Policy

This paper addresses the issue of data use for HRH policy-making. It will provide valuable information to the body of literature available to policy-makers and their development partners as they grapple with the development and implementation of workable HRH policies. [from summary]

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]

This paper aims to present the existing HRH problems exemplified by migration in the light of other related issues such as the nurse medic phenomenon, foreign doctors taking up residency training, quality of nursing education, paradoxical enrollment trends in nursing and medicine and the effects of migration on health service delivery.

This is a review of current multi-lateral agreements, codes of practice, bilateral agreements, regional agreements, and strategies and position statements that govern the migration of health workers from ESA (East and Southern African) countries. The main purpose of this paper is to provide an overview of the current situation in ESA. [from executive summary]

Telemedicine is viewed as a new way of offering medical services. It is seen as a means of overcoming the growing shortage of health practitioners in developing countries. The aim of this paper is to highlight the need for the formulation of guidelines for the ethical practice of telemedicine in South Africa. [from abstract]

This article identifies human resources for health policy options in low and middle income countries, and assesses the effectiveness of these policy options. The authors conclude that there is a need for more systematic reviews on the effects of policy options to improve human resources for health in countries with low and middle incomes, for assessments of any interventions that policy makers introduce to plan and manage human resources for health, and for other research to aid policy makers in these countries. [adapted from author]

This brief describes the Capacity Project's work with health workforce planning using HRIS in Rwanda.

In this paper we attempt to provide an overview of the concepts and practice of community health workers (CHWs) from across a range of (developing and developed) countries, and draw some insights into policy challenges that remain in designing effective CHW schemes, particularly in the Indian context. In the subsequent sections, we provide a review of the various ways in which community health workers have been deployed in different settings. [from introduction]

This report summarizes the speeches and discussions from the Practice to Policy: Global Perspectives in Nursing conference in 2006. Both healthcare professionals and th system are faced with a number of ongoing challenges, which may require a shift in organizational policy and can affect the way nurses practice. Nurses are and integral part of the healthcare system and play a key role in influencing these changes. Nurses’ voices need to be heard, and they must be able to articulate what they do. This will ensure open communication with policy and decision makers and facilitate an understanding of different cultures.

This report presents an overview of the policy implications of the international migration of health workers in Europe, based on case studies conducted in five countries – Estonia, Germany, Lithuania, Poland and the United Kingdom – and draws on information from other WHO European Region countries, such as Israel and Latvia. [from introduction]

This document is an environmental policy scan of activity in three areas related to physicians, nurses and pharmacists: education and training initiatives; recruitment and retention and work place initiatives; and capacity to do national health human resource planning. [adapted from introduction]

This document provides a systematic framework for establishing and maintaining community home-based care (CHBC) in resource-limited settings for people with HIV/AIDS and those with other chronic or disabling conditions.

This paper begins by clarifying the terms shortage and underserviced. Provincial and federal programs for underserviced areas in Ontario are then described and considered in terms of their relevance to nursing. A discussion of the issues associated with policies addressing shortage and underserviced areas follows. The paper concludes with recommendations for change. The importance of making funding decisions based on a clear understanding of relevant concepts and models is emphasized. [introduction]

Workplace violence is one of the most complex and dangerous occupational hazards facing nurses working in today's health care environment. This article includes critiques of the conceptual, empirical, and policy progress of the past decade, a discussion of the need for methodologically rigorous intervention effectiveness research, and a description of a joint-labor management research effort aimed at documenting a process to reduce violence in a state mental health system. [from abstract]

The purpose of this policy and guidelines is to ensure that in all violent incidents, appropriate action is consistently taken to protect health service staff, patients and visitors, and health service property from the effects of such behaviour. The guidelines are provided as a reference tool and should be used to develop local policies and procedures that reflect the intent of this document, and that are specifically targeted at and adapted to local workplace cultures, situations and needs. [from introduction]

West African-trained physicians have been migrating from the sub-continent to rich countries, primarily the US and the UK, since medical education began in Nigeria and Ghana in the 1960s. In 2003, we visited six medical schools in West Africa to investigate the magnitude, causes and consequences of the migration. We conducted interviews and focus groups with faculty, administrators (deans and provosts), students and post-graduate residents in six medical schools in Ghana and Nigeria. In addition to the migration push and pull factors documented in previous literature, we learned that there is now a well-developed culture of medical migration.

