Journal Articles

This article identifies human resources for health policy options in low and middle income countries, and assesses the effectiveness of these policy options. The authors conclude that there is a need for more systematic reviews on the effects of policy options to improve human resources for health in countries with low and middle incomes, for assessments of any interventions that policy makers introduce to plan and manage human resources for health, and for other research to aid policy makers in these countries. [adapted from author]

This article investigates pay structures for health workers in the public sector in sub-Saharan Africa; the adequacy of incomes for health workers; the management of public- and private-sector pay; and the fiscal and macroeconomic factors that impinge on pay policy for the public sector. The study finds that pay and income of health workers varies widely, whether between countries, by comparison with cost of living, or between the public and private sectors. To optimize the distribution and mix of health workers, policy interventions are needed. Fiscal constraints to increased salaries might need to be overcome in many countries, and non-financial incentives improved. [adapted from summary]

This article outlines different efforts at making strategic HRH plans in the developing world. The article focuses on the financial aspects of HRH planning and provides some general guidelines on the best way to make these plans.

Management Sciences for Health has developed an approach to helping managers become more like coaches, which has proven successful in various settings. This issue of the eManager will help you examine your managerial practices and give you the tools to expand your role from manager to manager as coach.

To understand how the private health sector might better complement Africa’s public health systems, we studied the health care sectors of 45 sub-Saharan African countries. The findings suggest opportunities for private enterprise to help improve the region’s woefully poor health outcomes.

This article discusses the challenges related to preventing the out-migration of health care workers from the developing world. Experimental policies and best practices are outlined. The authors call for new policies to be created to encourage health workers to remain at home.

This article describes the work of the Task Force for Scaling Up Education and Training for Health Workers, which was established to create to create practical proposals for a massive increase in the education and training of health workers, as part of a systematic effort to build up health systems in developing countries. [adapted from author]

The main aim of the study was to estimate how much clinician-time that malaria exacts on Malawi’s Ministry of Health resources. It estimates the proportion of finances that anti-malarial medications exact on the country’s health budget and determines whether the Malawi public health sector had adequate human resources to provide treatment. [adapted from author]

This article examines one new element of non-government provision in Tanzania: small-scale independent midwifery practices. Because of their location and emphasis on personalized care, small-scale independent practices run by retired midwives could potentially increase rates of skilled attendance at delivery at peripheral level. [from author]

In rural areas across Australia the recruitment and retention of adequate numbers of medical specialists, including psychiatrists, has been a long outstanding problem. Latrobe Regional Hospital reached a major crisis in 1994, with only one psychiatrist and a large number of vacancies. This led to a focus on the recruitment and retention of psychiatrists in order to improve this essential element of the workforce. [from abstract]

Rural healthcare provision is limited in many areas because of workforce recruitment and retention issues. Pharmacists and social workers are examples of allied health professionals who play vital roles in the provision of rural health care. Personal factors including an individual’s fit with a local community and their professional role were explored to determine the way they affect access to rural health care. [from abstract]

This study explores the views of nursing students in Uganda to assess their views on professional practice options and their intentions to migrate to wealthier countries. The surveys show that most students would like to work outside of Uganda. The authors conclude that nursing schools may want to recruit students desiring work in rural areas or public practice to lead to a more stable workforce in Uganda. [adapted from author]

One of the most significant challenges in fighting the AIDS epidemic in Southern Africa is securing the health care workforce to deliver care in settings where the manpower is already in short supply. The authors produced a demand-driven staffing model based on treatment protocols for HIV-positive patients that adhere to Mozambican guidelines.

Task shifting, a process whereby medical tasks are delegated to less specialized health-care workers, provides one mechanism to address some of the shortfalls of many health care systems. This article advocates for increased task shifting in health care systems, especially in the developing world. [adapted from author]

The configuration of rural health services is influenced by geography. Rural health practitioners provide a broader range of services to smaller populations scattered over wider areas or more difficult terrain than their urban counterparts. This has implications for training and quality assurance of outcomes. This exploratory study describes the development of a “clinical peripherality” indicator that has potential application to remote and rural general practice communities for planning and research purposes. [from introduction]

This is a review of the literature on attracting and retaining health workers. The findings suggest that recruitment and retention strategies are usually not comprehensive and often limited to addressing a single or limited number of factors. Because of the complex interaction of factors impacting attraction and retention, there is a strong argument to be made for bundles of interventions which include attention to living situations, working conditions and environments, and professional development opportunities. [adapted from author]

