Journal Articles

Medical education in Saudi Arabia is facing multiple challenges, including the rapid increase in the number of medical schools over a short period of time, the influx of foreign medical graduates to work in Saudi Arabia, the award of scholarships to hundreds of students to study medicine in various countries, and the absence of published national guidelines for minimal acceptable competencies of a medical graduate. We are arguing for the need for a Saudi national medical licensing examination that tests the basic science and clinical knowledge and the clinical skills and attitudes.

The use of private health care providers in low- and middle-income countries is widespread and is the subject of considerable debate. We review here a new model of private primary care provision emerging in South Africa, in which commercial companies provide standardized primary care services at relatively low cost. [from abstract]

The motivation for this study was to investigate how role stress among nurses could affect their job satisfaction and organizational commitment, and whether the job rotation system might encourage nurses to understand, relate to and share the vision of the organization, consequently increasing their job satisfaction and stimulating them to willingly remain in their jobs and commit themselves to the organization. [from abstract]

Since the early 1990s Indonesia has attempted to increase the level of skilled attendance at birth by placing rural midwives in every village in an effort to reduce persistently high levels of maternal mortality. Yet evidence suggests that there remains insufficient incentive to ensure an equal distribution across areas while the poor in all areas continue to access skilled attendance much less than those in richer groups.

Through an analysis of focus group discussion data, we examine Kenyan traditional birth attendants’ accounts of the persistence of homebirths and the key challenges they present. [from abstract]

In response to recent findings regarding migration of health workers out of Africa, we provide data from a survey of Indian nurses suggesting that up to one fifth of the nursing labour force may be lost to wealthier countries through circular migration. [abstract]

The objective of this article is to determine the stock of human resources for health in 15 districts, their service status and primary place of work. It also assesses the effect of decentralization on management of human resources and the implications for the future. [from abstract]

This document discusses China’s long struggle with rural coverage for health care through the barefoot doctors program, which was introduced as a national policy focused on quickly training paramedics to meet rural needs. [adapted from author]

In recent years, some efforts have been made at developing systems for assessing performance and generating information to assist in the distribution of resources in the health sector. However, most of these measurements have focused on the implementation of services and the intermediate steps that determine how inputs are transformed into outputs. This document uses available information to estimate the cost of providing service and workload analysis in order to provide a picture of efficiency in the delivery of services. [from introduction]

This report concludes that assigning nurses to community locations where they provide basic curative and preventive care substantially reduces childhood mortality and accelerates progress towards attainment of the child survival MDG. The research in Navrongo demonstrates that affordable and sustainable means of combining nurse services with volunteer action can accelerate attainment of both the International Conference on Population and Development agenda and the MDGs. [from summary]

Increased immunization coverage is an important step towards fulfilling the Millennium Development Goal of reducing childhood mortality. Recent cross-sectional and cross-national research has indicated that physician, nurse and midwife densities may positively influence immunization coverage. However, little is known about relationships between densities of HRH and vaccination coverage within developing countries and over time. This study examines HRH densities and coverage of the Expanded Program on Immunization (EPI) in Turkey from 2000 to 2006. [from abstract]

The purpose of this survey was to identify nurses' perceived challenges in implementing a community-based TB program in the Omaheke region of Namibia. The HIV pandemic has increased the number of TB patients and increased nurses' workloads, aggravating the burden of TB as a resurgent disease in this region. In order to implement a successful community-based TB program, the patient-related, access-related and knowledge-related challenges, perceived by the nurses, need to be addressed effectively. [from abstract]

A community health planning and service strategy was started in Ashanti region in 2001 with the intention of improving geographic access to comprehensive health care. The region used community-based surveillance as an entry point. The implementation process and health outcomes were tracked and evaluated after a year. [from summary]

It is well-recognised that medical students whose training exposure is largely limited to tertiary-level training hospitals may be inappropriately equipped to deal with the most relevant health issues affecting rural communities. This article evaluated the perceived educational value of a 2 week clinical rotation undertaken by senior undergraduate medical students at rural district hospitals and health care centers in the Western Cape Province, South Africa. [from abstract}

This is the first study to systematically review the available published literature describing innovative models of comprehensive primary health care (PHC) in rural and remote Australia since the development of the first National Rural Health Strategy (1993-2006). The study aimed to describe what health service models were reported to work, where they worked and why. [from abstract]

Despite progress in developing more effective training methodologies, training initiatives for health workers continue to experience common pitfalls that have beset the overall success and cost-effectiveness of these programs for decades. These pitfalls are now seen as aggravating the current crisis in human resources for health and impeding the effective scale-up of training and the potential impact of promising strategies such as task shifting to address health worker shortages.

