Health Professions

Aboriginal Workers Key to Indigenous Health in Australia

As a group, indigenous Australians are much less healthy and more likely to die at younger ages than their non-indigenous counterparts. Training more indigenous people as health workers could help to reduce these startling inequalities, say experts. [author's description]

Achieving Child Survival Goals: Potential Contribution of Community Health Workers

This article discusses the potential contribution of community health workers to child survival rates. Several trials show substantial reductions in child mortality, particularly through case management of ill children by these types of community interventions. However, community health workers require focussed tasks, adequate remuneration, training, supervision, and the active involvement of the communities in which they work. This article discusses the need for evaluation of programmes for community health workers. [from summary]

Achieving Functional HIV/AIDS Services through Strong Community and Management Support

The issue of The Manager focuses on designing and improving a package of HIV-related services using a conceptual framework called the Functional Service Delivery Point. The framework can help managers to identify the characteristics that make HIV-related services functional and to deliver these services with strong community and management support. [from editor]

Addressing Health Worker Shortages: Recruiting Retired Nurses to Reduce Mother-to-Child Transmission in Guyana

When GHARP set out to recruit new service providers [for preventing mother-to-child transmission], it faced a dilemma. Due to the limited supply of health workers in Guyana, the project needed to avoid recruiting health care providers already working for the MOH. Hiring existing health workers away from their jobs would simple reshuffle the distribution of health workers, rather than add new ones. To address the problem, GHARP staff decided to recruit retired nurses to fill the positions. [from author's description]

Addressing the Human Resource in Health Crisis: Empowering the Private Not for Profit Health Training Institutions to Play Their Role

This presentation was part of the International Conference on Global Health session, "Answering the Call: Innovations in Human Resources by African Faith-Based Organizations." From the perspective of the Uganda Catholic Medical Bureau experience, the presentation discusses why the private not-for-profit sector is important in service provision and training; why nurses are in the midst of the human resource crisis; obastacles to increasing the training capacity; and what the PNFP health training institutions are doing to address their weaknesses. [adapted from author]

Adequacy and Efficiency of Nursing Staff in a Child-Welfare Clinic at Umtata General Hospital, South Africa

South Africa has a serious shortage of human and financial resources to provide primary healthcare services especially in the historically under-served areas. It is a tedious task to carry out healthcare delivery for the masses without rationalizing human resources in the form of re-allocation and re-deployment of healthcare personnel. This study aimed to establish the level of adequacy and efficiency of nursing staff in the former Transkei region. The study was carried out in the child and family welfare clinic of the Umtata General Hospital. [from abstract]

Adressing the Human Resource Crisis in Malawi's Health Sector: Employment Preferences of Public Sector Registered Nurses

This paper examines the employment preferences of public sector registered nurses working in Malawi and identifies the range and relative importance of the factors that affect their motivation. The research was designed in the light of the Malawi government’s programme to address the shortage of health workers, which is based on salary top-ups as a means of increasing employee motivation and reducing high rates of attrition. This policy has been adopted despite relatively little quantitative exploration into the employment preferences of health workers in developing countries. This study aims to provide a clearer picture of the preferences of registered nurses about different aspects of their employment, and the factors that might persuade them to continue in the profession within their home country.

Africa's Neglected Surgical Workforce Crisis

This article outlines the challenges facing the surgical workforce in Africa. Funding priorities in Africa typically favor infectious diseases, and surgery and perioperative care have been neglected, even though essential surgical care at district hospitals is more cost effective than some other highly prioritized interventions, such as antiretroviral therapy for HIV. There is a need to integrate surgical and anesthetic training programs so health personnel, particularly in rural areas, can treat the full range of diseases appropriate to that level of care. [adapted from author]

Analysis of Adequacy Levels for Human Resources Improvement within Primary Health Care Framework in Africa

Human resources in health care system in sub-Saharan Africa are generally picturing a lack of adequacy between expected skills from the professionals and health care needs expressed by the populations. It is, however, possible to analyse these various lacks of adequacy related to human resource management and their determinants to enhance the effectiveness of the health care system. From two projects focused on nurse professionals within the health care system in Central Africa, we present an analytic grid for adequacy levels. [from abstract]

Appraisal of the Institutional Training Arrangement for Community Health Workers in Bangladesh

This research sheds light on the nature, design and provision of institutional services for providing training to the premier community health service providers in the public sector in Bangladesh. Virtually no major study exists on the training of the FWVs in the country. The methodology of the research mainly consists of a personal interview and questionnaire survey, covering the concerned trainers and officials of the major public health administration and training institutions of the country, including the National Institute of Population Research and Training, the Family Planning Directorate and the Family Welfare Visitors' Training Institute.

