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This material looks in detail at the preparation of a Nursing Act and is designed to offer guidance on the process of turning policy change in nursing into meaningful and effective legislation. This document has been prepared primarily to assist countries/jurisdictions who are either preparing legislation relating to nursing for the first time, or revising their existing legislation. It is intended to be used by nursing professionals who may not be familiar with the process of making or changing legislation.

The International Nurses Day Kit celebrates and illuminates the nursing role in primary health care. It is for nurses, planners, policy makers, educators, managers, regulators, researchers, national nurses associations and any other stakeholder committed to delivering quality care and serving communities through primary health care. The report analyse the evolution of primary health care, articulates nursing roles, highlights many examples of nurses delivering primary health care and provides a glimpse into the future. [adapted from introduction]

The success of primary health care programmes in Thailand over the past three decades can be attributed not only to medical advances but to the role of community health volunteers. Buddhist monks and their temples have been strongly involved in health promotion and education, particularly in remote, rural communities. [from introduction]

This article is an overview of the major HRH issues facing the health system in Zambia, including out-migration, an outdated medical-training infrastructure, faulty government management, and the effects of HIV/AIDS.

This editorial describes the widespread recruitment of health workers from sub-Saharan Africa to developed nations by recruiting agencies. The authors describe international efforts to criminalize this practice and express concern at the continued practice of recruitment.

This article describes the efforts of the Indian government to decrease maternal mortality by improving birthing conditions. The scheme created a partnership with the private sector and an NGO to provide free birth care to poor families through contracts with private obstetricians practicing in rural areas. The authors conclude that public-private partnerships can rapidly scale up the availability of human resources for skilled birth-attendance and emergency obstetric care to the poor in a very short time. [adapted from author]

This article outlines the challenges facing the surgical workforce in Africa. Funding priorities in Africa typically favor infectious diseases, and surgery and perioperative care have been neglected, even though essential surgical care at district hospitals is more cost effective than some other highly prioritized interventions, such as antiretroviral therapy for HIV. There is a need to integrate surgical and anesthetic training programs so health personnel, particularly in rural areas, can treat the full range of diseases appropriate to that level of care. [adapted from author]

This article discusses the requirements for improving the experience of health care workers in fragile states. Efforts are needed to establish performance-management systems, to support promotion based on merit, and to provide wider opportunities for professional development. These efforts must be accompanied by measures to restructure the workforce (in some cases radically), thus matching staffing levels with agreed norms and to redress imbalances between rural and urban areas and between different levels within the system. [adapted from author]

This article identifies human resources for health policy options in low and middle income countries, and assesses the effectiveness of these policy options. The authors conclude that there is a need for more systematic reviews on the effects of policy options to improve human resources for health in countries with low and middle incomes, for assessments of any interventions that policy makers introduce to plan and manage human resources for health, and for other research to aid policy makers in these countries. [adapted from author]

This article investigates pay structures for health workers in the public sector in sub-Saharan Africa; the adequacy of incomes for health workers; the management of public- and private-sector pay; and the fiscal and macroeconomic factors that impinge on pay policy for the public sector. The study finds that pay and income of health workers varies widely, whether between countries, by comparison with cost of living, or between the public and private sectors. To optimize the distribution and mix of health workers, policy interventions are needed. Fiscal constraints to increased salaries might need to be overcome in many countries, and non-financial incentives improved. [adapted from summary]

This article outlines different efforts at making strategic HRH plans in the developing world. The article focuses on the financial aspects of HRH planning and provides some general guidelines on the best way to make these plans.

This report describes how the war in Iraq and its aftermath continue to have a disastrous impact on the physical and mental health of the Iraqi people, and the urgent measures needed to improve health and health services. It assesses the current state of the health system, including the impact of insecurity, and the workforce, supplies, medicines and equipment it lacks. It also looks at health information and health policy in Iraq. The report ends with conclusions and recommendations, exploring what needs to happen now in Iraq and what lessons can be learned. [adapted from author]

Management Sciences for Health has developed an approach to helping managers become more like coaches, which has proven successful in various settings. This issue of the eManager will help you examine your managerial practices and give you the tools to expand your role from manager to manager as coach.

