Journal Articles

In a rural village in India, newborn deaths have been halved not by neonatologists or high-tech interventions but by local villagers trained in simple life-saving practices. Some experts, however, are sceptical about whether this strategy can work everywhere. [from author]

The objective of this research is to explore inequities in utilization of skilled attendance at birth, delivery by caesarean sections and use of postnatal care services, by key socioeconomic factors in two home-based SBA areas of Bangladesh to provide insights for future programming. [from introduction]

Despite ample evidence that HIV has entered the general population, most HIV awareness programs in India continue to neglect rural areas. Low HIV awareness and high stigma, fueled by low literacy, seasonal migration, gender inequity, spatial dispersion, and cultural taboos pose extra challenges to implement much-needed HIV education programs in rural areas. This paper describes a peer education model developed to educate and empower low-literacy communities in the rural district of Perambalur in India. [from abstract]

Infectious diseases kill more than 10 million people worldwide every year. It is therefore vital that doctors receive a good education in this field. Online learning is one way in which doctors can learn new knowledge and skills. We conducted this study to determine whether the infectious diseases interactive online learning packages enabled primary care professionals to increase their knowledge and skills in the area of infectious diseases. [from abstract]

The Canadian health care system is one of the places where push comes to pull in terms of attracting health care professionals from sub-Saharan Africa. The authors call this the perverse subsidy: the costs of training these professionals are paid for by poorer people in poorer countries. The pull to Canada is equally a push from Africa. Reflections on a pilot study on a labour mobility issue that is equally a question of conscience. [from author]

This study evaluated biases in guideline untilization of evidence-based practice concerning contraception perscription. It was found that in India, Peru, and Rwanda, health care providers underutilize evidence-based practice guidelines as they prescribe contraceptives. This article ends with recommendations for providers to most effectively utilize evidence-based practice. [adapted from abstract]

Telemedicine is viewed as a new way of offering medical services. It is seen as a means of overcoming the growing shortage of health practitioners in developing countries. The aim of this paper is to highlight the need for the formulation of guidelines for the ethical practice of telemedicine in South Africa. [from abstract]

Within the Southern African prevention of mother to child transmission (PMTCT) programmes, counsellors talk with pregnant mothers about a number of interrelated decisions and behaviour changes. Current counselling has been characterised as ineffective in eliciting behaviour change and as adopting a predominantly informational and directive approach. Motivational interviewing (MI) was chosen as a more appropriate approach to guide mothers in these difficult decisions, as it is designed for conversations about behaviour change. MI has not previously been attempted in this context. This paper reflects on how MI can be incorporated successfully into PMTCT counselling and what lessons can be learnt regarding how to conduct training with counsellors.

Clinical skills and the ability to perform procedures is a vital part of general medicine. Teaching these skills to aspiring doctors is a complex task and it starts with a good theoretical preparation and some practical experience at university. On graduating from university, each doctor is faced with the task of transforming theoretical knowledge into the practical, procedural skills of a competent professional. This study aims to assess the perceptions of intern doctors working in regional hospitals in the Western Cape of their skills training both at undergraduate level and during the intern year.

The first study of the Australian hospital pharmacy workforce (public and private hospitals) was undertaken in 2001. Data from this study provided a baseline and were used to estimate the future demand for hospital pharmacists. This article summarizes an update of this survey done in 2003. [adapted from author]

Following health sector reform, Ethiopia started training new categories of health workers. This study addresses students’ perspectives regarding their training and career plans. This study suggests that the current training programs have serious inadequacies that need to be addressed. [from abstract]

Training in communication skills for health professionals is important, but there are substantial barriers to individual in-person training for practicing clinicians. This study evaluated the feasibility and desirability of online training and sought suggestions for future courses. [adapted from abstract]

The objective of this study was to assess whether traditional birth attendants, drug-shop vendors, community reproductive-health workers, or adolescent peer mobilizers could administer intermittent preventive treatment (IPTp) for malaria with sulfadoxine-pyrimethamine to pregnant women. The study concludes that the use of the guideline with adequate training significantly improved correctness of malaria treatment with chloroquine at home. Adoption of this mode of intervention is recommended to improve compliance with drug use at home. The applicability for deploying artemisinin-based combination therapy at the community level needs to be investigated.