This tool seeks to assist HRH workers and policy makers in a country think through, diagnose, and stimulate dialogue about their HRH challenges by responding to questions and reflecting on the policy implications of their answers.

The shortage of health workers with the right expertise and experience has reached crisis levels in many developing countries. The ability of health services to deliver care depends on the knowledge, skills and motivation of health workers. Without enough skilled staff in the right place at the right time health systems cannot function effectively and populations are left without the treatment and support they need. [author's description]

As part of the High-Level Forum on the Health Millennium Development Goals, this issue paper discusses improving health workforce performance as a key factor in meeting MDGs. The required scaling up of interventions towards the MDGs depends on effective health services delivery systems (HSDS). The availability, the skills, the attitudes, motivation, and behaviors of health workers are key to well-functioning HSDS. [adapted from author]

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

Countries continue to have significant imbalances in their human resources for health (HRH). Frequently the failure to implement human resources development (HRD) policies is blamed on the lack of a favourable economic environment and real political commitment in countries. This paper proposes that a major explanation is the policy formulation process itself. Policy-makers and planners must learn more about policy formulation processes in HRD. An assessment of different approaches in a variety of contexts (economic, social, stage of reform, etc.) can provide valuable lessons. [author's descrip

The consequences of health professional mobility have become a prominent public policy concern. This paper considers trends in mobility amongst doctors and nurses and the consequences for health systems. Policy responses are shifting from a reactive agenda that focuses on stemming migration towards a more active agenda of managed migration that benefits source and destination countries. Improved working conditions and effective human resource practice are required to encourage retention of health professionals in both source and destination countries. [abstract]

This report focuses primarily on the policy implications of the international migration of nurses, and highlights recent trends. International recruitment and migration of nurses has been a growing feature of the global health agenda since the late 1990s. Nurses have always taken the opportunity to move across national borders in pursuit of new opportunities and better career prospects, but in the last few years nurse migration appears to have grown significantly, with the potential to undermine attempts to achieve health system improvement in some developing countries. [from executive summary

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]

This paper addresses the health care system from a global perspective and the importance of human resources management (HRM) in improving overall patient health outcomes and delivery of health care services.

This report describes global progress on the “3 by 5” (Treating 3 million by 2005: making it happen) project in scaling up access to [HIV/AIDS] antiretroviral therapy and outlines the areas in which important progress has been made and lessons learned. It also outlines the remaining challenges and roadblocks to treatment access. [author's description]

Chapter 2 (Strengthening Health Systems) provides an overview of HRH related approaches and progress.

The tools and guidelines collected in this book will assist health program managers, policymakers, and leaders to assess the impact of HIV/AIDS on the health workforce and its capacity to deliver and scale up HIV/AIDS services. The book provides materials to help decision-makers develop a strategy to mitigate the impact of HIV/AIDS, for both a short-term emergency response and a longer-term plan to strengthen HRM systems. This compilation also includes a tool developed by the World Health Organization to help HIV/AIDS programs to achieve a more sustainable workforce appropriately trained to provide ART.

The loss of skilled personnel to rich countries is a major concern for many developing countries today. However, large numbers of people from developing countries are also being trained overseas and, of those trained at home, many cannot be absorbed productively into their economies of origin. At the same time, the association between the presence or absence of health personnel and the health status of a population is seen as simplistic and a range of other factors are addressed. This Briefing examines the case for a two-tiered health training system, one for global markets and the other for local markets.

The relationship between poor conditions of employment and work of nursing personnel and shortages is complex. Consequences may include: increased patient morbidity and mortality; greater levels of violence in the workplace; reduced occupational safety and health for remaining personnel; high levels of job dissatisfaction with intention to quit; and unsustainable patterns of health worker migration from developing countries.The Nursing Personnel Convention articulates the kinds of provisions needed to address many of the identified problems. It must be implemented in the greatest number of countries in order to set decent standards of work, boost the professional and political profile of nursing personnel, and provide incentive for nursing personnel to remain in their jobs.

Some 60 participants from ministries of health, multilateral and bilateral international agencies, foundations, nongovernmental organizations (NGOs) and professional organizations discussed and debated a range of issues in order to contribute to the objectives of this workshop, which were to: further the development of an HRH framework for policies; identify policy questions and agree upon an agenda for development of policy options; identify gaps in evidence and priorities for obtaining evidence on which to base policy; build capacity and partnership for action at country level. [author's des