Documents & Reports

This meeting discussed the role of medical schools in the process of development and implementation for national health policies and plans, the need for medical education reforms to respond to national health challenges within the context of global and regional health strategies, the way forward for enhancing the capacity of medical schools to produce adequate human resources for health, and the formulation of recommendations for regular institutional evaluation. [adapted from executive summary]

The issues surrounding nursing shortages and global nurse migration are inextricably linked. The shortage of practicing nurses worldwide has led to aggressive recruiting by healthcare employers in the United States, the United Kingdom, and other countries. Foreign-educated healthcare professionals represent more than a quarter of the medical and nursing workforces of Australia, Canada, the United Kingdom, and the United States. [author’s description]

The report, in its first part, destroys three common myths regarding the private health care sector in Africa and discusses how to engage the private sector effectively. It provides examples of successful public-private partnerships and highlights some of the trends in these types of partnerships. [adapated from executive summary]

The World Bank commissioned the Center for Development Communication (CDC) to develop a communication strategy to help boost public-private partnerships in the African continent. CDC consulted with key informants and stakeholders identified by the World Bank’s Public-Private Partnerships (PPP) working group in order to develop a stakeholder analysis to help inform the larger communication strategy. This report summarizes the results of that consultation. [from executive summary]

When GHARP set out to recruit new service providers [for preventing mother-to-child transmission], it faced a dilemma. Due to the limited supply of health workers in Guyana, the project needed to avoid recruiting health care providers already working for the MOH. Hiring existing health workers away from their jobs would simple reshuffle the distribution of health workers, rather than add new ones. To address the problem, GHARP staff decided to recruit retired nurses to fill the positions. [from author’s description]

Both financial and nonfinancial factors influenced the tenure and job satisfaction of nurses at public maternity services in South Africa. Surveys suggest that strong management and fully equipped facilities could help redress staff turnover. [author’s description]

Se presentan una serie de recomendaciones de políticas y líneas de investigación que buscan instalar como “campo” de acción y de investigación la producción sistemática de información sobre recursos humanos en salud desde una perspectiva de género. [rusumen]

This chapter of the Global Health Watch focuses on the global dimension of health migration, although it recognizes that the agenda for coherent and comprehensive health systems development must place human resources at its centre. [author’s description]

The Argentine Maternal-Child Health Insurance Program uses an interesting approach of combining output-based contracting with an output-based funding mechanism. Particularly innovative is the combination of enrollment numbers and performance indicators as a way to address the trade off between quantity and quality.

This report is based on deliberations from an international consultation on strengthening leadership and management as an essential component to scaling health services to reach the Millennium Development Goals. The focus was on low-income countries though the principles discussed concerned leadership and management in other settings as well. The report describes a technical framework adopted by the consultation for approaching management development and sets out key principles for sustained and effective capacity building. [author’s description]

While the availability and use of trained midwives can shape the quality of care received in pregnancy and childbirth, a number of other underlying health systems structures and processes are important. The management of health workforces, the mix of public and private provision and the impact of reforms affect quality of care across countries…[This study] examined how the structure and operation of a health system influences maternal health care provision and outcomes in Bangladesh, Russia, South Africa and Uganda. [author’s description]

Sub-Saharan Africa has the worst rate of maternal ill-health in the world. Maternal deaths occur partly because health systems are inadequately staffed to deal effectively with birth complications. How can maternal health human resources be managed better to ensure that all women, especially in poor, rural areas, can access good quality maternal health care? [author’s description]

In countries where available human resources for health (HRH) are insufficient to meet the needs, it is increasingly vital that health workers are supported to do their jobs effectively and efficiently. Health care worker productivity is a key ingredient of quality health services. The benefits of addressing productivity include greater efficiency, reduced workload intensity, increased worker satisfaction and a higher quality of care. [author’s description]

Nurses are falling ill, incurring workplace injuries, and suffering disabilities from exposure to workplace hazards. As a result, the global community is losing critical members of the health care team, compounding the already existing nurse staffing crisis and adversely affecting the health and well-being of the world’s population. Yet, despite the evidence of broad support for health and safety programmes, nurses worldwide continue to be exposed to serious and preventable work place hazards. [from introduction]

Credentialing is a means of assuring quality and protecting the public by confirming that individuals, programmes, institutions or products meet agreed standards. Credentialing is becoming increasingly important as health systems strive to address issues of public safety and quality services. [author’s description]

The results [of this study] combined with the small size of El Salvador suggest that alternative strategies to community health workers may be a more cost effective approach. While prevention is desirable, community health workers do not have the skills or services that the communities value, which makes them less effective in promoting prevention. Alternative modes of reaching the community could reduce costs and raise the effectiveness of public health spending. [from abstract]

Remarkable improvements in key health indicators have been achieved in the six years since payment for performance was phased in. Although it is difficult to isolate the effects of performance-based payment on these improved indicators from the efforts aimed at strengthening NGOs and other factors, panel regression results suggest that the new payment incentives were responsible for considerable improvements in both immunization coverage and attended deliveries. [from abstract]

This paper analyzes the use of financial and material incentives for patients and healthcare providers to improve tuberculosis detection and successful completion of treatment.

