Human Resources Management

This paper reviews the situation and trend in human resources for health and its priority problems in Thailand. It also highlights the issue of the inequitable distribution of doctors. Through several brainstorming sessions among stakeholders, it summarizes a package of recommendations for the future continuous and sustainable knowledge-based human resources for health development. [from abstract]

This presentation was part of the 2006 Global Health Mini-University. A key approach to address the global shortage of healthcare providers is to improve the productivity of existing workers, thereby improving the quality and coverage of services. Improving the work environment and task shifting of health functions to different cadres of providers are two promising interventions that are being used for this purpose. This session will describe and discuss these and some of the other innovative solutions to enhance the capacity and productivity of the current workforce and to build coherence into the management of human resources for stronger health systems. [publisher's description]

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.

Provider payment methods are important to consider any time a government or a payor wants to improve the efficiency and the quality of health services with the use of its funds. Changes in provider payment methods are often pivotal to broader health reform measures to contain costs and use existing resources effectively, and also to improve quality of care and equitable financial access to care. [author's description]

The task of improving quality is a demanding job. It requires focusing on clients, using data, working collaboratively with other team members, and maintaining an overarching view of the health system in which we work. Benchmarking is a process for finding, adapting, and applying best practices. [adapted from author]

This assessment establishes the link between service quality and initial training by examining the skill retention of 2 cohorts of service providers who participated in a family planning (FP) training program in Kenya during 1994–1995. The following two questions were considered: 1) Do providers use the skills in which they were trained? 2) Is the length of time after the course concludes related to whether trained providers retain their new skills? [publisher's description]

This issue of The Manager offers financial and program managers—from headquarters to the service delivery level - reasons to assess their financial management systems and a method for performing this assessment. It introduces FIMAT, the Financial Management Assessment Tool, a step-by-step process and instrument for rapidly assessing budgeting, accounting, purchasing and other financial systems. It describes how managers can use their assessment results to develop detailed action plans that can be incorporated into their organization's annual operation plans. [from author]

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]

The original purpose of the ADHA scheme was to compensate doctors for hours worked beyond the standard 40 hours per week or 160 hours per month. This study investigated how the scheme impacted a number of human resources (HR) factors associated with health worker recruitment, deployment, retention and performance - specifically, how the significantly higher income levels resulting from the ADHA scheme influenced job satisfaction, motivation, workplace climate and the relationship between clinical and administrative staff, as well as productivity. The study provides a detailed chronology of the ADHA scheme and explores lessons learned from the way in which the GOG implemented and administered the scheme.

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]

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]

Australia is experiencing workforce shortages across a number of health professions despite a significant and growing reliance on overseas trained health workers. The shortages are even more acute in rural and remote areas. It is critical to increase the efficiency and effectiveness of the available health workforce, and to improve its distribution. This report describes the Australian government's objectives of developing a more sustainable and responsive health workforce while maintaining a commitment to high quality and safe health outcomes. A set of national workforce objectives are also proposed.

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.

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 paper, which was prepared as background for the Working Group on Performance Based Incentives, looks at a particular type of financing intervention that has been applied in several different ways around the world to address the joint problems of underutilization and low quality of health services. The focus is on demand- and supply-side financial and material (examples: food, travel vouchers) incentives that can be used to improve utilization and quality of ambulatory health care services, especially for the poor. [from introduction]

Capacity management systems create insight into required resources like staff and equipment. For inpatient hospital care, capacity management requires information on beds and nursing staff capacity, on a daily as well as annual basis. This paper presents a comprehensive capacity model that gives insight into required nursing staff capacity and opportunities to improve capacity utilization on a ward level. [from abstract]

In this discussion document, the Department of Health and Children identifies key development issues facing nursing and midwifery in the future. This is in order to establish a strong platform for the formulation of a strategic response to these issues. The document contains an insightful analysis of the challenges ahead and identifies a range of possible responses. [from preface]

This presentation was part of the International Conference on Global Health session, "Integration and Application: Successes and Challenges in Health-Worker Training." It talks about the need for supervision, the supervisory problems at the Health Center, the approaches taken to address the problem, improving supervisor skills, and monitoring.