To understand how the private health sector might better complement Africa’s public health systems, we studied the health care sectors of 45 sub-Saharan African countries. The findings suggest opportunities for private enterprise to help improve the region’s woefully poor health outcomes.

The original purpose of the ADHA scheme was to compensate doctors for hours worked beyond the standard 40 hours per week or 160 hours per month. This study investigated how the scheme impacted a number of human resources (HR) factors associated with health worker recruitment, deployment, retention and performance - specifically, how the significantly higher income levels resulting from the ADHA scheme influenced job satisfaction, motivation, workplace climate and the relationship between clinical and administrative staff, as well as productivity. The study provides a detailed chronology of the ADHA scheme and explores lessons learned from the way in which the GOG implemented and administered the scheme.

This presentation was given at the First Forum on Human Resources for Health in Kampala. It defines health leadership and management, why strengthening it is important, the lessons learned so far, and the main components and uses of the WHO framework. [adapted from author]

This presentation was given at the First Forum on Human Resources for Health in Kampala. It covers the imbalance in physician deployment in Ethiopia and the lottery system for ensuring coverage in rural areas.

This presentation was given at the First Forum on Human Resources for Health in Kampala. It details the financial issues involved in scaling up health worker training such as the cost of hiring additional staff, educating health workers and expanding training capacity. It also outlines the current and possible future sources of increasing expenditure for health worker training. [adapted from author]

This presentation was given at the First Forum on Human Resources for Health in Kampala. It reviews a study of how Rwanda, faced with constrained fiscal conditions, has implemented innovative reforms to create fiscal space for human resources and to make these resources more responsive to needs through an analysis of budget documents and policy and regulation changes and key informant interviews. [adapted from author]

This presentation was given at the First Forum on Human Resources for Health in Kampala. It talks about goverment spending policies on health worker wages and how they affect the health workforce.

This presentation was given at the First Forum on Human Resources for Health in Kampala. It breaks down current health spending including HRH resource needs and gaps, provides a critical assessment of HRH financing by some of the top donors and addresses campaiging for adequate and sustained donor financing. [adapted from author]

This presentation was given at the First Forum on Human Resources for Health in Kampala. It presents five questions on the financial concerns of scaling up the number of health workers to provide adequate health care.

This presentation was given at the First Forum on Human Resources for Health in Kampala. It describes a study to identify the level of satisfaction and intent to stay among health workers and effort to develop strategies to improve retention. [adapted from author]

This presentation was given at the First Forum on Human Resources for Health in Kampala. It describes a study done to analyze health worker perceptions of renumeration and determine the factors that affect the mobility of the health workforce in Burkina Faso

This presentation was given at the First Forum on Human Resources for Health in Kampala. It discusses the Zambia Health Workers Retention Scheme, an incentive program targeting key health worker cadres primarily in rural district to decrease attrition rates of critical service providers. [adapted from author]

This presentation was given at the First Forum on Human Resources for Health in Kampala. It outlines HRH in the eastern Mediterranean region, trends in international nurse migration, and the Lebanese context. [adapted from author]

This presentation was given at the First Forum on Human Resources for Health in Kampala. It outlines the Philippine’s HRH Master Plan to develop and install HHRMD systems that will support Philippine health sector reforms to improve health outcomes. [adapted from author]

This presentation was given at the First Forum on Human Resources for Health in Kampala. It details a study done to assess the feasibility and interest among stakeholders in the Netherlands, UK and US in facilitating recruitment and placement of foreign health care professionals to work in public sector health care in South Africa. [adapted from author]

This presentation was given at the First Forum on Human Resources for Health in Kampala. It discusses the situtation of rural health workers citing Mali and Madagascar as examples.

This presentation was given at the First Forum on Human Resources for Health in Kampala. It outlines the micro-economics of health worker behaviour and discusses a study done to evaluate migration in Ghana.