Americas & Caribbean

The peculiarities of the scattered small states of the Caribbean region call for a model of training practitioners that is effective, relevant and sustainable. Distance education (DE) as an approach offers advantages that meet some of the challenges inherent in training family physicians for the region. This paper examines some of these challenges and shows where DE is being used to structure delivery of the programme. In particular, the need for context-specific training, managing time strictures and the cost issues of training are discussed. [from abstract]

This study provides initial information about current nursing issues that have arisen as a result of health care reform initiatives. Regardless of differences in service models or phases of health sector reform implementation, in all the countries the participating nurses identified many common themes, trends, and changes in nursing practice. The driving forces for change and their intensity have been different in the five countries. Nurses maintain their core values despite increased work stress and greater patient care needs in all the countries as well as economic crises in the Latin American countries.

This text presents the context and background, the methodology and some of the main results of the regional consultation on the critical challenges for human resources in health in the Americas. This consultation hopefully documents how the countries in the Americas are facing the main challenges to the development of the health workforce. The main results and suggestions by the actors consulted with regard to the role of international cooperation in the countries of the Region are presented, so that the countries and international agencies can better formulate common strategies of development and strengthening of the work force in health.

This document summarizes the human resources management situation in the region, its determinants, and the projects for its development. To promote improvements in the human resources management function as part of the sectoral changes under way at the national and regional level, the Pan American Health Organization is proposing a series of strategies, actions, and operational tools through the Observatory of Human Resources in Health Sector Reform initiative. [adapted from author]

The experience of the Training in Health and Environmental Health in the Caribbean Community project has demonstrated that distance education techniques is an effective medium through which participants in more than eleven countries can be brought together to be educated on topics that are significant to both the region and to individual countries. This paper examines the means through which individuals are educated and meaningful communication among them facilitated. The discussion evaluates the experiences of participants in relation to the technology; designing of pre and post activities; selection and preparation of presenters; the setting and ground rules established; and the interactive process utilized for the project.

HIV/AIDS provider stigma has been understudied in the context of prevention, testing, and treatment. This article documents the results of a survey of persons associated with HIV/AIDS education, health care, and social service delivery in the Eastern Caribbean.

This document review the Observatory of Human Resources in Health in the Health Sector Reform Processes in Latin America and Caribbean, which is a cooperative initiative among the countries of the Americas aimed at producing information and knowledge in order to improve human resource policy decisions as well as contributing to human resoures development within the health sector on the basis of sharing experiences among countries. [adapted from author]

Ensuring high performance of health care delivery systems is a challenge facing all governments. Dealing with the incentive problems underlying public health care delivery to improve productivity, quality, and performance is a common theme of health sector reforms in many countries. However, the impact of these reforms is often hard to establish. This book presents a series of case studies of health systems innovations by the Central American republics in the 1990s. The cases have a common theme of efforts to improve specific aspects of health system performance through the introduction of innovative and alternative financial, organizational, or delivery models…The case studies in this book report on the results of these experiences, encompassing a range of issues from the expansion of primary care to the use of public-private partnerships and the establishment of a social security-financed delivery system.

This series of 13 short video scenarios (each between 30 seconds and five minutes long) were produced to trigger discussion about common situations in Caribbean health care settings where HIV and AIDS stigma and discrimination may occur and can be prevented. The videos were produced to be used during HIV and AIDS training for health workers at all levels, including physicians, nurses, lab technicians, janitors and receptionists. A companion Facilitator Guide, provides detailed instructions for effective use of each trigger scenario, including suggested discussion questions and activities. The scenarios portray professional actors in various roles.

