Deployment

This video clip is 6 minutes and 58 seconds and provides information on the training and retention of health workers in Cape Verde. The majority of the training is done abroad due to poor medical educational facilities in country, and the video communicates the policies and programs Cape Verde has used to ensure trained doctors return to the country as well as how they ensure deployment of doctors to rural areas.

The township health system in Myanmar is regarded as means to achieve the end of an equitable, efficient and effective health system based on the principles of primary health care approach. A township hospital caters medical care at the second referral level. Under the leadership and management of a Township Medical Officer in each township, para-professionals deployed at Rural Health Centers (RHCs) and Sub-centers under each RHC’s jurisdiction play key roles for providing primary health care services for rural population. There had been an expansion of township hospital beds, RHCs and Sub-centers during the past 15 years.

This study explored the distribution of public sector health workers [in Zimbabwe] to show how its pattern impacts on equity objectives in health care delivery. [from executive summary]

In 2003 the Network published a discussion paper reviewing available literature and identifying key issues in need of further work, which this paper summarizes. In Southern Africa there are inadequate ratios of personnel to population for key skilled health personnel. There are a variety of push and pull factors that impact on the movement of healthcare workers. A more rigorous policy analysis is needed to stimulate innovation and to avoid measures and incentives counteracting each other. It is important to provide clearer policy analysis on production of health workers, on availability and distribution, and on movement and migration.

Against the backdrop of growing concern about shortages of health personnel, the report focuses on one of the most critical components of the workforce – nurses. Nurses are the “front line” staff in most health systems, and their contribution is recognised as essential to meeting these development goals and delivering safe and effective care. In presenting a global overview, the paper reports on key trends, main challenges and potential solutions. The emphasis is on breadth of coverage, but specific nursing workforce issues in different countries are highlighted to illustrate the main challenges facing those responsible for developing and implementing policies on the nursing workforce. The report presents a snapshot of a dynamic and challenging situation worldwide. [from executive summary]

Chapter 2, section A discusses the distribution of HRH in Thailand as well as providing recommendations to address the unequal distribution of health personnel between Bangkok and other regions with respect to providing equal access to health services. [adapted from author]

The goal of this study was to develop and test a way to establish, monitor, and predict the need for nursing services by using the health needs of the population. This study explored the relationship between the health needs of Ontarians, their use of community and hospital nursing services, and variations in outcomes. The findings suggest that decisions about the deployment of nursing resources are associated with differences in outcomes. [adapted from author]

The report provides evidence of inadequate ratios of personnel to population for key skilled health personnel, and a maldistribution of personnel along three different axes, between: public and private heath sectors, urban and rural areas and tertiary and primary levels of the health system. It describes the exodus of healthcare workers from areas of poverty and low socio-economic development, to more highly developed areas. [from executive summary]

Ghana, a low income developing country, is undergoing health sector reforms aimed at achieving greater equity of access to services, improved efficiencies in resource utilization, development of wider linkages with communities and other partners, as well as improved quality of health services. These reforms have strong influences on, and are influenced by, issues of human resources development, deployment and motivation. Some of the human resources issues debated under the reforms include issues of distribution of personnel, reprofiling of staff types and skill mixes including delegation of some essential skills.

Despite a pool of unemployed health staff available in Kenya, staffing levels at most facilities were only 50%, and maldistribution of staff left many people without access to antiretroviral therapy. Because in the current system it takes one to two years to fill vacant positions, even when funding is available, an emergency approach was needed to fast-track the hiring and deployment process. A stakeholder group was formed to bring together leaders from several sectors to design and implement a fast-track hiring and deployment model that would mobilize 830 additional health workers. [from abst

While publications like the World Health Report have described general approaches that can be taken to improve the human resources for health (HRH) situation at the country level, there is a relative paucity of more detailed documentation that describes promising practices that would be useful to HRH leaders and practitioners. As a result, USAID’s Africa Bureau commissioned a study to identify and document promising practices in a way that takes into account the context of the practice, describes lessons learned and puts forth potential implications for replication in other countries. The intent of the promising practices study is to “serve as a practical and much needed resource for governments, partners and donors in promulgating policies and approaches that have successfully mitigated the negative effects of the health workforce crisis.” After consultation within USAID, it was decided that the study would focus on promising practices in four African countries: task shifting in Ghana and Uganda, improving retention in Malawi, and increasing recruitment and rapid deployment in Namibia.

