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This paper reviews the challenges facing the public health workforce in developing countries and the main policy issues that must be addressed in order to strengthen the public health workforce.

This report examines whether Zambia’s hospital accreditation program improved health outcomes and other indicators. Performed after an accreditation program had been launched in about 40 hospitals, the evaluation examined eight indicators of healthcare quality at hospitals that had and had not been exposed to the accreditation program.

Using Thailand as a case study, this paper aims to explore the potential implications of integrated health system intervention. Within the Thai context, it is argued in this paper that autonomy of a network of public providers, rather than autonomy of individual hospitals, should be encouraged if management of health manpower is to be optimized. [from abstract]

This guide describes the step-by-step process used to create a positive environment on the national level for strengthening medical, nursing, and preservice education, and the steps on the institutional level to improve the existing curriculum and its implementation. Adapted from the World Health Organization’s 2001 document Integrated Management of Childhood Illness (IMCI): Planning, Implementing and Evaluating Pre-Service Education.

Results of a study of human resources and antiretroviral therapy (ART) at 41 sites in 11 countries, presented in three sections: an overview of service delivery models for ART, a more in-depth account of the systems studied and a report of an international workshop on HRH and ART delivery.

This paper reviews several theoretical perspectives to increase understanding of the key determinants of health worker performance, including theories of behavior change, diffusion of innovation, health education, and social influence. The main types of interventions that have been used to encourage health workers to perform in accordance with standards are described, and evidence from empirical research for their effectiveness is summarized. [author’s description]

As a key contribution toward increasing human capacity in national health systems, the Capacity Project is hosting a series of Human Resources for Health (HRH) Action Workshops. The initial workshop—held in Johannesburg in partnership with the United Nations Development Programme/Southern Africa Capacity Initiative (UNDP/SACI)—facilitated the exchange of knowledge and best practices in planning, developing and supporting the health workforce.

The three and one-half day workshop brought together 38 HRH leaders from 11 countries (Kenya, Lesotho, Malawi, Namibia, Rwanda, Sudan, South Africa, Swaziland, Tanzania, Uganda and Zambia).

This paper reviews lessons learned regarding getting decision-makers to recognise the nexus between workforce planning, overall health service development and operational policy; data collection and collation; moving beyond a simple personnel to population ratio approach; and adjusting the model to suit local circumstances. The project has identified some emerging and worrying trends in health workforce development. The need for consistent, sustained technical assistance which reflects long and wide experience in health service development and management is underlined. [abstract]

This pilot study focused on self-identified factors of nursing students who expressed an interest in rural practice post-graduation. The sample included students from the USA and Canada, who were enrolled in graduate and undergraduate programs of nursing, and were attending an international rural nursing conference. [From abstract]

To inform the design and implementation of improved workforce planning systems, a review of healthcare systems and interaction between systems of service delivery and approaches to planning human resources was done in five countries: Australia, France, Germany, Sweden and the United Kingdom. These represent different welfare state regimes, and a range of health systems dominated by national taxation, local taxation and social insurance. [from executive summary]

The aim of the code of practice is to promote high standards of practice in the international recruitment and employment of healthcare professionals. [author’s description]

The Health Sector Policy is the basis of national health planning and the first point of reference for all actors working in the health sector. It sets the health policy objectives, identifies the priority health interventions for meeting these objectives, outlines the role of each level in the health system, and provides guidelines for improved planning and evaluation of activities in the health sector. One of the priority interventions elaborated is Human Resources. [adapted from introduction]

This guide is designed for managers, supervisors, educators, planners, and evaluators. Its purpose is to discuss ways to improve decisions that affect how human resources are used to provide health services. Improved decisions require up-to-date and detailed information about three components of human resources for health: (1) the workforce, (2) the work performed and (3) the work settings. This guide discusses how to establish an information system that links these three components to form a unified model of human resources planning, training, and utilization. [from overview]

Establishing a salary policy is a critical function of human resource administration which serves to support the organization’s most valuable asset, its human resources. A salary policy should be equitable, structured and clearly understood. By following these components of a salary policy and answering the questions posed, an organization can reflect on its past and present salary policy and establish a salary policy that is sound. [author’s description]

African public health care systems suffer from significant brain drain of its health care professionals and knowledge as health workers migrate to wealthier countries. In this paper, the brain drain is defined as both a loss of health workers (hard brain drain) and unavailability of research results to users in Africa (soft brain drain).

