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One of the resolutions at the RCN’s 2000 Congress expressed concerned at the lack of a universal mechanism to determine safe staffing levels. This reflected widespread concern within the profession about the potential increase in risks to patient safety posed by increased levels of activity, and inadequate levels of nurse staffing, in the NHS. Over the years, there have been many attempts to develop a universally acceptable and reliable formula which will be able to predict the precise nurse staffing levels needed to ensure patient safety. Even if this is not a realistic goal, and the literature on workforce planning suggests that it is not, the Congress resolution provided a timely opportunity to reconsider the important professional and managerial issues associated with setting safe staffing levels.

Many health service managers are familiar with the problem of absenteeism in district hospitals. It affects the running of the hospital and can seriously compromise the quality of care which patients receive. For the purpose of this Kwik-Skwiz absenteeism is defined as staff taking time off that has not been scheduled or staff taking more leave than is necessary or reasonable. Clearly there are many legitimate reasons for taking sick or other types of leave. It is often debatable how much leave is reasonable. It often depends on the pattern and circumstances, rather than the actual total amount of leave that an individual takes. Managers have a responsibility to balance the rights and needs of individual staff members, with the needs of the hospital. High levels of absenteeism, both on the part of individuals or in the whole hospital, are often symptomatic of underlying problems. Addressing these issues can result in lower absenteeism levels that benefits staff, managers and patients. [author’s description]

This document attempts to review the HRH situation in the WHO European Region. Section 2 addresses the problems associated with varying definitions to ensure a common understanding of the issues involved. In section 3, a number of key methodological issues (the relevance of HRH, education, management, regulation, etc.,) are analyzed. Section 4 summarizes the key HRH facts and figures for the region. In conclusion, section 5 describes the way forward and the main EURO policy proposals for supporting member states in this complex sphere. [author’s description]

This Kwik-Skwiz addresses the important area of clinic supervision. This document is aimed at district management teams; clinic supervisors and program managers may find it especially useful. Key areas of effective supervision are presented with the aim of assisting district management teams to critically assess clinic supervision in your district. [author’s description]

This action guide offers practical guidance on creating or expanding HIV/AIDS workplace programs for civil services. Human resource managers, employee welfare managers, medical officers and labor representatives in government ministries and agencies can use the guide to design and develop effective and appropriate HIV/AIDS prevention, care and support programs. Public Sector Workforce is intended to be a basic reference tool. Users can select chapters to assist with specific aspects of an HIV/AIDS program.

The competency-based approach used in JHPIEGO-supported training improves performance by ensuring that trainees go back to their worksites with the knowledge and skills required to provide FP services. Once back at the workplace, however, participants often face constraints that limit their ability to provide quality services. Factors that can affect the performance of the healthcare provider include: job expectations, performance feedback, supplies and equipment, motivation, possessing the knowledge and skills to provide services, and supervision.

This book examines some of the major challenges facing health care professions in Europe and the potential responses to these challenges. The authors document how health care systems in Europe are confronting existing challenges in relation to the health workforce and identify the strategies that are likely to be most effective in optimizing the management of health professionals in the future. [from publisher]

Concern about increasing demand for reproductive health services has led program managers to examine the productivity and costs of existing programs. While all programs can advocate for additional funds from their governments and establish or increase prices for services to clients, often they can also use their existing resources more efficiently. Evidence from reproductive health programs across developing countries suggests that service providers are often underutilized. [author’s description]

JHPIEGO has been working since 1991 to support the development of a national integrated clinical training system used for both family planning/reproductive health (FP/RH) preservice education and inservice training in Turkey.

From 1987 to 1998, JHPIEGO, through its Training in Reproductive Health (TRH) Project, collaborated with the Association of Deans of Philippine Colleges of Nursing (ADPCN) and the Association of Philippine Schools of Midwifery (APSOM) to strengthen preservice nursing and midwifery education in the Philippines. Between 1987 and 1994, JHPIEGO initiated activities to strengthen family planning/reproductive health (FP/RH) and enhance trainer/faculty development in five nursing schools and five midwifery schools.

Beginning in 1992, JHPIEGO worked in close collaboration with the Bolivia Ministry of Health (MOH) to develop an integrated family planning/reproductive health (FP/RH) training network throughout the country. The focus of the assistance was the establishment of nine national training centers (NTCs) for inservice training conducted by physician-nurse teams and located at departmental maternity hospitals in departmental capitals. By 2000, the government of Bolivia and other stakeholders had shifted the training emphasis to preservice education efforts.

JHPIEGO and the United States Agency for International Development/Ghana, has now focused on strengthening preservice education for nurses and midwives who provide FP/reproductive health (RH) and safe motherhood services. The phased strategy will ultimately strengthen preservice classroom and clinical training components in all ten midwifery training schools (MTS) in Ghana. To clarify the needs of the training institutions and guide program planning, two needs assessments were conducted at the MTS in Kumasi and Koforidua.

