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African Atlas of the Health Workforce

The starting point for this online database was a comprehensive health workforce survey conducted by the WHO Regional Office for Africa in collaboration with WHO department of human resources for health in Geneva in 2004/2005. All 46 member states of the African Region have contributed to this data collection. The data base presented here is the best available information base on the health workforce in the African Region to date and it will be continuously updated. Data is provided for 23 different types of health care cadres, both as total numbers and densities per 1000 population.

Initial Community Perspectives on the Health Service Extension Programme in Welkait, Ethiopia

The Health Service Extension Programme (HSEP) is an innovative approach to addressing the shortfall in health human resources in Ethiopia. It has developed a new cadre of Health Extension Workers (HEWs), who are charged with providing the health and hygiene promotion and some treatment services, which together constitute the bedrock of Ethiopia’s community health system. This study seeks to explore the experience of the HSEP from the perspective of the community who received the service. [from abstract]

Quality of Communication about Older Patients between Hospital Physicians and General Practitioners: a Panel Study Assessment

The main objectives of this study were to assess the quality of the written communication between physicians and to estimate the number of patients that could have been treated at primary care level instead of at a general hospital. [from abstract]

Salud Pública: Objeto de Conocimiento, Prácticas y Formación; Public Health: Knowledge, Practice and Training

This paper presents a discussion regarding public health’s main challenges in Latin America: knowledge of it, professional practice and training human resources. Emphasis is placed on three components: knowledge of public health, social practice and human resources training. [from abstract]

Building Global Alliances III: the Impact of Global Nurse Migration on Health Service Delivery

The issues surrounding nursing shortages and global nurse migration are inextricably linked. The shortage of practicing nurses worldwide has led to aggressive recruiting by healthcare employers in the United States, the United Kingdom, and other countries. Foreign-educated healthcare professionals represent more than a quarter of the medical and nursing workforces of Australia, Canada, the United Kingdom, and the United States. [author’s description]

Chiranjeevi: Involving Private Obstetricians to Reduce Maternal Mortality in Gujarat (India)

This PowerPoint was presented at the 2007 GHC expert panel “Making it Work: Private Sector Partnerships to Improve Women’s Health.” It discusses the challenges, costs and results of a program to use private practitioners for improving maternal and child survival.

Trends and Opportunities in Public-Private Partnerships to Improve Health Service Delivery in Africa

The report, in its first part, destroys three common myths regarding the private health care sector in Africa and discusses how to engage the private sector effectively. It provides examples of successful public-private partnerships and highlights some of the trends in these types of partnerships. [adapated from executive summary]

Building Support for Public Private Partnerships for Health Service Delivery in Africa: Critical Issues for Communication: Results from a Stakeholder Consultation

The World Bank commissioned the Center for Development Communication (CDC) to develop a communication strategy to help boost public-private partnerships in the African continent. CDC consulted with key informants and stakeholders identified by the World Bank’s Public-Private Partnerships (PPP) working group in order to develop a stakeholder analysis to help inform the larger communication strategy. This report summarizes the results of that consultation. [from executive summary]

Addressing Health Worker Shortages: Recruiting Retired Nurses to Reduce Mother-to-Child Transmission in Guyana

When GHARP set out to recruit new service providers [for preventing mother-to-child transmission], it faced a dilemma. Due to the limited supply of health workers in Guyana, the project needed to avoid recruiting health care providers already working for the MOH. Hiring existing health workers away from their jobs would simple reshuffle the distribution of health workers, rather than add new ones. To address the problem, GHARP staff decided to recruit retired nurses to fill the positions. [from author’s description]

Improve Facility Management to Increase Nurse Retention

Both financial and nonfinancial factors influenced the tenure and job satisfaction of nurses at public maternity services in South Africa. Surveys suggest that strong management and fully equipped facilities could help redress staff turnover. [author’s description]

Human Resources for Health: a Gender Analysis

In this paper I discuss gender issues manifested within health occupations and across them. In particular, I examine gender dynamics in medicine, nursing, community health workers and home carers. I also explore from a gender perspective issues concerning delegation, migration and violence, which cut across these categories of health workers. These occupational categories and themes reflect priorities identified by the terms of reference for this review paper and also the themes that emerged from the accessed literature. [from summary]

Equidad de género y calidad en el empleo: Las trabajadoras y los trabajadores en salud en Argentina

Se presentan una serie de recomendaciones de políticas y líneas de investigación que buscan instalar como “campo” de acción y de investigación la producción sistemática de información sobre recursos humanos en salud desde una perspectiva de género. [rusumen]

Global Health Watch: Global Health Worker Crisis

This chapter of the Global Health Watch focuses on the global dimension of health migration, although it recognizes that the agenda for coherent and comprehensive health systems development must place human resources at its centre. [author’s description]

Accelerating Action: a Technical Support Guide to Develop Capacity and to Benefit from Global Health Financing

Section 6, “Developing Human Resources for Health,” describes the dire shortage of human resources in the health systems of low and middle income countries and the special challenges posed by this crisis. It touches on ways of addressing shortages of qualified staff and gives several examples of how countries can use technical support to build stronger a health workforce. [author’s description]

Family Planning - Integrated HIV Services: a Framework for Integrating Family Planning and Antiretroviral Therapy Services

This document focuses on FP integration with HIV services, more specifically with HIV care and treatment services. It encourages supervisors or planners, service providers, and community-based personnel to consider opportunities for operationalizing client-responsive integration of FP and HIV services.

