Browse by Resource Type

This paper represents the second phase of a larger study examining health worker motivation in two hospitals in Tbilisi, Georgia. The overall objective of the 360 degree assessment was to begin to identify the major organizational, situational, and individual factors associated with health worker motivation, and to better understand how major constituencies (i.e., managers, supervisors, workers, and patients) perceive the hospital/work environment. Specific objectives of this study component were to: assess congruence between managers, supervisors and workers on perceptions of hospital goals; compare perceptions of hospital and worker characteristics among types of workers (physician, nurse, other) and levels of respondents (managers, supervisors, workers, patients); and identify possible factors for stimulating good performance and possible interventions for enhancing motivation.

This presentation was part of the International Conference on Global Health session, “Answering the Call: Innovations in Human Resources by African Faith-Based Organizations.” From the perspective of the Uganda Catholic Medical Bureau experience, the presentation discusses why the private not-for-profit sector is important in service provision and training; why nurses are in the midst of the human resource crisis; obastacles to increasing the training capacity; and what the PNFP health training institutions are doing to address their weaknesses. [adapted from author]

Poverty and limited health services in rural Africa present barriers to adherence to antiretroviral therapy that necessitate innovative options other than facility-based methods for delivery and monitoring of such therapy. We assessed adherence to antiretroviral therapy in a cohort of HIV-infected people in a home-based AIDS care programme that provides the therapy and other AIDS care, prevention, and support services in rural Uganda. [author’s description]

This study attempted to determine the feasibility of a private sector led long-term intervention to reduce the HIV-infection rate among apparel workers and to provide care and support for those already infected. [author’s description]

This presentation was given at the second annual AAMC Physician Workforce Research Conference, “2020 Vision: Focusing on the Future.” It discusses out migration and brain drain from sub-Saharan Africa and gives an overview of the issues related to this problem, particularly in respect to a project done in Uganda.

Note: This resource is no longer available online

The main objectives of this study in Uganda Catholic Medical Bureau (UCMB) affiliated hospitals were to: assess the
quality of services delivered in accordance to the
available standards; compute staffing requirements for
the hospitals; and set standard workloads for each
type of staff cadre. [from introduction]

Chapter 19 of this report discusses “Palliative Care in Resource-Poor Settings.”

Palliative care is crucial in every care setting, rich or poor, for it is a philosophy of care that centers on improving quality of life for patients and their families. In this chapter, we focus attention on the need to integrate palliative care into national government strategies in order to address the pandemic in resource-poor settings, which includes many developing countries and low-income areas in some industrialized countries. [author’s description]

To identify problems and barriers to [family planning] services specific to each district, to provide data that could assist with project implementation, and to allow determination of benchmarks and targets to measure success, the project started with a baseline assessment of facilities, providers, and community members in the five core districts. The objectives of the assessment were to evaluate factors contributing to the current use of FP services, including: the supply of FP in the public and private sectors: the availability and quality of facilities providing FP services, including the availability of contraceptive methods, IEC materials, and trained providers; and the demand for FP: the population’s knowledge of, attitudes toward, and practice of pregnancy prevention.

In family planning programs, good face-to-face interaction between the client and providers is key to meeting clients’ needs and program goals. Programs can best improve client-provider interaction (CPI) when they move beyond just training providers and strengthen CPI continuously in multiple ways. [summary]

Recent studies have shown evidence of a direct and positive causal link between the number of health workers and health outcomes. Several studies have identified an adequate health workforce as one of the key ingredients to achieving improved health outcomes. This article explores how the Global Fund addresses the challenges of a health workforce bottleneck to the successful implementation of priority disease programmes. [abstract]

In response to increased global public health funding initiatives to HIV/AIDS care in Africa, this study aimed to describe practice models, strategies and challenges to delivering end-of-life care in sub-Saharan Africa. A survey end-of-life care programs was conducted, addressing the domains of service aims and configuration, barriers to pain control, governmental endorsement and strategies, funding, monitoring and evaluation, and research. Both closed and qualitative responses were sought. [author’s description]

Here, we review challenges and approaches to clinical HIV training, and suggest an agenda for implementation research

HIV counselling and testing is a key component of both HIV care and HIV prevention, but uptake is currently low. We investigated the impact of rapid HIV testing at the workplace on uptake of voluntary counselling and testing (VCT). [author’s description]

These guidelines are designed as a practical tool to help businesses implement effective malaria control programmes in order to protect their employees and the surrounding communities. They are also intended to make the case, from social, economic and business perspectives, for businesses to do so. The guidelines provide companies with a framework for choosing suitable malaria control interventions and give detailed information on how employers can initiate and manage these activities. [author’s description]

Many NGOs providing reproductive health (RH) services are facing reductions in donor funding, requiring them to generate more of their own resources. Prosalud, CIES and APSAR, Bolivian NGOs, wanted to build skills in costing and market research to support efforts to improve financial sustainability. Staffs attended a one-week workshop, followed by implementation of three operations research (OR) studies designed to reinforce skills and generate information for decisionmaking. The Prosalud and CIES studies included the calculation of unit cost per service; measurement of client willingness to pay (WTP) higher prices for services, and a market segmentation assessment in selected areas where Prosalud clinics are located.