JHPIEGO’s strategies for strengthening Ghanaian preservice education in family planning/reproductive health and essential maternal and neonatal care have included: developing and implementing a standardized, competency-based curriculum; improving knowledge and skills of tutors and clinical trainers/preceptors; reinforcing service delivery sites used for clinical practice; and providing schools and clinical training sites with anatomic models and supporting training materials. [adapted from author]

WHO, World Bank, and other human resources for health experts globally have recognized the dearth of human resource data for the health sector in many developing countries. In the present assessment, JHPIEGO reviewed the availability of staff deployment and training data from routine information systems in Malawi to inform the Ministry of Health and Population (MOHP) of deficiencies that would need to be addressed in order to better inform the development and ongoing monitoring of deployment and training policies and plans.
[publisher’s description]

This report presents the results of a longitudinal, quasi-experimental study evaluating the introduction and use of COPE and the resulting changes in service quality in two countries, Kenya and Guinea. At the end of a 15-month period, providers’ attitudes, providers’ ability to solve problems, service quality, and client satisfaction were assessed at eight intervention sites and at eight matched control sites, using both qualitative and quantitative methods. [author’s description]

Using the training needs projection methods in the Spectrum Policy Modeling System software module ProTrain, this report estimates the numbers of family planning/reproductive health service providers needed to reach total fertility rate and contraceptive prevalence goals for Malawi from 2001-2007. [adapted from publisher]

COPE, which stands for “client-oriented, provider-efficient” services, is a process that helps health care staff continuously improve the quality and efficiency of services provided at their facility and make services more responsive to clients’ needs. COPE provides staff with practical, easy-to-use tools to identify problems and develop solutions using local resources, and it encourages all levels of staff and supervisors to work together as a team and to involve clients in assessing services. Through COPE, staff develop a customer focus, learning to define quality in concrete terms by putting themselves in their clients’ shoes.

The goal of this paper is to describe the establishment of a self-sustaining Student Learning Center (SLC) employing humanistic anatomical models to aid in the teaching of family planning and reproductive health clinical skills to nursing students in Nepal.

During the past several years there has been a global trend in business and industry to move from training to performance improvement. This paper presents a review of selected performance improvement and training literature that has been helpful to JHPIEGO in identifying issues related to this trend and in shaping our performance improvement strategy. [author’s description]

While the need to measure performance in the field of family planning and reproductive health care FP/RH) is widely recognized, there is no consensus on a standard definition of the term. Consequently, when organizations and projects describe or measure performance, particularly in the context of health worker or program evaluations, the term may be used in ambiguous and confusing or even contradictory ways. [author’s description]

The Malawi Ministry of Health and Population (MOHP) sought the assistance of JHPIEGO to implement a performance and quality improvement (PQI) initiative in infection prevention (IP), as one intervention in response to concerns of healthcare workers and potential healthcare workers regarding the existing risks of exposure to infection with major communicable diseases, especially HIV/AIDS, at the country’s hospitals and other health facilities.

The handbook includes descriptions of the facilitative approach to supervision and the roles and characteristics of facilitative supervisors in involving staff in the QI process, leading staff through change, creating a nonthreatening environment, and helping staff use data for decision making. [publisher’s description]

This publication is for training managers, trainers of health providers, decision-makers, and those who fund and support training actvities. It examines distance learning as an effective training approach for reproductive health providers in developing countries. In addition to describing the components of distance learning, this publication will provide illustrative examples for training health workers, outline steps for starting a distance learning program and suggest additional resources. It will help readers plan and implement effective distance learning. [author’s description]

This report summarizes findings from Phase 2 of a two-phase case study to determine why certain reproductive healthcare facilities in low-resource settings perform better than others. The study examined the characteristics, behaviors, and coping strategies of high-performing reproductive healthcare facilities in Kenya, exploring elements of resilience and factors influencing performance.

The roles that women and men play should guide the ways in which clinic staff assess their clients’ needs and provide care. This edition of The Manager shows how awareness of gender issues can improve the design, mangement, and delivery of health services, and takes you step by step through the process of assessing the influence of gender on organizational management. [editor’s description]

The Performance Improvement approach gives organizations the tools they need to find out which essential components of good performance are missing, and then match interventions to root causes, closing the gaps between the performance they are experiencing and the performance they desire.


This document is in English, French and Spanish.

AVSC defines facilitative supervision as an approach to supervision that emphasizes mentoring, joint problem solving, and two-way communication between the supervisor and those being supervised. This definition recognizes that supervisors play an essential role as intermediaries who can facilitate the implementation of institutional goals and who can facilitate local-level problem solving and quality improvement.

There is a serious human resource crisis in the health sector in developing countries, particularly in Africa. One of the challenges is the low motivation of health workers. Experience and the evidence suggest that any comprehensive strategy to maximize health worker motivation in a developing country context has to involve a mix of financial and non-financial incentives. This study assesses the role of non-financial incentives for motivation in two cases, in Benin and Kenya. [abstract]

This report is designed as a general resource to help family planning program managers strengthen their programs and meet growing family planning needs…It offers a broad overview of key programmatic considerations. Each subsection includes a list of practical specialized resources and hands-on tools that can support program managers desiring to bring about programmatic change…

This presentation was part of the International Conference on Global Health session, “Expanding Emergency Obstetric Care: Overcoming Challenges in Training and Service Delivery.” It discusses the first planned effort by the the largest association of ob/gyns and its academic wing to help build human resource capacity in India to develop EmOC in rural areas. It also presents the specifics of the training EmOC certification course they have developed to address the issue.