entrenched flow of physicians migrating from developing to developed countries. [from introduction]

Innovations in Rwanda’s Health System: Looking to the Future

This report describes three health system developments introduced by the Rwandan government that are improving these barriers to care

Shortage of Personnel Hurting Delivery of Anaesthesia in Africa

Most children undergoing surgery in Kenya are anaesthetised by clinical officers or anaesthetists with minimal training in paediatric anaesthesia. This article details the statistics of how this personnel shortage impacts anaesthesia delivery. [from introduction]