Financial Aspects

Pay-for-performance (P4P) is one of the primary tools used to support healthcare delivery reform. This paper summarizes evidence, obtained from studies published between January 1990 and July 2009, concerning P4P effects, as well as evidence on the impact of design choices, and contextual mediators on these effects. [from abstract]

Shortages of health workers are obstacles to utilising global health initiative (GHI) funds effectively in Africa. This paper reports and analyses two countries’ health workforce responses during a period of large increases in GHI funds. [from abstract]

Telehealth is the delivery of health care at a distance, using information and communication technology. The major rationales for its introduction have been to decrease costs, improve efficiency and increase access in health care delivery. This systematic review assesses the economic value of one type of telehealth delivery - synchronous or real time video communication – rather than examining a heterogeneous range of delivery modes as has been the case with previous reviews in this area. [from abstract]

This paper reports on two separate experiences of human resources development plans costing in Mozambique and Guinea Bissau to provide insight into the practice of costing exercises in information-poor settings and contribute to the existing debate on HRH costing methodologies. [adapted from abstract]

This report presents the results and conclusions of a case study conducted within the broader context of assessing resource flows into the development of human resources for health (HRH). Using the example of Mozambique, it examines whether the emerging policy focus on aid effectiveness responds to the evident needs in scaling up HRH. [from publisher]

The purpose of the present paper is to shed light on the treatment of health workforce issues under health sector investments by the World Bank and its African country borrowers and their project agencies. [from introduction]

This paper looks at the potential for decentralization to lead to better health workforce recruitment, performance and retention in rural areas through the creation of additional revenue for the health sector; better use of existing financial resources; and creation of financial incentives for health workers. [from introduction]

While constrained health budgets and health worker shortages have been blamed for the low rates of surgery, there has been little empirical data on the providers of surgery and cost of surgical services in Africa. This study described the range of providers of surgical care and anesthesia and estimated the resources dedicated to surgery at district hospitals in three African countries. [from abstract]

In this study, we aimed to determine the cost and cost-effectiveness of involving health extension workers in tuberculosis treatment in Southern Ethiopia. This paper presents an ancillary cost-effectiveness analysis of data from a randomized control trial. [adapted from introduction]

This paper identifies key considerations for countries and policymakers planning the financing of their health workforce, and is based on an extensive review and synthesis of the literature, research findings, and experience on the financing and economic aspects of health workforce scale-up and improvement. [from author]

This document explains seven financing and economic issues that matter for health workforce scale-up and financing. It then states twenty-nine actions that policy-makers could take right away to address the issues, independent of any long-term HRH interventions in progress. [from introduction]

This background paper to the World Health Report 2006 discusses the fiscal and macroeconomic implications associated with scaling up health workforce capacity. While these general issues and concepts are relevant in all setting, the focus of the discussion is on low-income countries and sub-Saharan Africa in particular. [from publisher]

Managing health workforce expenditure requires the generation of evidence in order to support informed policy decisions. This background paper for the World Health Report 2006 takes a step forward in exploring HRH expenditures and presents the results of a first measurement for the health workforce in WHO Member States in the years 1998–2003. [from publisher]

This paper reviews the costs and cost-effectiveness of vaccination programme interventions involving lay or community health workers. [from abstract]

Some critics have claimed that disease-specific global health initiatives (GHIs) burden health systems that are already fragile in countries with few resources, whereas others have asserted that weak health systems prevent progress in meeting disease-specific targets. We use a review and analysis of existing data, and 15 new studies to describe the complex nature of the interplay between country health systems and GHIs. There are sections that specifically address the human resources for health and health information systems impacts. [from author]

This book examines two key health workforce policy questions: the impact of government wage bill policies on the size of the health wage bill and on the health workforce staffing levels in the public sector; and if current human resource management policies and practices lead to strategic use of health wage bill resources in the public sector. [from foreword]

This paper aims to describe the design, methods and approaches used to assess the effectiveness and cost-effectiveness of the skilled care initiative in reducing pregnancy-related and perinatal mortality in Ouargaye district, Burkina Faso. [from summary]

This paper evaluates the effectiveness and cost-effectiveness of alternative training strategies for increasing access to emergency obstetric care in Burkina Faso. [adapted from abstract]

This report summarizes the key problems in the health sector and their implications on human resources for health and financing of the health sector; discusses the issues on human resources for health; explores options for improving the production, deployment, retention and management of these workers; analyzes the current state of financing in the health sector; explores options for the financing of essential health services and non-EHP services; and summarizes the way forward. [adapted from introduction]

This presentation was part of the WHO-OECD Hosted Dialogue on migration and other
health workforce issues in a global economy. It discusses the cost of providing the minimum number of health workers for developing countries in terms of increasing the production of health workers, taking into account the diversity and competencies of health workers, and augmenting financial rewards and improving the working environment. [adapted from author]

In response to the critical HRH shortages in Africa, DFID and Office of the US Global Aids Coordinator (OGAC) have been in discussion with a number of African countries to develop strategies and country level actions. The aim is to demonstrate the maximum flexibility of disease specific programmes to support broad based primary care in line with countries’ health plans.

This introductory presentation on maintaining economically sustainable staffing levels was offered during a dialogue hosted by the WHO and OECD.

Improving the capacity of developing countries to respond to emerging diseases and especially influenza pandemics is essential to reduce both transmission around the globe and the human toll of outbreaks in the developing world. Investing in this capacity in developing countries is thus increasingly seen as a shared concern within the global community. [from introduction]

This presentation discusses the various aspects of private providers as they pertain to contracting for health services. [from presentation]

This article outlines different efforts at making strategic HRH plans in the developing world. The article focuses on the financial aspects of HRH planning and provides some general guidelines on the best way to make these plans.

This presentation was given at the First Forum on Human Resources for Health in Kampala. It details the financial issues involved in scaling up health worker training such as the cost of hiring additional staff, educating health workers and expanding training capacity. It also outlines the current and possible future sources of increasing expenditure for health worker training. [adapted from author]

This presentation was given at the First Forum on Human Resources for Health in Kampala. It reviews a study of how Rwanda, faced with constrained fiscal conditions, has implemented innovative reforms to create fiscal space for human resources and to make these resources more responsive to needs through an analysis of budget documents and policy and regulation changes and key informant interviews. [adapted from author]

This presentation was given at the First Forum on Human Resources for Health in Kampala. It talks about goverment spending policies on health worker wages and how they affect the health workforce.

This presentation was given at the First Forum on Human Resources for Health in Kampala. It breaks down current health spending including HRH resource needs and gaps, provides a critical assessment of HRH financing by some of the top donors and addresses campaiging for adequate and sustained donor financing. [adapted from author]

This presentation was given at the First Forum on Human Resources for Health in Kampala. It presents five questions on the financial concerns of scaling up the number of health workers to provide adequate health care.