To provide good quality health care services, it is important to develop strategies influencing staff motivation for better performance. An exploratory qualitative research was carried out among health workers in two provinces in North Viet Nam so as to identify entry points for developing strategies that improve staff performance in rural areas. [from abstract]

This paper seeks to provide a compelling evidence base to reveal the factors that lead to high turnover and to promote tested responses to retain health workers. The literature researched is presented to support country-level action. [abstract]

Human resources in health care system in sub-Saharan Africa are generally picturing a lack of adequacy between expected skills from the professionals and health care needs expressed by the populations. It is, however, possible to analyse these various lacks of adequacy related to human resource management and their determinants to enhance the effectiveness of the health care system. From two projects focused on nurse professionals within the health care system in Central Africa, we present an analytic grid for adequacy levels. [from abstract]

This report presents findings from a survey of 252 primary health facilities and 30 local governments carried out in the states of Kogi and Lagos in Nigeria in the latter part of 2002. Nigeria is one of the few countries in the developing world to systematically decentralize the delivery of basic health and education services to locally elected governments. Its health policy has also been guided by the Bamako Initiative to encourage and sustain community participation in primary health care services. The survey data provide systematic evidence on how these institutions of decentralization are functioning at the level local—governments and community based organizations—to deliver primary health service.

This paper aims to summarize strategies to solve inequitable distribution of human resources for health (HRH) between urban and rural areas, by using four decades of experience in Thailand as a case study for analysis. [from abstract]

When health care workers participating in training are able to transfer their newly acquired knowledge and skills to their jobs, higher levels of performance and sustained improvements in service delivery are likely to result. A joint publication of PRIME II and JHPIEGO, Transfer of Learning uses a dynamic matrix to outline specific steps for supervisors, trainers, learners and co-workers to follow before, during and after a learning intervention to promote the transfer of learning. PRIME II has also created an interactive website based on Transfer of Learning.

For a health district to function, referral from health centres to district hospitals is critical. In many developing countries referral systems perform well below expectations. Niger is not an exception in this matter. Beyond obvious problems of cost and access this study shows to what extent the behaviour of the health worker in its interaction with the patient can be a barrier of its own. [from abstract]

Academic medicine has the opportunity to improve the quantity and quality of the health workforce as a means of strengthening the broader health system. However, it must address the gender dimensions of enrollment, curriculum, and promotion to have a positive impact on human resources for health around the world. [author’s description]

This document outlines five key areas requiring intervention: human resources planning and capacity building, management of personnel, evidence-based practice, education, and stewardship. It provides a tangible response to resolution WHA54.12, which was adopted by the World Health Assembly in May 2001, and facilitates the achievement of WHO’s four strategic directions as well as the United Nations Millennium Development Goals. The document consists of two sections. Part I introduces the Strategic Directions, Key Result Areas and Objectives with the Expected Results to achieve them.

There has been a lively debate in the media about working conditions in rural South African Hospitals, with a particular focus on staffing and quality of care. From a medical perspective, it has been stated that poorly equipped and managed hospitals, inappropriate training and an excessive workload are significant contributors to the problem. This study was conducted to investigate the experiences of medical practitioners in performing their professional duties in rural district hospitals in the Western Cape. [from abstract]

The purpose of this strategy is to guide the planning, management and development of human resources for health in Eritrea for the period 2006 - 2014. Whilst much progress has been made with the staffing of the health services in the health sector, there is still more work to be done. There is a general shortage of health professionals, particularly amongst more highly skilled groups. Although geographic distribution is relatively good compared to many countries in Africa, there are still health stations and health centres that are under-staffed. There is a major shortage of midwives, exacerbating the high rate of maternal mortality. [from author]

This issue outlines the connections between work climate, employee motivation, and performance. It describes how managers can assess the climate in their work group and shows how they can use the results to make changes in leadership and management practices that will motivate their group to do the best work possible and improve results. [editor’s description]

This WHO strategy aims to set out in clear detail how life-long antiretroviral treatment can be provided to 3 million people living with HIV/AIDS in poor countries by the end of 2005. Core principles include urgency, equity and sustainability. HIV/AIDS has devastated the populations and health services of many developing countries. We must act now. Further, since this magnitude of scaling up HIV/AIDS treatment has never been attempted before, we must learn by doing. [summary from author]

Using incentives and disincentives to direct individuals’ energies and behaviour is common practice in all work settings, of which the health care system is no exception. The range and influence of economic incentives/disincentives affecting community nurses are the subject of this discussion paper. The tendency by nurses to disregard, and in many cases, deny a direct impact of economic incentives/disincentives on their motivation and professional conduct is of particular interest. The goal of recent research was to determine if economic incentives/disincentives in community nursing exist, whether they have a perceivable impact and in what areas.

The Global Alliance for Vaccines and Immunization (GAVI) was established in 1999 to finance and speed the delivery of new and improved vaccines for children in the developing world. Through collaborative leadership and international funding, GAVI aims to improve health in developing countries, increase international public health equity, and serve as a model for others in the global health community. However, this paper questions the extent to which GAVI can actually achieve its goals.