Contribution of International Health Volunteers to the Health Workforce in Sub-Saharan Africa

In this paper, we aim to quantify the contribution of international health volunteers (IHVs) to the health workforce in sub-Saharan Africa and to explore the perceptions of health service managers regarding these volunteers. [from abstract]

Human Resource Management in the Georgian National Immunization Program: a Baseline Assessment

Georgia’s health care system underwent dramatic reform after gaining independence in 1991. The decentralization of the health care system was one of the core elements of health care reform but reports suggest that human resource management issues were overlooked. The Georgian national immunization program was affected by these reforms and is not functioning at optimum levels. This paper describes the state of human resource management practices within the Georgian national immunization program in late 2004. [from abstract]

Tumaini Home-Based Care Program: a Case Study

This case study was conducted to impart a thorough understanding of the Tumaini Home-Based Care Program model and to document lessons learned that could be applied to other initiatives. While the Tumaini program addresses the needs of both people living with HIV and AIDS (PLHA) as well as OVC, the case study focuses particular attention on specific services and program impact for OVC. The program goals were to provide care and support to OVC; to provide care and support to PLHA; Tumaini: Home-Based Care and to build the capacity of local organizations to provide sustainable HBC services. [from

Output-Based Aid in Health: the Argentine Maternal-Child Health Insurance Program

The Argentine Maternal-Child Health Insurance Program uses an interesting approach of combining output-based contracting with an output-based funding mechanism. Particularly innovative is the combination of enrollment numbers and performance indicators as a way to address the trade off between quantity and quality.

Developing a Nursing Database System in Kenya

The objective [of this report is] to describe the development, initial findings, and implications of a national nursing workforce database system in Kenya. [from abstract]

Crossing Borders: International Nurses in the US Workforce

The story of the international nurse in the U.S. workforce is generally one of perserverance - not only in obtaining a visa and a state license, but in adjusting to living and working in the United States. [author’s description]

Towards Better Leadership and Management in Health Working Paper: Report on an International Consultation on Strengthening Leadership and Management in Low-Income Countries

This report is based on deliberations from an international consultation on strengthening leadership and management as an essential component to scaling health services to reach the Millennium Development Goals. The focus was on low-income countries though the principles discussed concerned leadership and management in other settings as well. The report describes a technical framework adopted by the consultation for approaching management development and sets out key principles for sustained and effective capacity building. [author’s description]

What Can Be Done about the Private Health Sector in Low-Income Countries?

In recent years there has been a considerable growth of interest in the activities of providers in the private health sector in low income countries, and in how policy-makers might best capitalize on the accessibility and popularity of this sector. However, the evidence is limited as to which approaches work best. The aim of the present paper is to consider how the activities of the private health sector in low-income countries can be influenced so that they help to meet national health objectives. [from introduction]

Public Sector Doctors with Second Jobs

It is common for doctors working in the public sector to hold second jobs in private practice. Dual medical practice occurs in virtually all countries regardless of income. [author’s description]

Shortages and Shortcomings: the Maternal Health Workforce Crisis

Providing maternal care requires a viable and effective health workforce. In many countries, and certainly in all countries where maternal mortality is high, the size, skills and infrastructure of the workforce is inadequate… Apart from taking urgent corrective action on salaries and conditions, strategic decisions must be made in three areas: training, deployment, and retention of health workers. [author’s description]

Pilfering for Survival: How Health Workers Use Access to Drugs as a Coping Strategy

Coping strategies have, in some countries, become so prevalent that it has been widely assumed that the very notion of civil services ethos has completely – and possibly irreversibly – disappeared. This paper describes the importance and the nature of pilfering of drugs by health staff in Mozambique and Cape Verde, as perceived by health professionals from these countries. Their opinions provide pointers as to how to tackle these problems. [from abstract]

Comparing Maternal Health Services in Four Countries

While the availability and use of trained midwives can shape the quality of care received in pregnancy and childbirth, a number of other underlying health systems structures and processes are important. The management of health workforces, the mix of public and private provision and the impact of reforms affect quality of care across countries…[This study] examined how the structure and operation of a health system influences maternal health care provision and outcomes in Bangladesh, Russia, South Africa and Uganda. [author’s description]

Maternal Health in Sub-Saharan Africa: Tackling the Skills Shortage

Sub-Saharan Africa has the worst rate of maternal ill-health in the world. Maternal deaths occur partly because health systems are inadequately staffed to deal effectively with birth complications. How can maternal health human resources be managed better to ensure that all women, especially in poor, rural areas, can access good quality maternal health care? [author’s description]

Going to Scale with Professional Skilled Care

Because most women prefer professionally provided maternity care when they have access to it, and since the needed clinical interventions are well known, we discuss in their paper what is needed to move forward from apparent global stagnation in provision and use of maternal health care where maternal mortality is high. To increase the supply of professional skilled birthing care, strategic decisions must be made in three areas: training, deployment, and retention of health workers. [from summary]

Productivity Challenge: Developing Approaches to Improve Health Care Worker Efficiency

In countries where available human resources for health (HRH) are insufficient to meet the needs, it is increasingly vital that health workers are supported to do their jobs effectively and efficiently. Health care worker productivity is a key ingredient of quality health services. The benefits of addressing productivity include greater efficiency, reduced workload intensity, increased worker satisfaction and a higher quality of care. [author’s description]