Journal Articles
Occupational Stress Experienced by Caregivers Working in the HIV/AIDS Field in South Africa
Occupational stress and burnout merit concern in South Africa as the severity and intensity of the HIV epidemic is often perceived as overwhelming, leaving many caregivers with intense feelings of hopelessness and despair. This study explores and describes the experiences, feelings and perceptions of South African caregivers working in various capacities (healthcare, counselling and teaching) in the HIV/AIDS field. [from abstract]
- 3291 reads
Working Conditions of Nurses: Confronting the Challenges
This issue of the Health Policy Research Bulletin examines research on the state of working conditions facing Canada’s nurses and discusses the implications for the larger health care system. [author’s description]
- 1827 reads
Taming the Brain Drain: a Challenge for the Public Health Systems in Southern Africa
In southern Africa, rapid out-migration of health professionals is compounding the problems of health systems already faced with budget constraints and the impacts of HIV/AIDS. The authors outline a program of research on how Canada and the international community might address the negative impacts of the brain drain. [abstract]
- 2116 reads
Uganda: Delivering Analgesia in Rural Africa: Opioid Availability and Nurse Prescribing
Hospice Africa Uganda introduced palliative medicine to Uganda in 1993 with enough funds to support a team of three clinicians for three months. Training in the medical and nursing schools was introduced in 1994. Since then, Uganda has achieved the three essential components of an effective public health strategy. It has also been the first country to have palliative care described as an essential clinical service and to change the law to allow nurses and clinical officers who complete special training in palliative medicine at Hospice Uganda to prescribe morphine. Palliative care is spreading throughout the districts of Uganda, ensuring that morphine will be available to everyone who needs it. [adapted from publisher’s description]
- 2521 reads
Medicines without Doctors: Why the Global Fund Must Fund Salaries of Health Workers to Expand AIDS Treatment
Recent comments from the Global Fund suggest an intention to focus more on the three diseases, and to leave the strengthening of health systems and support for the health workforce to others. This could create a “Medicines without Doctors” situation in which the medicines to fight AIDS, tuberculosis, and malaria are available, but not the doctors or the nurses to prescribe those medicines adequately. [author’s description]
- 2074 reads
Attitude of Health-Care Workers to HIV/AIDS
The study sought to assess the knowledge of health-care providers about HIV/AIDS, determine the potential for discrimination in the provision of services based on patients’ HIV sero-status and review the factors that may contribute to such attitude. [from abstract]
- 3478 reads
HIV and Infant Feeding Counselling: Challenges Faced by Nurse-Counsellors in Northern Tanzania
Infant feeding is a subject of worry in prevention of mother to child transmission (pMTCT) programmes in settings where breastfeeding is normative. Nurse-counsellors, expected to counsel HIV-positive women on safer infant feeding methods as defined in national/international guidelines, are faced with a number of challenges. This study aims to explore the experiences and situated concerns of nurses working as infant feeding counsellors to HIV-positive mothers enrolled in pMTCT programmes in the Kilimanjaro region, northern Tanzania. [abstract]
- 3712 reads
Non-Physician Clinicians in 47 Sub-Saharan African Countries
Many countries have health-care providers who are not trained as physicians but who take on many of the diagnostic and clinical functions of medical doctors. We identified non-physician clinicians (NPCs) in 25 of 47 countries in sub-Saharan Africa, although their roles varied widely between countries… Low training costs, reduced training duration, and success in rural placements suggest that NPCs could have substantial roles in the scale-up of health workforces in sub-Saharan African countries, including for the planned expansion of HIV/AIDS prevention and treatment programmes. [summary]
- 3136 reads
Reincentivizing: a New Theory on Work and Work Absence
Work capacity correlates weakly to disease concepts, which in turn are insufficient to explain sick leave behavior. With data mainly from Sweden, a welfare state with high sickness absence rates, our aim was to develop an explanatory theory of how to understand and deal with work absence and sick leave. In this paper we present a theory of work incentives and how to deal with work absence. [from abstract]
- 17368 reads
Staff Training and Ambulatory Tuberculosis Treatment Outcomes: a Cluster Randomized Controlled Trial in South Africa
The objective of this study was to assess whether adding a training intervention for clinic staff to the usual DOTS strategy (the internationally recommended control strategy for tuberculosis (TB)) would affect the outcomes of TB treatement in primary care clinics with treatemet success rates below 70%. [from abstract]
- 2512 reads
Community-Based Approaches to HIV Treatment in Resource-Poor Settings
The main objections to the use of [antiretroviral therapies] in less-developed countries have been their high cost and the lack of health infrastructure necessary to use them. We have shown that it is possible to carry out an HIV treatment programme in a poor community in rural Haiti, the poorest country in the western hemisphere.