While evaluation is, in theory, a component of training programmes in health planning, training needs in this area remain significant. Improving health systems necessarily calls for having more professionals who are skilled in evaluation. This article describes a four-week course taken by two cohorts of health professionals from 11 francophone African countries. We discuss how the course came to be, its content, its teaching processes and the master’s programme results for students. [from abstract]

The overall human resource shortages and the distributional inequalities in the health workforce in many developing countries are well acknowledged. However, little has been done to measure the degree of inequality systematically. This paper describes and measures health worker distributional inequalities in Tanzania on a per capita basis; and it suggests and applies additional health care needs indicators in the measurement of distributional inequalities. [adapted from abstract]

The Central America Field Epidemiology Training Program (CA FETP) is a public health capacity-building training programme aimed at developing high-caliber field epidemiologists at various levels of the public health system. The curriculum is competency-based, and is divided into a three-tiered training pyramid that corresponds to the needs at the local, district and central levels of the health system.[adapted from abstract]

Strong leadership and management skills are crucial to finding solutions to the human resource crisis in health. Health professionals and human resource (HR) managers worldwide who are in charge of addressing HR challenges in health systems often lack formal education in leadership and management. The Virtual Leadership Development Program is a web-based leadership development program that combines face-to-face and distance learning methodologies to strengthen the capacity of teams to identify and address health challenges and produce results. [adapted from abstract]

The two main objectives of this study were to examine aspects of the acculturation of overseas-born and Australian-trained health professionals in the Australian health discourse and identify key coping strategies used by them when in working in the rural context. [from abstract]

The preclinical years of undergraduate medical education provide educational content in a structured learning environment whereas clerkships provide clinical training in a more experiential manner. Although early clinical skills training is emphasized in many medical schools, students still feel unprepared and anxious about starting their clerkships. This study identifies the skills medical students perceive as essential and those skill areas students are most anxious about prior to starting clerkship rotations. [from abstract]

The current global tuberculosis (TB) epidemic has pressured health care managers, particularly in developing countries, to seek for alternative, innovative ways of delivering effective treatment to the large number of TB patients diagnosed annually. One strategy employed is direct observation of treatment for all patients. In high-burden settings innovation with this strategy has resulted into the use of lay community members to supervise TB patients during the duration of anti-TB treatment.

This paper provides a review of the reported barriers that prevent doctors from managing HIV infected patients. The four most commonly reported barriers were: fear of contagion, fear of losing patients, unwillingness to care, and inadequate knowledge /training about treating HIV patients. [from abstract]

The International Council of Nurses expressed concerns regarding the aggressive international recruitment of nurses and maintained that internationally recruited nurses might be particularly at risk of exploitation or abuse. The purpose of this study was to explore and describe how recruitment agencies contributed to the emigration of South African nurses. [adapted from abstract]

The global shortage of nurses, creating opportunities for South African nurses to work in foreign countries, as well as a variety of factors related to nursing, health care and the general living conditions in South Africa influence nurses’ decisions to emigrate. The purpose of this study was to explore and describe the factors that influence nurses’ decisions to emigrate. [from abstract]

This qualitative study was undertaken to explore and describe the experiences of professional nurses in their relationships with nurse managers. [from abstract]

This cross-sectional study assessed knowledge and utilization of the partograph, an effective tool for monitoring labour that can prevent prolonged or obstructed labour, among health care workers in southwestern Nigeria. [adapted from author]

The development of educational context around free and open-source materials available on the Internet has the ability to help build public health capacity in low- to middle-income countries. In a partnership across the global and digital divides, the People’s Open Access Education Initiative has been established to identigy open-access materials linked to the competences required to tackle public health problems, teach through online facilitation by volunteers in conjunction with members of local universities, and accredit learned competences. [adpated from abstract]

The global burden of disease falls disproportionately upon the world’s low-income countries, which are often struggling with weak health systems. Both the public and private sector deliver health care in these countries, but the appropriate role for each of these sectors in health system strengthening remains controversial. This debate examines whether the private sector should step up its involvement in the health systems of low-income countries. [from author]