Many Nigerian children with malaria are treated at home. Treatments are mostly incorrect, due to caregivers’ poor knowledge of appropriate and correct dose of drugs. A comparative study was carried out in two rural health districts in southwest Nigeria to determine the effectiveness of a guideline targeted at caregivers, in the treatment of febrile children using chloroquine. [from abstract]

Gender issues are important to address during medical education, however research about the implementation of gender in medical curricula reports that there are obstacles. The aim of this study was to explore physician teachers’ attitudes to gender issues. [from abstract]

This article discusses the implementation of training programmes in field epidemiology as a strategy for improving the number and quality of health workers. [adapted from abstract]

The purpose of this study was to assess physicians’ knowledge, attitude and global comfort in caring for patients with AIDS (PWA), to determine the sociodemographic variables that could influence physicians and to identify any relationship between their knowledge, attitude and comfort. The study reinforced the need for an ongoing education focused on experiential learning and professional socialization in order to influence physicians’ attitude and enhance their feeling of comfort when caring for PWA. [adapted from abstract]

This article describes an intervention for training traditional birth attendants and integrating them into an improved health care system, which was proven to be achievable and effective in reducing perinatal mortality. This model could result in large improvements in perinatal and maternal health in developing countries. [adapted from abstract]

In the rural areas of sub-Saharan Africa, the majority of young children affected by malaria have no access to formal health services. Home treatment through mothers of febrile children supported by mother groups and local health workers has the potential to reduce malaria morbidity and mortality. [from author]

This article describes the experience of Guatemalan students at Cuba’s Latin American Medical School. The students’ education emphasizes health problems and diseases characterizing the epidemiological situation in their home country and in-depth courses in disaster management, as well as clinical experience in Guatemala. [adapted from author]

This article describes the efforts within the Cuban medical system to collaborate with health authorities around the globe to develop medical education programs to train such urgently-needed professionals with curricula formulated to meet international standards and local health needs. Special emphasis is placed on the assistance that Cuba provided to Gambia in establishing a medical school in that country. [from author]

This article describes the Cuban medical education system. The role of Cuban physicians internationally is discussed, as well as the placement of international students in Cuban medical schools.

The world’s 1,691 medical schools and 5,492 nursing schools are not producing enough graduates to cover the massive global deficit of doctors, nurses, and midwives. One scaling-up initiative addressing these critical shortages is Cuba’s Latin American Medical School. This article describes those efforts. [adapted from introduction]

The Institute of Medicine’s Academy of Science has recommended that medical schools incorporate information on CAM (complementary and alternative medicine) into required medical school curricula so that graduates will be able to competently advise their patients in the use of CAM. The report states a need to study models of systems that integrate CAM and allopathic medicine. The authors present Cuba’s health care system as one such model and describe how CAM (or natural and traditional medicine) is integrated into all levels of clinical care and medical education in Cuba. The authors conclude that there is much to learn from the Cuban experience to inform U.S.

This article discusses the development of a decision framework to assist policymakers in choosing and designing effective incentive systems. The researchers identified several models that have proven to be effective in changing or enabling a health provider’s performance.

This article is an overview of the major HRH issues facing the health system in Zambia, including out-migration, an outdated medical-training infrastructure, faulty government management, and the effects of HIV/AIDS.

This editorial describes the widespread recruitment of health workers from sub-Saharan Africa to developed nations by recruiting agencies. The authors describe international efforts to criminalize this practice and express concern at the continued practice of recruitment.

This article describes the efforts of the Indian government to decrease maternal mortality by improving birthing conditions. The scheme created a partnership with the private sector and an NGO to provide free birth care to poor families through contracts with private obstetricians practicing in rural areas. The authors conclude that public-private partnerships can rapidly scale up the availability of human resources for skilled birth-attendance and emergency obstetric care to the poor in a very short time. [adapted from author]

This article outlines the challenges facing the surgical workforce in Africa. Funding priorities in Africa typically favor infectious diseases, and surgery and perioperative care have been neglected, even though essential surgical care at district hospitals is more cost effective than some other highly prioritized interventions, such as antiretroviral therapy for HIV. There is a need to integrate surgical and anesthetic training programs so health personnel, particularly in rural areas, can treat the full range of diseases appropriate to that level of care. [adapted from author]

This article discusses the requirements for improving the experience of health care workers in fragile states. Efforts are needed to establish performance-management systems, to support promotion based on merit, and to provide wider opportunities for professional development. These efforts must be accompanied by measures to restructure the workforce (in some cases radically), thus matching staffing levels with agreed norms and to redress imbalances between rural and urban areas and between different levels within the system. [adapted from author]