- 29169 reads
Systemic Capacity Building: a Hierarchy of Needs
Too often capacity building becomes merely a euphemism referring to little more than training. This paper argues that it is more important to address systemic capacity building, identifying a pyramid of nine separate but interdependent components.
- 3341 reads
Losing the "Eyes in the Back of Our Heads": Social Service Skills, Lean Caring, and Violence
Violence in the social services work place in general, and the developmental services in particular, has increased in the last several years. Findings from an ethnographic study suggests that new, lean forms of work organization remove opportunities to use or learn many of the tacit or practice skills workers previously used to keep themselves and their clients safer in the work place. This article describes many of these skills and the new management schemes that remove the possibility to develop or transmit these praxis skills.
- 2223 reads
Prevalence of Workplace Violence Against Nurses in Hong Kong
To objective of this article was to determine the prevalence and nature of workplace violence against nurses, how nurses deal with such aggression; and to identify the risk factors related to violence in the hospital environment. [author’s description]
- 4323 reads
Physical and Psychological Violence in Jamaica's Health Sector
This study was done to determine the prevalence of experiences with physical violence and psychological violence that health staff have had in the workplace in Jamaica, and to identify factors associated with those experiences of violence. [from abstract]
- 3753 reads
Workplace Violence in Health Care: Recognized but Not Regulated
Workplace violence is one of the most complex and dangerous occupational hazards facing nurses working in today’s health care environment. This article includes critiques of the conceptual, empirical, and policy progress of the past decade, a discussion of the need for methodologically rigorous intervention effectiveness research, and a description of a joint-labor management research effort aimed at documenting a process to reduce violence in a state mental health system. [from abstract]
- 3196 reads
Know Workplace Violence: Developing Programs for Managing the Risk of Aggression in the Health Care Setting
Strategies to prevent and manage violence and aggression in the health care setting have become a primary health and safety issue. A series of vignettes are provided to highlight key elements in developing a program for preventing behavioural violence and aggression in a tertiary hospital. Key components of the program include staff education and training, risk assessment and management practices, the use of patient contracts and policy development. The program aims to integrate and balance occupational health and safety obligations to staff with the duty of care owed to patients. [abstract]
- 2048 reads
Providing the Providers
Although the [critical shortage of health care workers] is not new, recent international efforts to vaccinate children and to fight HIV/AIDS, malaria, tuberculosis, and other diseases have brought it into sharper focus. The worker shortage derives from a combination of underproduction, internal maldistribution, and emigration of trained workers (“brain drain”). Fortunately, many African countries have begun attacking the problem by implementing innovative programs that may serve as models for other countries. Once effective pilot programs have been identified, scaling up will be the next hurdle: programs that are found to work on a small scale or in a particular environment may not be easy to expand or replicate.
- 2000 reads
Postoperative Outcome of Caesarean Sections and Other Major Emergency Obstetric Surgery by Clinical Officers and Medical Officers in Malawi
Clinical officers perform much of major emergency surgery in Malawi, in the absence of medical officers. The aim of this study was to validate the advantages and disadvantages of delegation of major obstetric surgery to non-doctors. [abstract]
- 2109 reads
United States Physician Workforce and International Medical Graduates: Trends and Characteristics
International medical graduates (IMGs) have been a valuable resource for the United States physician workforce, and their contribution to the United States workforce is likely to increase. This article describes the historical trends and compare the characteristics of IMGs to United States medical graduates in the United States. It also recommends that policymakers consider the consequences for both the United States and source countries. [adapted from abstract]
- 2265 reads
College of Medicine in the Republic of Malawi: Towards Sustainable Staff Development
Malawi has a critical human resources problem particularly in the health sector. The College of Medicine (COM)is the only medical school. For senior staff it heavily depends on expatriates. We explore to what extent a brain drain took place among the COM graduates by investigating their professional development and geographical distribution.
