Latest Resources

Costs of HIV/AIDS Among Professional Staff in the Zambian Public Health Sector

Despite their high level of training and medical knowledge, health professionals remain a population that is vulnerable to HIV/AIDS. AIDS-related mortality has been recognized as a significant factor in the loss of trained health staff in high prevalence countries, but little empirical research has been done to quantify the damage. In this study, we applied a case/comparison methodology to estimate the costs of HIV infection in the professional workforce at three Zambian healthcare institutions: Lusaka District Health Management Team, University Teaching Hospital (the national tertiary care hospital) and Kasama District Hospital and Health Management Team. Deaths or medical retirements among professional staff were analyzed wherever the complete personnel records were available, with the exclusion of cases resulting from violence, accident or disease of sudden onset. 108 cases were identified over a three-year period ending in October 2003. Each case was matched with two comparisons of similar age, sex and professional training. Data were collected for both cases and comparisons on absenteeism, compensation and medical care and reimbursement. Data were also collected on death and retirement benefits paid, or owed, to the cases. [author’s description]

Guidelines for Implementing Supportive Supervision: A Step-by-Step Guide with Tools for Immunization

This resource guide assists program managers in planning and implementing supervision systems in healthcare settings. Emphasis is placed on clear job expectations, leadership, and communication.

Health Sector Human Resource Crisis in Africa: An Issues Paper

The human resource (HR) problem in the health sector in sub-Saharan Africa has worsened to an extent that it has reached crisis proportions in some countries. Although the gravity of the problem varies across the continent, the situation in some of the countries is so grave that urgent action is needed. A complex set of factors has contributed to this problem, some exogenous, such as the austere fiscal measures introduced by structural adjustment, often resulting in cutbacks in the number of health workers.

Joint ILO/WHO Guidelines on Health Services and HIV/AIDS

The ILO and the WHO decided to join forces in order to assist health services in building their capacities to provide their workers with a safe, healthy and decent working environment, as the most effective way both to reduce transmission of HIV and other blood-borne pathogens and to improve the delivery of care to patients.

Quick and Dirty Evaluation of Capacity Building

This Praxis Note describes the author’s response to the challenge of documenting and evaluating a capacity building process that had taken place in the Tangababwe Red Cross Society (TRCS). The hope is that it will stimulate ideas and show that even quick and dirty evaluations can prove useful, and are certainly better than nothing. [publisher’s description]

Human Resources Management (HRM) in the Health Sector

Over the last two decades, health sector reform in many countries has been characterized by spirited efforts to bring down costs and reduce gaps in coverage. Various approaches to decentralization and public-private partnerships have been introduced, but there has been hardly any attempt to understand or address the human resources (HR) aspects and implications of such structural changes. This technical brief synthesizes findings from recent publications to help promote general understanding among the various HRM actors, especially advocates and practitioners in developing countries. [from aut

Expanded Response to Tuberculosis

This document describes USAID’s strategy for combating Tuberculosis. The strategy focuses on four main areas: a) expand and strengthen DOTS, b) increase and strengthen human resource capacity, c) develop and disseminate new tools and strategies, and d) adapt DOTS to address special challenges.

Monitoring and Evaluation of Human Resources for Health: An International Perspective

Despite the undoubted importance of human resources to the functions of health systems, there is little consistency between countries in how human resource strategies are monitored and evaluated. This paper presents an integrated approach for developing an evidence base on human resources for health (HRH) to support decision making, drawing on a framework for health systems performance assessment. [from abstract]

HIV/AIDS and the Workforce Crisis in Health in Africa: Issues for Discussion

This paper summarizes the key issues confronting human resources (HR) in the health sector in sub-Saharan Africa and the role that HIV/AIDS has played in exacerbating this crisis. Section I reviews the causes and consequences of this crisis. Section II focuses on the effects of the HIV/AIDS epidemic on the crisis. Section III analyzes the constraints faced by recent health initiatives in addressing HR issues. Finally, Section IV provides recommendations on how donors and other partners can address HR issues in a more intensive, sustained, and concerted manner. [summary]

Impact of HIV/AIDS on Health Systems and the Health Workforce in Sub-Saharan Africa

The purpose of this paper is to advocate for and guide planners in the collection and use of appropriate information to develop and manage the health workforce in a manner that enables health systems to respond to the service demands created or worsened by HIV/AIDS. The paper also intends to guide the development of tools for assessing impacts of HIV/AIDS on the health sector. Such tools can assist policymakers, planners, and advocacy groups to shape and accelerate the implementation of national HIV/AIDS policies and programs throughout the continent. [Description from author]