As strides are made in the prevention and treatment of HIV, it is important to take advantage of opportunities to expand and integrate reproductive health services. Integration is an approach that uses a client visit as an opportunity to address other health and social needs beyond those that prompted the current health visit.

Given the very limited health infrastructure and resources and the need to provide a palliative care service to about one percent of the population each year, community and home-based care is viewed as the key to responding to these needs. Some countries have already developed strong home-based care networks in coordination with the PHC system to respond to the HIV/AIDS epidemic. Palliative care, as part of the continuum of care of HIV/AIDS, cancer and other chronic conditions can be integrated into this existing network. [author’s description]

This report covers the work done to complete another phase of the Initiatives Inc. program of work in human resource development (HRD) in the Ministry of Health (MOH) in Jordan. The essence and purpose of this assignment was to conduct a workshop and produce as a result the first strategic projection of staff requirements and supply in the health sector as a whole, with particular emphasis on the public sector, over the period 2004 to 2014. [from introduction]

This article discusses the cost-effectiveness of a recent programme that involved training shopkeepers and community mobilisation for treating childhood fevers in the rural Kilifi District in Kenya. The programme offered workshops for shopkeepers on appropriate treatment for malaria in young children and also ran community information activities, with impact maintained through refresher training and monitoring. [author’s description]

Policy makers and hospital administrators are seeking evidence to support nursing staffing decisions that includes both the volume and mix of nurses required to provide efficient and effective care. The principal objective of this study was to examine the interrelationships between variables thought to influence patient, nurse, and system outcomes. The results provide quality, evidence-based standards for adjusted ranges of nursing productivity/utilization and for staffing levels for patients receiving cardiac and cardiovascular nursing care. [from executive summary]

This paper begins by clarifying the terms shortage and underserviced. Provincial and federal programs for underserviced areas in Ontario are then described and considered in terms of their relevance to nursing. A discussion of the issues associated with policies addressing shortage and underserviced areas follows. The paper concludes with recommendations for change. The importance of making funding decisions based on a clear understanding of relevant concepts and models is emphasized. [introduction]

Th is report focuses on the supply and employment of nursing graduates in Ontario and their absorption into the workforce over the two-year period from 2003/4 to 2004/5. It begins with a review of labour market trends in the health care sector and discusses nursing supply, mobility, and cross-border migration in the recent past. The major repositories of data on
nurse education are identified and an overview of the entry of new nurses into the workforce is provided. Based on a survey of new graduands, a profile of new nurses is presented.

This data creates a profile of the nursing workforce, which is useful for projecting trends and estimating future requirements. At the corporate level, longitudinal examination over a series of years would demonstrate the relationship between the characteristics of the nursing workforce and the overall requirements for patient care. At the unit level, the data is helpful to examine human resource needs and fluctuations in the workforce characteristics.

The three sources of nursing supply in Canada are new graduates, internationally educated nurses (IENs) and nurses returning to the workforce. This report focuses on IENs. Globalization has led to high rates of migration of professionals to economically vibrant countries such as Canada. Because many skilled and educated migrants do not always realize their full potential in their new country, policies to maximize brain gain are imperative. [from executive summary]

Understanding the supply and utilization of nurses is critical to maintaining an effective community health system. There has to be sufficient staff and a work environment that builds on the existing strengths of community health nursing to meet emerging needs. This report provides a demographic profile of community health nurses (CHNs) in Ontario and identifies enablers that support optimal practice of their competencies. [from executive summary]

Rural health care is changing. Following restructuring in the 1990s some small hospitals remained independent, while others reorganized as amalgamations and alliances. In 2004, Ontario was divided into 14 Local Health Integration Networks (LHINs) to create accessible, quality health care at a local level. Th is study was designed to gain an understanding of the impact on nursing work and the workforce. [from executive summary]

The challenges inherent in planning, developing and supporting a sustainable health care workforce are all the more difficult in countries where conflict or the aftermath of conflict can impede the implementation of short- and long-term approaches to building human resources for health (HRH). Based on field experiences implementing programs in such situations and supplemented by a carefully targeted literature review, this resource paper explores operational challenges, opportunities and goals common to initiating HRH programs in conflict and post-conflict situations. [introduction]