Presbyterian Church of East Africa (PCEA) Chogoria Hospital is a faith based non-governmental organization providing a wide range of healthcare services. The organization faces a number of challenges related to sustainability: declining donor support (especially for reproductive health services), low cost recovery levels, and increasing poverty levels among its clientele. In response to these concerns, a team from Chogoria Hospital attended a one-week workshop held in Ghana on financial sustainability and developed a small scale operations research project to determine the cost of providing a selected number of reproductive health (RH) services and to evaluate their cost recovery levels.

This paper describes the experiences of three types of programs (government, reproductive health NGO, and women’s health NGO) in Kenya, India, and Guatemala that integrate gender in their work and examines how they integrate gender into programs that improve quality of care and access to care. It should be emphasized that this report does not document whether gender integration results in higher quality and access, but rather documents how gender integration can take place. [author’s description]

Palliative care aims to maximise quality of life and relieve the suffering of patients with life-limiting incurable disease, and to support their families and carers. It is provided through specialist services such as hospices and palliative care teams and in general settings. The HIV/AIDS pandemic and rising cancer rates in Africa have increased the need for well-developed and integrated palliative care services. In sub-Saharan Africa, the concept of palliative care is not well developed and palliative care is largely confined to isolated specialist centres. Services have developed, but in very varied ways. In order to inform future developments, this review aimed to identify and appraise activities, opportunities and evidence of the status of palliative care in Africa.

These training modules and handouts provide the materials to conduct a two day workshop designed to help participants define gender and related concepts; understand the continuum of gender as it relates to integration in projects; understand the six domains of gender and related questions; apply a process for gender analysis to HRH contexts; understand where and how gender can be integrated in HRH country strategies. [adapted from author]

This paper focuses on lessons learned about building quality improvement into service delivery programs. Addressed to the program leaders and donor agencies that allocate resources for service delivery programs, the paper offers guidance on the actions that must take place to improve the quality of reproductive health and child survival programs. This guidance is based on the field experiences of members of the Management and Supervision Subcommittee of the MAQ Initiative. [publisher’s description]

This paper explores the implications and impact of knowledge management on family planning and reproductive health care. Using case studies and illustrative vignettes, the paper highlights the experiences of a number of developing country family planning/reproductive health organizations in integrating knowledge management tools and strategies to improve work processes and outcomes. [publisher’s description]

Using all of the tools in the document will provide a comprehensive assessment of skills and service delivery. Each tool, however, may be used separately or combined with others to create a document appropriate for the content of a specific maternal and newborn health training course. [author’s description]

This document aims to facilitate the development of quality-oriented health sector reforms by providing a clear conceptual framework that can serve as a roadmap for policymakers and senior managers. By taking advantage of opportunities to integrate quality assurance activities into health sector reforms, healthcare leaders can maximize the effectiveness of reform and move toward optimizing health outcomes for the citizens of Latin America and the Caribbean. [author’s description]

There is compelling evidence for the success of the “rural pipeline” (rural student recruitment and rurally based education and professional training) in increasing the rural workforce. The nexus between clinical education and training, sustaining the health care workforce, clinical research, and quality and safety needs greater emphasis in regional areas.

The medical workforce shortage and efforts to maintain the safety and quality of health services are putting acute pressure on the profession. Task transfer or role substitution of medical services is mooted as a potential solution to this pressure. This has the potential to drastically transform the profession. How task transfer will evolve and change medicine depends on the vision and leadership of the profession and a flexible pragmatism that safeguards quality and safety and places patient priorities above those of the profession. [from abstract]

This paper summarizes the importance of improving maternal and reproductive health, the progress made to date and lessons learned, and the major challenges confronting programs today. The paper highlights the progress that some countries, including very poor ones, have made in reducing maternal mortality, but cautions that progress in many countries remains slow. Relying on evidence from the most recent research and survey information, the paper also analyzes the key determinants and evidence on effective interventions for attaining the maternal health MDG. [from abstract]


Section 3 dis

In Thailand, family practice was developed primarily through a small number of self-styled family practitioners, who were dedicated to this professional field without having benefited from formal training in the specific techniques of family practice. In the context of a predominantly hospital-based health care system, much depends on their personal motivation and commitment to this area of medicine. The purpose of this paper is to compare the responsiveness, degree of patient-centredness, adequacy of therapeutic decisions and the cost of care in 37 such self-styled family practices, i.e. practices run by doctors who call themselves family practitioners, but have not been formally trained, and in 37 conventional public hospital outpatient departments (OPDs), 37 private clinics and 37 private hospital OPDs.

The migration of doctors and nurses from Africa to rich countries has raised fears of an African medical brain drain. But empirical research on the issue has been hampered by lack of data. How many doctors and nurses have left Africa? Which countries did they leave? Where have they settled? As part of a larger study of the consequences of the international migration of African health professionals, we compiled a database of the cumulative bilateral net flows of African-born physicians and nurses to the nine most important destination countries. It is the first database of net bilateral migration flows specific to a skilled profession collected systematically for a large number of developing countries.

This paper examines various aspects of the nursing and midwifery workforce in Africa, looking at education and supply systems; recruitment, retention and motivation and career systems. It further investigates attrition from migration and HIV/AIDS, as well as other factors and makes some recommendations on how to move forward using examples of experiences from countries. These experiences, albeit on a small scale, show promise of good results after being scaled up. [author’s description]

Human resources become increasingly relevant in this context. Health human resource (HHR) is currently experiencing a three-fold problem, which encompasses old issues, together with the effects of reform, and the consequences of globalisation. This includes the workforce crisis in nursing which, facing all kinds of difficulties, requires complex in-depth analysis, synergies and alliances in order to ensure quality nursing services.