- 1980 reads
Flight of Physicians from West Africa: Views of African Physicians and Implications for Policy
West African-trained physicians have been migrating from the sub-continent to rich countries, primarily the US and the UK, since medical education began in Nigeria and Ghana in the 1960s. In 2003, we visited six medical schools in West Africa to investigate the magnitude, causes and consequences of the migration. We conducted interviews and focus groups with faculty, administrators (deans and provosts), students and post-graduate residents in six medical schools in Ghana and Nigeria. In addition to the migration push and pull factors documented in previous literature, we learned that there is now a well-developed culture of medical migration.
- 10211 reads
Metrics and Correlates of Physician Migration from Africa
Physician migration from poor to rich countries is considered an important contributor to the growing health workforce crisis in the developing world. This is particularly true for Africa. The perceived magnitude of such migration for each source country might, however, depend on the choice of metrics used in the analysis. This study examined the influence of choice of migration metrics on the rankings of African countries that suffered the most physician migration, and investigated the correlates of physician migration. [from abstract]
- 1595 reads
Nurses' Experiences of Recruitement and Migration from Developing Countries: a Phenomenological Approach
There is growing concern globally at the current flows of nurse migration, particularly from low-income to middle and high-income countries. Recruitment practices of many countries such as Ireland are thought to be fuelling this rate of migration. This paper aims to establish the perceptions and opinions of those involved in the recruitment process on their role in recruitment and the effects recruitment has on both source and destination countries. [from abstract]
- 1552 reads
Impact of an In-Built Monitoring System on Family Planning Performance in Rural Bangladesh
This article assesses interventions aimed at improving family planning mechanisms and reviewing the problem-solving processes to build an effective monitoring system of the interventions at the local level of the overall system of the Ministry of Health and Family Welfare of the Government of Bangladesh. [adapted from author]
- 7354 reads
Needlestick Injuries in an Era of HIV: Technical and Personal Aspects
Hospitals are workplaces in which HIV has double significance. Needlestick accidents link patients, healthcare workers and cleaning staff through the risk of occupational exposure to HIV. Additionally, concern over needlestick injuries may embody HIV stigma, discrimination and fear. This paper draws on qualitative research from a one-year case study at a large, private South African healthcare company that runs a number of hospitals across the country. Issues surrounding needlestick injuries were discussed with hospital managers, union members, infection-control nurses, health and safety representatives, HIV/AIDS counsellors, and general nursing staff. [from abstract]
- 2481 reads
Evaluation of the Nigerian National Antiretroviral (ARV) Treatment Training Programme
The Nigerian national ARV treatment training programme was conceived to meet the human resource needs in hospitals providing ARV therapy. This paper reports on the evaluation of the training programme. It examines knowledge and skills gained, and utilization thereof. Recommendations are made for improved training effectiveness and for specific national policy on training, to meet the demand for scaling up therapy to the thousands who need ARV. [from abstract]
- 15890 reads
New Role, New Country: Introducing USA Physician Assistants to Scotland
This paper draws from research commissioned by the Scottish Executive Health Department (SEHD). It provides a case study in the introduction of a new health care worker role into an already well established and ‘mature’ workforce configuration. It assesses the role of USA style physician assistants (PAs), as a precursor to planned ‘piloting’ of the PA role within the National Health Service (NHS) in Scotland. The evidence base for the use of PAs is examined, and ways in which an established role in one health system (the USA) could be introduced to another country, where the role is ‘new’ and unfamiliar, are explored.
- 2171 reads
Health Workers and Vaccination Coverage in Developing Countries: an Econometric Analysis
Although health workers are needed to do vaccinations, the role of human resources for health as a determinant of vaccination coverage at the population level has not been investigated. The author’s aim was to test whether health worker density was positively associated with childhood vaccination coverage in developing countries. [from summary]
- 2477 reads
Succession Planning and Leadership Development: Critical Business Strategies for Healthcare Organizations
As labor shortages intensify, succession planning and leadership development have become strategic initiatives requiring rigorous consideration. Traditional methods of replacing personnel will not accommodate the vacancies expected to plague healthcare organizations. Managers should focus on identifying potential gaps of key personnel and adapting programs to accommodate organizational need. Attention should be placed on capturing the intellectual capital existent in the organization and developing diverse groups of leadership candidates. [executive summary]
- 4192 reads