This report is the result of the meeting of the 47th Directing Council and 58th session of the Regional Committee in Washington DC. It is a summary of actions and proposals for a plan of action on human resources for health in the Americas submitted for the consideration of the Directing Council. This document summarizes the activities carried out to date in the countries and in the Governing Bodies. It provides an overview of the situation and the predominant trends in the Region, as well as a vision of the technical proposals and agreements for activities that are being developed. [adapted

Many countries in Latin America and the Caribbean have too many specialists and too few primary care providers and community health workers. These countries need to overhaul their training and payment practices to address this imbalance, say human resources experts. [author’s description]

The Regional Meeting “Human Resources: a Critical Factor in Health Sector Reform,” was held in the city of San Jos

This article discusses the reasons that led health workers to oppose reform; the institutional and legal constraints to implementing reform as originally designed; the mismatch between the types of personnel needed for reform and the availability of professionals; the deficiencies of the reform implementation process; and the regulatory weaknesses of the region. The discussion presents workforce strategies that the reforms could have included to achieve the intended goals, and the need to take into account the values and political realities of the countries. [from abstract]

This speech contends that a well performing workforce is the most critical determinant of the performance of services. Well functioning infrastructures and equipment do not serve if the people who deliver the services are not there (be it that there are none available, that they are absent from work, or that they are on strike). Well trained health workers, without the appropriate tools and supplies cannot do much either. And even when all ingredients are there, if workers are not motivated, services underperform. Advocacy to convince policy and decision-makers, as well as international agencies and donors to do something to improve the performance of the health workforce (HW) has been fervent these last 3-4 years, and it has been quite successful.

This article intends to provide a contextual analysis of the Caribbean region with respect to forces shaping the current and emerging nursing workforce picture in the region; discuss country-specific case(s) within the Caribbean; and describe the Managed Migration Program as a potential framework for addressing regional and global nurse migration issues. [from abstract]

This document aims to facilitate the development of quality-oriented health sector reforms by providing a clear conceptual framework that can serve as a roadmap for policymakers and senior managers. By taking advantage of opportunities to integrate quality assurance activities into health sector reforms, healthcare leaders can maximize the effectiveness of reform and move toward optimizing health outcomes for the citizens of Latin America and the Caribbean. [author’s description]

Even though the situation of human resources in health varies between the countries of the Region of the Americas, all of them are confronted by deep imbalances in the availability, composition, and distribution of the work force. These imbalances can be present as acute shortages of health personnel, chronic and persistent problems of inappropriate distribution of the work force with regard to needs, or inequities in composition of health providers in relation to the population served. Combined with coexisting deteriorating working conditions, poor incentive systems, and lack of appropriate competency maintenance strategies, these situations often have serious implications for the efficient functioning of health systems and may be associated with severe inadequacies in the performance of health professionals.

Human resources become increasingly relevant in this context. Health human resource (HHR) is currently experiencing a three-fold problem, which encompasses old issues, together with the effects of reform, and the consequences of globalisation. This includes the workforce crisis in nursing which, facing all kinds of difficulties, requires complex in-depth analysis, synergies and alliances in order to ensure quality nursing services. This paper was drafted by the Pan-American Health Organization (PAHO) as the basis for the examination of this important aspect of health care in the region of Latin America, and as a contribution to the International Council of Nurses (ICN).

This database can be used to produce tables of health indicator data according to year, country within the Americas, and indicator type. Human Resources for Health indicators are included in the “Resources, services, and coverage” section. The available data is from 1995-2007.

This document outlines the issues for human resources for health in the Americas and what the Pan American Health Organization resolves should be done to address them.

This report reviews the current status of provider payment reform in selected Asian and atin American countries, as well as possible research questions and research approaches. Provider payment method, the mechanism for transfering financial resources from the payers of health services (the government, insurers, and/or patients) to the providers, influences providers’ behavior (in terms of the types, amounts, and quality of services they offer) and financial performance. The research found that reforms in Asia are largely national level reforms affecting the whole of the social security system, reforms in Latin America tend to be less centrally driven and uniform.

This paper presents a discussion regarding public health’s main challenges in Latin America: knowledge of it, professional practice and training human resources. Emphasis is placed on three components: knowledge of public health, social practice and human resources training. [from abstract]

This paper seeks to explore the possibilities of distance education for the training of health workers in small states. It reviews two programmes conducted by regional organizations in the context of the limitations of small island states. Theoretical and operational issues connected to the design of the training programmes are also discussed. [from abstract]