Little is known about the impact of implementing nursing-oriented best practice guidelines on the delivery of patient care in either hospital or community settings. The results of this study indicate that implementation of nursing best practice guidelines can result in improved practice and patient outcomes in some settings. [adapted from author]

This study shows that graduates from higher quality institutions account for a disproportionately large share of emigrating physicians in India. Even within high-end institutions, better physicians are more likely to emigrate. Interventions should focus on the highly trained individuals in the top institutions that contribute disproportionately to the loss of human resources for health. The findings suggest that affirmative-action programmes may have an unintended benefit in that they may help retain a subset of such personnel. [adapted from author]

The purpose of the study was to examine the association between the health workforce, particularly the nursing workforce, and the achievement of the HIV/AIDS-related Millenium Development Goals, taking into account other factors known to influence health status, such as socioeconomic indicators.

This study evaluated the skills and competency levels of hospital managers in South Africa to determine whether there are any significant differences between managers in the public and private sectors. The results show that managers in the private sector perceived themselves to be significantly more competent than their public sector colleagues in most of the management facets. Public sector managers were also more likely than their private sector colleagues to report that they required further development and training. [adapted from abstract]

This article focuses on the field of telemedicine in developing countries and its role in improving health, using examples from the experience of the International Development Resource Centre. [adapted from publisher]

This study analyzes the Lithuanian family physician (FP) workforce to determine if an adequate supply of FPs will be available in the future to take over emerging tasks. The authors conclude that despite the rapid expansion of the FP workforce during the last fifteen years, forecasts of supply and demand indicate that the number of FPs in 2015 will not be sufficient. [adapted from author]

The objective of this study was to quantify staff requirements in primary health care facilities in South Africa through an adaptation of the WHO workload indicator of staff needs tool. The results show that the application of an adapted WHO workload tool identified important human resource planning issues. [adapted from abstract]

This article discusses the gaps exist between the potential of health systems and their actual performance. Best practices from various countries are discussed. The author concludes that the crisis can be tackled if there is global rsponsibility, political will, financial commitment and public-private partnership for country-led and country-specific interventions that seek solutions beyond the health sector. [adapted from abstract]

A study was undertaken in Mexico, Colombia, and El Salvador to determine the impact of a management training program on health managers’ job performance. Factors associated with a successful training outcome were training techniques, strengthening of enabling factors, and reinforcement mechanisms. [adapted from abstract]

This article presents the results of a 2002 social audit of the health sector of three Baltic States. Comparisons were made of perceptions, attitudes and experience regarding unofficial payments in the health services of Estonia, Latvia and Lithuania. The findings can serve as a baseline for interventions and to compare each country’s approach to health service reform in relation to unofficial payments. [adapted from abstract]

The Swiss government decided to freeze new accreditations for physicians in private practice in Switzerland based on the assumption that demand-induced health care spending may be cut by limiting care offers. This legislation initiated an ongoing controversial public debate in Switzerland. The aim of this study is therefore the determination of socio-demographic and health system-related factors of per capita consultation rates with primary care physicians in the multicultural population of Switzerland. [from abstract]

This paper proposes a methodological approach to estimating the requirements of human resources to achieve the goals set forth by the Millennium Declaration. The method builds on the service-target approach and functional job analysis. [adapted from abstract]

Staff shortages could harm the provision and quality of health care in Uganda and therefore staff retention and motivation are crucial. Understanding the impact of HIV/AIDS on staff contributes to designing appropriate retention and motivation strategies. This research aimed to identify the influence of HIV/AIDS on staff working in general hospitals at district level in rural areas and to explore support required and offered to deal with HIV/AIDS in the workplace. Results from interviews and surveys show that HIV/AIDS is an important contextual factor that impacts working conditions in various ways.

Twelve percent of the adult population in Malawi is estimated to be HIV infected and 15% to 20% of these are in need of life saving antiretroviral therapy. Using data on the total number of patients on highly active antiretroviral treatment (HAART) and estimates of the number of health professionals required to deliver HAART, researchers set out to determine the human resources requirements for HAART scale-up in Malawi. Results show that the human resources requirements are significant and that Malawi is using far fewer human resources than would be expected based on past studies. [adapted