Are Skilled Birth Attendants Really Skilled? A Measurement Method, Some Disturbing Results and a Potential Way Forward

Delivery by a skilled birth attendant (SBA) serves as an indicator of progress towards reducing maternal mortality worldwide – the fifth Millennium Development Goal. Though WHO tracks the proportion of women delivered by SBAs, we know little about their competence to manage common life-threatening obstetric complications. We assessed SBA competence in five high maternal mortality settings as a basis for initiating quality improvement. [from abstract]

Assessing Clinical Skills: Standard Setting in the Objective Structured Clinical Exam (OSCE)

Family Medicine training and assessment is becoming more formalized and developed in South Africa. Assessment of competency in relation to clinical skills can involve observation in the clinical setting, but is more usually assessed in an examination. Summative assessment of family physician’s clinical skills now usually includes an Objective Structured Clinical Examination (OSCE). Standardisation of the OSCE is required to define the pass mark above which a candidate performs at the level expected of a family physician. [from abstract]

Assessment of Health Personnel Management and Cost Recovery Mechanisms Related to Capacity Building in Church Hospitals

This study is meant to enable the Christian Social Services Commission to strengthen the coordination of the health personnel hired by church hospitals. On the part of the administration of the hospitals, the study is meant to harmonize the criteria and principles on which the management of the health staff can be based. The study is ultimately to lead to a human resource policy package, which in turn should lead to the production of a Health Personnel Management Policy Manual for the church hospitals coordinated by the CSSC. [adapted from author]

At Breaking Point: a Survey of the Wellbeing and Working Lives of Nurses in 2005

The RCN commissioned a survey of 6,000 members in 2000 to explore nurses’ wellbeing and working lives. The results subsequently helped shape RCN policy and materials for members on topics such as bullying and harassment, violence, needlestick injury and employee-friendly working practices. Five years later, the RCN has commissioned a second survey looking at a similar range of issues. This report documents the findings of that survey, and describes differences between the 2000 and 2005 survey findings. [introduction]

Atlas: Nurses in Mental Health 2007

Mental health care is an essential but often forgotten component of health care. Nurses are core health-care providers and they need to be able to contribute effectively to mental health care. [This document] presents results of a global survey on the availability, education, training and role of nurses in mental health care. [from foreword]

Attitudes of Nursing Students of Kolkata Toward Caring for HIV/AIDS Patients

This study examines the attitudes of nursing students toward caring for HIV/AIDS patients and their knowledge and perceptions about the disease. Findings revealed a very positive outlook of the nursing students in regards to caring for HIV/AIDS patients. Although most of them expressed their willingness to take any job offer concerning caring for HIV/AIDS patients, 34.3% apprehended resistance from their family members in this regard. However, they also considered that it would be possible for them to overcome the resistance. Although 100% of the students had heard of HIV/AIDS, a number of them had misconceptions about various aspects of the disease.

Attitudes Towards Immunization in Cambodia: a Qualitative Study of Health Worker and Community Knowledge, Attitudes and Practices in Kompong Chhnang

Childhood immunization is a major public health concern in Cambodia. Given the high infant and child mortality rates and the low uptake rate of immunizations, a study of knowledge, attitudes and practices (KAP) of communities and health workers was conducted to identify barriers to immunization and inform future information, communication and education (IEC) strategies. Quantitative and qualitative research was conducted to discover the KAP of communities and health workers towards immunization services and the introduction of hepatitis B vaccine. This paper reports on qualitative research with villagers and health workers.

Attracting and Retaining Nurse Tutors in Malawi

This paper focuses on the scheme by the Malawi Ministry of Health (MOH) to retain nurse tutors in collaboration with the Christian Health Association of Malawi (CHAM). It chronicles the scheme's successful elements for purposes of eventual replication, suggests how to address some of the challenges and identifies effective incentives, including salary supplements. [from executive summary]

Attracting Psychiatrists to a Rural Area 10 Years On

In rural areas across Australia the recruitment and retention of adequate numbers of medical specialists, including psychiatrists, has been a long outstanding problem. Latrobe Regional Hospital reached a major crisis in 1994, with only one psychiatrist and a large number of vacancies. This led to a focus on the recruitment and retention of psychiatrists in order to improve this essential element of the workforce. [from abstract]

