Medical Officers

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

This curriculum is designed to help as a guide for the training of both generic and post basic health officers.

A number of ART projects are trying to tackle the HRH problematic by delegating certain tasks from medical doctors to other cadres. While this task-shifting is certainly an important step, we contend that it will not be enough for scaling up ART in the high HIV-prevalence countries with the most severe HRH shortages. In the present report we argue that an altogether different approach to HIV/AIDS care and treatment might be required for overcoming the HRH bottleneck. [from summary]

A preliminary report of a small-scale study of health worker motivation in South Africa exploring the links between motivation and performance, and the relevance of workplace trust as an influence over motivation. In general, health workers appear to give less emphasis to trust in colleagues as an influence over motivation, and much great emphasis to trust in manager/supervisor and trust in employing organization. The initial findings suggest that: health care provision is affected by health worker motivation and performance problems; there is potential to strengthen motivation and performance through changed management practices; the way in which management decisions are implemented is a critical influence over the impact of any decision on motivation; and management action needs to recognize the perceived risk and powerlessness expressed by many health workers, and seek to tackle these perceptions.

A study exploring the influence of workplace trust over health worker performance at primary care level was undertaken in Tanzania and South Africa in 2003. The main factors identified by respondents as underlying poor health worker performance and motivation in the public sector were: staff shortages and low salaries; poor working conditions; favoritism and lack of transparency in human resource management practices; limited supervision and monitoring; weak disciplinary procedures; limited and slow opportunities for promotion; differential salary levels; rigid employment management policies; slow decision-making across the public service; and conflicting lines of accountability at district level.

Massive shortages in trained health care professionals in sub-Saharan Africa have led to an examination of substitute health workers as an immediate response to the workforce crisis. This article provides an overview of the advantages and disadvantes of utilizing substitute health workers. [adapted from author]

This review aims to support efforts to integrate, plan and manage mid-level health workers by collating what we know about experiences with mid-level cadres in low-income countries in Africa, south-east Asia and the Pacific, regions that heavily rely on them. It interrogates the existing evidence on the evaluation of different types of mid-level workers and their impact on health outcomes and it identifies knowledge gaps. The review focuses specifically on the role of mid-level workers as independent practitioners in areas that suffer from severe shortages of professionals. [adapted from execu

Clinical officers perform much of major emergency surgery in Malawi, in the absence of medical officers. The aim of this study was to validate the advantages and disadvantages of delegation of major obstetric surgery to non-doctors. [abstract]

This presentation was given at the First Forum on Human Resources for Health in Kampala. It discusses training Clinical Officers, a cadre of mid-level health professionals, as a method of filling the health worker gap in a post-conflict area.

This video clip is 6 minutes and 48 seconds. It is a brief overview of Tanzania's use of assistant medical officers and clinical officers to address the shortage of doctors in rural areas. It contains short interviews with health workers and administrators on how these substitute workers are viewed and the role they play in the health system.
You must have access to a media player to see the video. Download instructions are available from the WHO Best Practices in Human Resources for Health Development website.