This Issues in Health Economics presents the main conclusions of an international literature review of policies designed to tackle geographical inequalities in the distribution of health professionals. [author’s description]

Maldistribution of human resources for health is a worldwide phenomenon and may appear in different dimensions. The first and greatest concern is the inequitable distribution, particularly of high level professionals like doctors, both among countries in the world and within each country. [author’s description]

This study demonstrates how Workload Indicators of Staffing Need (WISN) can be used as a human resources planning and management tool for improving decisions at all levels of health services about the provision, allocation and deployment of staff. [from abstract]

WHO, World Bank, and other human resources for health experts globally have recognized the dearth of human resource data for the health sector in many developing countries. In the present assessment, JHPIEGO reviewed the availability of staff deployment and training data from routine information systems in Malawi to inform the Ministry of Health and Population (MOHP) of deficiencies that would need to be addressed in order to better inform the development and ongoing monitoring of deployment and training policies and plans.
[publisher’s description]

The transformation of the university taught knowledge into a practical professional activity and decision responsibility of a medical doctor needs a period of learning by doing under guidance and supervision. The government’s proposal of a medical internship gives place for such a transformation. A medical internship is therefore incorporated in the curricula of medical doctors’ training in Rwanda. [author’s description]

This document outlines the national medical internship program in Rwanda, including how the deployment of these interns can help alleviate the deficiency of health

This discussion paper represents the first step in the process of examination and review of medical workforce benchmark assumptions. It attempts to explain the supply and demand mismatches that have arisen in the Australian medical care system as it is today and to seek agreement from stakeholders on indicators of segments of the workforce in shortage, in balance and in excess of need. An understanding of the indicators of workforce surplus and shortage, and the evidence presented by those indicators, will provide a firm basis for repeating the Australian medical workforce benchmark analysis, using updated data sources and improvements in methodology, and taking into account changes in government policies and programs since 1995 which impact on the distribution of the workforce.

Planning for the efficient and effective delivery of health care services to meet the health needs of the populations is a significant challenge. Globally policy makers, educators, health service researchers, leaders of unions and professional associations, and other key stakeholders struggle with the best way to plan for a workforce to fulfill the health needs of populations. To meet this challenge, achieving the appropriate balance between human and non-human resources is important and requires continuous monitoring, careful attention to the country specific context in which policy decisions are made, and evidence-based decision-making.

As part of the East, Central and Southern African College of Nursing’s 7th Scientific Conference, this presentation gives the context of inequitable distribution on HRH, challenges to equitable deployement and outlines some of the projects the EQUINET has implemented to address this issue.

Through its Community-Based Health Planning and Services (CHPS) initiative, Ghana has deployed more than 310 auxiliary nurses in 53 of the country’s most deprived districts. These nurses, who receive two years of training and the title Community Health Officer (CHO), are part of an innovative approach that shifts staff from low-impact static health centers with limited outreach to high-impact mobile community-supported services. CHOs provide doorstep services to underserved rural populations and have improved access to health services for nearly one million Ghanaians (each CHO serves an average of 4,500 people), resulting in substantial improvements in community health.

This presentation was given at the First Forum on Human Resources for Health in Kampala. It details a study done to assess the feasibility and interest among stakeholders in the Netherlands, UK and US in facilitating recruitment and placement of foreign health care professionals to work in public sector health care in South Africa. [adapted from author]

This presentation was part of the AIDS Law Project’s Human Resources for Health seminar, which was held to address the challenges facing the health sector. The PowerPoint discusses the rural physician training pipeline, the maldistribution of doctors, challenges for women doctors, and human resource needs for effective ARV roll-out.


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The Workload Indicators for Staffing Levels was created to provide a rational method of setting the correct staffing levels in health facilities, taking into account the the wide local variations which are found within every country, such as the different levels and patterns of morbidity in different locations, the ease of access to different facilities, the patient attitudes in different parts of the country to the services provided, and the local economic circumstances. This Manual sets out all the activities which are necessary in order to design and implement the WISN Method in a country.