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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]

Abundant for the Few, Shortage for the Majority: the Inequitable Distribution of Doctors in Thailand

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]

Acceptability and Feasibility of Introducing the WHO Focused Antenatal Care Package in Ghana

The Government of Ghana has adopted the WHO focused antenatal care (ANC) package in a move to improve access, quality and continuity of ANC services to pregnant women. As part of these efforts, the Government has exempted fees for ANC clients. The main objective of this study, undertaken by Noguchi Memorial Institute for Medical Research in collaboration with the Ghana Health Service (GHS), FRONTIERS, and with USAID funding, was to examine the extent to which adaptation of the package influenced quality of care received by pregnant women and its acceptability to both providers and clients. The study used a policy analysis and a situation analysis in ten intervention clinics in which the package had been introduced and four comparison clinics.

Acceptability and Sustainability of the WHO Focused Antenatal Care package in Kenya

To promote the health and survival of mothers and babies, Kenya has adapted the WHO goal-oriented Antenatal Care (ANC) package, popularly known as focused ANC (FANC). The Ministry of Health (MOH) has designed new guidelines for ANC services, placing emphasis on refocusing antenatal care, birth planning and emergency preparedness, and the identification, prevention and management of life threatening complications during pregnancy and childbirth. ANC visits are now used as an entry point for a range of other services, thus promoting comprehensive integrated service delivery. A major challenge, however, is whether the Kenyan health care system can cope with the implementation of this package.

Access to Continued Professional Education Among Health Workers in Blantyre, Malawi

This study was carried out to document the current situation regarding continued or in-service training opportunities amongst healthcare workers serving in government (public) health centres within Blantyre District Health office. Knowledge of such a situation would better inform health personnel trainers, professional regulatory bodies, the Ministry of Health and international agencies to design appropriate intervention programs towards professional development of healthcare personnel. [from introduction]

Accreditation of Providers for the National Health Insurance Fund of Tanzania

This report will review the critical elements of quality assessment in Section 1. In the second section it will review the National Health Insurance Fund Act requirements for accreditation and the current means of registering and evaluating health providers. What is needed in accreditation, the options for Tanzania, and the potential problems there may be with accreditation. The final section provides practical guidance for implementing a short-term and longterm strategy for accreditation of NHIF providers and more broadly for all Tanzanian providers. Appendix A provides a practical tool: An Accreditation Survey Instrument for Hospitals.

Acting Now to Overcome Tanzania's Greatest Health Challenge: Addressing the Gap in Human Resources for Health

The focus of McKinsey's research effort is on the HRH constraint, faced by many developing countries, in absorbing development aid and scaling up urgently needed health programs. HRH in this context is defined as the health workers at the front line of healthcare service delivery. The field work necessary to diagnose the problem and identify possible solutions has been initiated in Tanzania. We believe these findings, accounting for certain differences, will be broadly applicable to several developing countries.

Action against Sexual Harassment at Work in Asia and the Pacific: Technical Report for Discussion at the ILO/Japan Regional Tripartite Seminar on Action against Sexual Harassment at Work in Asia and the Pacific (Penang, Malaysia, 2-4 October 2001)

This report, Action against Sexual Harassment at Work in Asia and the Pacific, is intended to serve as a technical report for discussion at the ILO Regional Tripartite Seminar on Action against Sexual Harassment at Work, to be held in Penang, Malaysia from 2 to 4 October, 2001. The aims of the technical report, prepared for the ILO Regional Tripartite Seminar, are to familiarize participants with the phenomenon of sexual harassment at work and to give an overview of initiatives and good practice for its prevention and elimination as taken by governments, employers’, workers’ and women’s organizations.

Action Plan to Prevent Brain Drain: Building Equitable Health Systems in Africa

The causes of brain drain are complex and interrelated, involving social, political, and economic factors. The necessary responses will therefore be varied and cover an array of areas. Drawing on growing interest and scholarship, Physicians for Human Rights (PHR) proposes this plan of action for addressing brain drain and the unequal distribution of health personnel within countries, recommending actions by high-income countries, African governments, WHO, international financial institutions, private businesses, and others. [author's description]

Addressing Africa's Health Workforce Crisis

The disparity is staggering. Africa bears one-quarter of the burden of disease around the world yet has barely 3 percent of all health workers. Millions of people across the continent thus suffer needlessly because they cannot obtain medical care from trained personnel. In sub-Saharan Africa, where the crisis is most acute, fully 820,000 additional doctors, nurses, and midwives are needed to provide even the most basic health services. To meet this shortfall, most of the region’s countries would have to increase the size of their health workforce by 140 percent. [author's description]

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 Crisis: a Case Study of the Namibian Health Service

This paper addresses an important practical challenge to staff management. We use a case study based on semi-structured interview data to explore the steps that Namibia, a country facing severe health problems that include an alarmingly high AIDS infection rate, has taken to manage its health workers. [from abstract]

