India

A researcher from the University of Surrey (UK) proposes a basic framework for estimating relative shortages of medical personnel in rural and urban areas of developing countries. The author distinguishes between qualified doctors, trained non-doctors and untrained non-doctors. Using data for Ujjain district in the state of Madhya Pradesh, India, the author then estimates their impact on the quality of health care available. [from author]

This two-year study to assessed the usefulness and effectiveness of using paraprofessionals in educating and providing emergency contraceptive pill services to potential users. [from summary]

This article describes the Public Health Resource Network, an innovative distance-learning course in training, motivating, empowering and building a network of health personnel from government and civil society groups. Its aim is to build human resource capacity for strengthening decentralized health planning, especially at the district level. [from abstract]

The United Kingdom has recruited nurses from countries with a reported surplus in their nursing workforce, such as India and the Philippines. However, little is known about the decision to emigrate made by nurses from these countries. One theory suggests that individuals weigh the benefits and costs of migration: the push and pull factors. This paper challenges the restricted economic focus of this predominant theory and compares the diverse motivations of nurses from different countries as well as those of nurses with previous migratory experience and first-time migrants. [from abstract]

This paper will use India as a lens to examine the broader issues surrounding human resources and public health. It will explore some of the HR strategies employed in a variety of settings with mixed results. Finally, it will look at several very contrasting approaches employed by two Indian states, Tamil Nadu and Gujarat, in dealing with human resource shortages as they struggle to reduce maternal mortality. [from author]

In this paper, we describe the design, development and implementation of a public-private partnership for managing urban health services in Ahmedabad city, Gujarat. Our model has succeeded in bringing together compatible public and private partners to plan and deliver quality healthcare services to meet the community needs of Vasna ward, in Ahmedabad. [from abstract]

The toolkit is a collection of participatory educational exercises for educating health care providers on the issues of stigma and gender-based violence. It was developed for and with health care providers in Andhra Pradesh, India. The goal is to facilitate open discussion on HIV stigma and gender violence, and on what health workers can do to promote a change in attitude and practice. [from publisher]

In response to recent findings regarding migration of health workers out of Africa, we provide data from a survey of Indian nurses suggesting that up to one fifth of the nursing labour force may be lost to wealthier countries through circular migration. [abstract]

This case study of the Indian state of Rajasthan highlights the challenges and draws lessons for effective implementation of District Health Action Plans. [from presentation]

One of the most significant impacts of globalization on India’s healthcare industry has been the direct trade in health-related goods, services and health professionals. This paper examines the opportunities and challenges for medical tourism in India and attempts to assess its potential impact on the country’s health workforce and health system. [adapted from introduction]

There is increasing consensus that training programmes should focus on know-how instead of know-all. IntraHealth International’s Learning for performance: a guide and toolkit for health worker training and education programs offers a step-by-step, customizable approach designed to develop the right skills linked to job responsibilities. Using Learning for Performance yields more efficient training that focuses on what is essential for health workers to do their jobs and on effective learning methods.

This article suggests that India’s maternal mortality rate is so high due to political, administrative and managerial issues such as the lack of exclusive midwifery training and professional midwives. [adapted from author]

India has traditionally had a bureaucratic approach to regulating its health service. Research suggests that this approach has failed to protect the interests of poor and vulnerable groups and has not gained the trust of providers or the public. So are there any other ways to make India’s health systems more accountable? [from author]

This presentation addresses the role and impact of traditional health service providers in India and how they help fill the gaps in health worker coverage. [from author]

This paper reports on AIDS-related stigma baseline findings from a study to evaluate the impact of a stigma-reduction intervention in three large hospitals in New Delhi, India. The study highlights issues particular to the health care sector in limited-resource settings. [from abstract]

This study was implemented to develop and evaluate the effectiveness of a home based intervention in reducing caregiver burden, promoting caregiver mental health and reducing behavioural problems in elderly persons with dementia. [from abstract]

The community score card process is a community-based monitoring tool that is a hybrid of the techniques of social audits and citizen report cards.The CSC is an instrument to exact social and public accountability and responsiveness from service providers. By linking service providers to the community, citizens are empowered to provide immediate feedback to service providers. [from author]

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]

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]

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]

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]

The Institute of Health Management Research conceived an operational research project to develop and test key management interventions in order to improve the efficiency and effectiveness of the district health system and services at the district level. [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 India Local Initiatives Program adapted a model used in Indonesia and Bangladesh to implement the government’s reproductive and child health strategy. From 1999 to 2003, three Indian nongovernmental organizations (NGOs) provided services for 784,000 people in four northern states. This model proved to be a suitable platform upon which to build health-care service delivery and create behavioral change, and the NGOs quickly found ways to sustain and expand services. [from abstract]

The report aims to share findings from an assessment to explore how access to critical services for populations at risk of HIV and unintended pregnancy can be strengthened by converging HIV and sexual and reproductive health (SRH) services under the National Rural Health Mission (NRHM) and the National Aids Control Programme (NACP). The report provides information on the demand and opportunities for and the challenges of implementing HIV and SRH convergence in four states—Andhra Pradesh, Bihar, Maharashtra, and Uttar Pradesh. [adapted from executive summary]

The objective of this paper is to explore the context of sexual harassment of women in the health sector in Kolkata, West Bengal. Specifically, it explores women’s perceptions of the occurrence of sexual harassment in hospital settings, and probes women’s own experiences of sexual harassment and incidents of sexual harassment in the hospital environment about which women are aware. The study also investigates the nature of action taken to seek redress, and the extent to which working women are aware of the complaint mechanism outlined by the Supreme Court. [from introduction]

Under the ENABLE Safe Motherhood Core Initiative, CEDPA/India collaborated with the Community Aid and Sponsorship Program on the Safe Motherhood Initiative to reduce maternal death by showing women, their families and their communities how to prepare for a safe delivery, to identify pregnancy-related complications at their onset, and to seek medical help immediately. [publisher’s description]

Hospital managers who used a checklist to assess their facilities’ policies and practices took action to improve staff safety and reduce AIDS-related stigma. Findings suggest that the actions taken, including education, training, policy formulation, and involvement of AIDS NGOs, contributed to improved knowledge, attitudes, and practices among health workers. UNAIDS has recognized the intervention as a best practice, and NACO has endorsed the intervention’s tools and approaches. [author’s description]

This presentation is from PSP-One’s GHC Expert Panel— Expanding Health Service Access, Quality, and Equity in Developing Countries: The Role of the Private Sector. It presents franchise models for delivering family planning and reproductive health services by the private sector. The presentation slides, video of the seminar, and transcript of the resulting discussion are available.

This paper describes the practice of international recruitment of Indian nurses in the model of a business process outsourcing of comprehensive training-cum-recruitment-cum-placement for popular destinations like the United Kingdom and United States through an agency system that has acquired growing intensity in India. [from abstract]