This issue of Health Action looks at a few of the many [health] challenges, their likely impact on health workers and how they might be met. What may surprise some readers is that many challenges do not involve medical advances. Rather, they are concerned with adapting health systems to cope with new developments (for example, demographic changes, non-communicable diseases) and finding new ways of working effectively. [author's description]
The issue contains articles on: supporting staff strengths; building better partnerships; and partners in planning.

Effective teamwork between doctors and clinical nurse practitioners (CNP) is essential to the provision of quality primary care in the South African context. The Worcester Community Health Centre (CHC) created dedicated practice teams offering continuity of care, family-orientated care, and the integration of acute and chronic patients. The teams depended on effective collaboration between the doctors and the CNPs. This inquiry focuses on the question of how more effective teams of doctors and clinical nurse practitioners offering clinical care could be created within a typical CHC. [adapted f

The purpose of this publication is to highlight the major issues and challenges associated with human resources management in the public health sector and to affirm the importance of these as a priority focus for the technical cooperation efforts of PAHO’s Human Resources for Health Unit and the World Health Organization (WHO) over the coming years. [publisher's description]

The checklist described in this document has been developed as a tool to assist those involved in a systematic review of the human resource development component of the NTP. This component is often referred to as "training." In this document, the term training is used in a broader context than the more traditional interpretation of the term, where training refers to organization and implementation of training courses. Training in this document is often replaced by the term "HR development" to stress the need for a broader and more long-term approach within NTPs. [from introduction]

This manual is a collection of adaptable tools and guidelines designed to help clinic supervisors and clinic managers achieve objective improvements in the quality of health care. The manual is especially useful for managers supervising integrated health services, who, on any given day, may be called on to support the provision of a full range of primary health services. The manual is designed to complement more detailed standard operating procedures that may be in use for specific services, for example, antiretroviral therapy. It is based on the belief that regular, systematic supervision is essential to upgrading clinic services and maintaining improvements.

This leaflet has been designed as an introduction to clinical supervision. It aims to stimulate ideas and to encourage occupational health nurses to set up supervision practice in their workplaces. Clinical supervision isn’t a management tool, but can be used as a support and prompt to professional practice in a creative way. [from introduction]

Management Sciences for Health has developed an approach to helping managers become more like coaches, which has proven successful in various settings. This issue of the eManager will help you examine your managerial practices and give you the tools to expand your role from manager to manager as coach.

This best practice guideline focuses on nursing teams and processes that foster healthy work environments. The focus for the development of this guideline was collaborative practice among nursing teams with the view that this may be a first stage in a multi-staged process that could eventually result in interprofessional guidelines. A healthy work environment for nurses is a practice setting that maximizes the health and well being of nurses, quality patient outcomes and organizational performance. Effective nursing teamwork is essential to the work in health care organizations. [from purpose]

This paper examines the experience with using various incentives to motivate and retain community health workers (CHWs) serving primarily as volunteers in child health and nutrition programs in developing countries.

Donor funds may be inadequate to support the growing demand for services provided by community-based distribution (CBD) programs. One solution may be to reduce the remuneration of CBD agents, but this approach may lower their productivity. Programs also need to consider reducing other costs, including those for supervision and training. The cost per agent visit—including costs associated with payments to agents and to supervisors and the costs of training—was calculated for three CBD programs in Tanzania. The output measure was visits in which contraceptives were provided or referrals made for family planning services.

As the complexity of the challenges facing the public health workforce has increased, many have argued that insufficient resources have been devoted to the preparation of the workforce, including its leaders. Here we describe the growth of national advocacy for public health leadership and workforce development. We discuss the creation of the National Public Health Leadership Development Network (NLN), a consortium of institutes providing a system for leadership development, and we review the network’s creation of the Leadership Competency Framework for core curriculum design and development of performance standards for public health practice.

This paper looks at the successes and failures of today's health care workforce. Hargadon and Plsek argue that our current solutions to the problems in the health workforce are insufficient. To overcome these insufficiencies, they believe that we need to better understand the complexities of the workforce. However, this is not an easy feat, because these problems challenge our traditional mental models of how things should work. [abstract]