Metrics of the Physician Brain Drain

There has been substantial immigration of physicians to developed countries, much of it coming from lower-income countries. Although the recipient nations and the immigrating physicians benefit from this migration, less developed countries lose important health capabilities as a result of the loss of physicians. With the use of World Health Organization data, this article presents an emigration factor for the countries of origin of the immigrant physicians to provide a relative measure of the number of physicians lost by emigration. [from abstract]

Migration of Nurses: Trends and Policies

This paper examines the policy context of the rise in the international mobility and migration of nurses. It describes the profile of the migration of nurses and the policy context governing the international recruitment of nurses to five countries: Australia, Ireland, Norway, the United Kingdom, and the United States.

South African Health Review 2005

The 10th edition of the South African Health Review has the major theme of Human Resources for Health (HRH). South Africa has made significant progress in producing policies supportive of a good quality of health for all residents. However, there are challenges and gaps in translating these policies into action. Probably the most important of these challenges is the lack of adequate human resources. [Publisher’s description]

Efforts Underway to Stem Brain Drain of Doctors and Nurses

International recognition that the growing shortage of health workers poses a major threat to fighting diseases such as HIV/AIDS and tuberculosis has prompted a flurry of measures to stem the exodus of health professionals from developing countries. The initiatives — such as ethical recruitment codes to try to limit damage inflicted by the brain drain, and exchange and training programmes and projects to tap the resources of what has become known as the diaspora of migrant health workers — remain fragmented but at least mark a start in the search for solutions to the crisis. [autho

Migration of Health-Care Workers from Developing Countries: Strategic Approaches to its Management

Medical practitioners and nurses represent a small proportion of the highly skilled workers who migrate, but the loss for developing countries of human resources in the health sector may mean that the capacity of the health system to deliver health care equitably is significantly compromised. The aim of this paper is to examine some key issues related to the international migration of health workers and to discuss strategic approaches to managing migration. [from abstract]

How Can We Achieve and Maintain High-Quality Performance of Health Workers in Low-Resource Settings?

In low and middle income countries, health workers are essential for the delivery of health interventions. However, inadequate health-worker performance is a very widespread problem. We present an overview of issues and evidence about the determinants of performance and strategies for improving it. [authors’ description]

Stopping the Migration of Ghana's Health Workers

Ghana’s health sector has lost many health care workers, including those migrating to other countries. Strategies aimed at keeping personnel have had varied results. This article briefly reviews these strategies. [adapted from author]

Data on the Migration of Health-Care Workers: Sources, Uses and Challenges

Most statistics on the migration of health-care workers are neither complete nor fully comparable, and they are often underused, limited, because they often give only a broad description of the phenomena, and are not as timely as required. This paper presents information on the uses of statistics and those who use them, the strengths and limitations of the main data sources, and other challenges that need to be met to obtain good evidence on the migration of health workers. This paper also proposes methods to improve the collection, analysis, sharing, and use of statistics on the migration of health workers.

Migration of Health Professionals in Six Countries: A Synthesis Report

This report presents findings of a study on the migration of health professionals in Cameroon, Ghana, Senegal, South Africa, Uganda and Zimbabwe. The report provides detailed information about migration patterns and numbers, reasons for migration, effects on the quality of health care and the policies being undertaken in the respective countries to reduce outward migration. [from executive summary]

Tackling International Health Worker Recruitment

Billions of dollars have been invested in efforts to prevent the spread of HIV and other diseases in the world’s poorest countries. Yet at the same time, qualified health workers are leaving the same areas to work in the world’s richest countries. This article provides a brief overview of this issue. [author’s description]

Plumbing the Brain Drain

The departure of a large proportion of the most competent and innovative individuals from developing nations slows the achievement of the critical mass needed to generate the enabling context in which knowledge creation occurs. To favourably modify the movement and distribution of global talent, developing countries must implement bold and creative strategies that are backed by national policies.

Skill-Mix and Policy Change in the Health Workforce: Nurses in Advanced Roles.

This report was commissioned by OECD to examine the evidence on role change and delegation from physicians to advanced practice nurses (APN), nurse practitioners and nurses in other advanced roles in the hospital setting and primary care. The report has three components: a literature review, an assessment of country responses to an OECD questionnaire, and two more detailed country case studies, on England and the US. [author’s description]