Attracting, Retaining and Managing Nurses in Hospitals: NSW Health

The NSW Department of Health is responsible for managing nurse supply. It needs to identify the extent and nature of shortages and develop ways to attract, retain and best manage nurses working in public hospitals. This audit looks at how nurses are managed in four of our public hospitals and examines how the Department has responded to expected nurse shortages. It also highlights actions that have helped reduce the number of nurses leaving hospitals. [from foreword]

Barriers to Training Family Physicians in the Caribbean: Distance Education as a Promising Prescription

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]

Baseline Projection of Requirements for Dental Health Manpower in Thailand (1995-2015)

This study is intended to compare the dental health personnal supply to the requirement in each 5-year interval from 1995 to 2015. The results show that there will be 10,100 dentists and 7,718 dental nurses in supply in the year 2015. The personnel requirement was calculated using 3 different techniques. The results show that in the year 2015, the supply of dentists exceeds the requirement regardless of what technique is used. [from abstract]

Basic Medical Education: WFME Global Standards for Quality Improvement

A central part of the World Federation for Medical Education strategy is to give priority to specification of international standards and guidelines for medical education, comprising both institutions and their educational programmes. Adoption of international standards will constitute a new framework for medical schools to measure themselves. Furthermore, internationally accepted standards could be used as a basis for national and regional recognition and accreditation of medical schools’ educational programs. [from introduction]

Better Data, Better Decisions: a Profile of the Nursing Workforce

This data creates a profile of the nursing workforce, which is useful for projecting trends and estimating future requirements. At the corporate level, longitudinal examination over a series of years would demonstrate the relationship between the characteristics of the nursing workforce and the overall requirements for patient care. At the unit level, the data is helpful to examine human resource needs and fluctuations in the workforce characteristics. A human resource profile has many data elements and results from the input of a variety of sources and requires high standards of data entry and management.

Better Data: Better Performance: Community Health Nursing in Ontario

Understanding the supply and utilization of nurses is critical to maintaining an effective community health system. There has to be sufficient staff and a work environment that builds on the existing strengths of community health nursing to meet emerging needs. This report provides a demographic profile of community health nurses (CHNs) in Ontario and identifies enablers that support optimal practice of their competencies. [from executive summary]

Beyond the Clinic Walls

This book contains a series of case studies which depict the management issues a family planning organization faces in designing and implementing a new community-based distribution (CBD) program for contraceptives. The cases, which take place in a fictional country Momonboro, are based on an actual program initiated in an African country, and reflect the problems and successes which that program experienced. The book is divided into seven sections: an overview of CBD, planning, effective management, supervision, compensation and pricing, financial control, and a start-up kit that serves as a guide through the major tasks of planning and implementing a CBD project.

Birth Attendants Trained in Prevention of Mother-to-Child HIV Transmission Provide Care in Rural Cameroon, Africa

This article discusses a program that established primary health centers in remote villages and trained literate women in these villages as birth attendants to offer antenatal care, low-risk delivery, and triage of high-risk mothers to larger health facilities. In 2002, the birth attendants were trained to provide Prevention of Maternal-to-Child HIV Transmission (PMTCT) services, including counseling, voluntary testing, performing oral rapid HIV tests, posttest counseling, and administering single-dose nevirapine to HIV-positive women, to be taken in labor, and to their newborns. Ongoing supervision is provided by nurse supervisors. [adapted from abstract]

Black and Minority Ethnic and Internationally Recruited Nurses: Results from RCN Employment/Working Well Surveys 2005 and 2002

In order to help improve Royal College of Nursing understanding of the employment experiences of internationally recruited nurses and UK trained black and minority ethnic (BME) nurses, the RCN commissioned a secondary analysis to draw together commentary and analysis from previous surveys.

Bridging the Health Gap in Uganda: the Surgical Role of the Clinical Officer

A scarcity of trained medical personnel impedes Uganda’s ability to deliver healthcare effectively. The role of the Clinical Officer (CO) was established to assist the provision of primary healthcare to rural communities. The primary aim of this study was to explore the role that the CO performs in delivery of primary and secondary healthcare in Uganda. A secondary aim was to determine the resources and facilities that are available to COs in order to carry out these duties. A further aim was to determine the confidence of COs at performing surgical and obstetric procedures. [from introducti

Building Global Alliances III: the Impact of Global Nurse Migration on Health Service Delivery

The issues surrounding nursing shortages and global nurse migration are inextricably linked. The shortage of practicing nurses worldwide has led to aggressive recruiting by healthcare employers in the United States, the United Kingdom, and other countries. Foreign-educated healthcare professionals represent more than a quarter of the medical and nursing workforces of Australia, Canada, the United Kingdom, and the United States. [author's description]