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]

Adherence to Antiretroviral Therapy in a Home-Based AIDS Care Programme in Rural Uganda

Poverty and limited health services in rural Africa present barriers to adherence to antiretroviral therapy that necessitate innovative options other than facility-based methods for delivery and monitoring of such therapy. We assessed adherence to antiretroviral therapy in a cohort of HIV-infected people in a home-based AIDS care programme that provides the therapy and other AIDS care, prevention, and support services in rural Uganda. [author's description]

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 Health Workforce Observatory

This presentation was part of the ECSA Workforce Observatory Meeting in Arusha. It describes the Africa Health Workforce Observatory as a cooperative initiative and partnership (public sector, NGO/ CSOs, academy, professional associations, international & subregional organizations, development partners) to improve human resources development through promoting and facilitating evidence-based policy-making. The presentation details the benefits and some of the functions of the Observatory such as: country monitoring and information; research and analysis; sharing and dissemination; promoting national and intercountry networking; and capacity building for HRH. [author's description]

Africa's Health in 2010: Capacity Strengthening of African Institutions and Networks: a Strategy

The purpose of this document is to provide Africa 2010’s strategy for strengthening regional and local capacity for adopting effective policies and innovations to improve the health status of Africans. [from introduction]

Africa's Medical Deficit: a Permanent Drain of Trained Health Personnel

The African continent is facing 25% of the world’s morbidity rate with only 3% of its healthcare personnel. This is the result of years of neglect and underinvestment by African governments and the international community, plus harsh IMF restraints on nations’ budgetary expeditures. [author's descripton]

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]

African Atlas of the Health Workforce

The starting point for this online database was a comprehensive health workforce survey conducted by the WHO Regional Office for Africa in collaboration with WHO department of human resources for health in Geneva in 2004/2005. All 46 member states of the African Region have contributed to this data collection. The data base presented here is the best available information base on the health workforce in the African Region to date and it will be continuously updated. Data is provided for 23 different types of health care cadres, both as total numbers and densities per 1000 population. For many health care cadres, additional data e.g.

African Higher Education Institutions Responding to the HIV/AIDS Pandemic

Paper presented at the AAU Conference of Rectors, Vice Chancellors and Presidents of African Universities, 2003. The paper examines the situation of HIV/AIDS globally, and in Africa. The central message of the paper is that higher education institutions must develop a comprehensive HIV prevention programme which runs through and drives each of the following: HIV/AIDS policy and strategy development; developing culturally appropriate prevention messages; tackling socio-economic factors; establishing partnerships; sustaining awareness and education; challenging denial and stigma; situating prevention in a community context; linking care to prevention; rigorous scientific reflection.

African Regional Health Report: the Health of the People

This report provides an overview of the public health situation across the 46 Member States of the African Region of the World Health Organization. The report charts progress made to date in fighting disease and promoting health in the African Region. It reviews the success stories and looks at areas where more efforts are needed to improve people’s health. [author's description] Chapter 6 includes a discussion of the human resources for health crisis and approaches to filling the gap as well as health information systems.

African Union and Health Care Challenges in Africa: Strategies and Initiatives on Health Care Delivery

Various constraints are being experienced in the health delivery systems, namely weak health infrastructure, limited tools, inadequate human resource capacity, limited public financing to the health sector as a whole (and not only to disease specific programs), poor management and planning and lack of integrated health systems and misapplication of human, technical and financial resources. In order to improve health in Africa, inequalities to health service access between and within countries should be addressed within the health system. [author's description]

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]

Andhra Pradesh, India: Improving Health Services through Community Score Cards

The community score card process is a community-based monitoring tool that is a hybrid of the techniques of social audits and citizen report cards.The CSC is an instrument to exact social and public accountability and responsiveness from service providers. By linking service providers to the community, citizens are empowered to provide immediate feedback to service providers. [from author]

Application of Activity-Based Costing (ABC) in a Peruvian NGO Healthcare System

This paper describes the application of activity-based costing (ABC) to calculate unit costs for a healthcare organization in a developing country. It also describes the ways in which these calcualtions can provide information for improving the efficiency and quality of healthcare services. [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.

Appreciating Assets: Mapping, Understanding, Translating and Engaging Religious Health Assets in Zambia and Lesotho

This study documents the contribution made by religion and religious entities to the struggle for health and wellbeing in Zambia and Lesotho, in a context dominated by poverty, stressed public health systems and the HIV/AIDS pandemic. By mapping and understanding these Religious Health Assets (RHAs), the study calls for a greater appreciation of the potential they have for the struggle against HIV/AIDS and for universal access and offers recommendations for action by both public health and religious leaders at all levels. Through respectful engagement these assets have the potential to increase in strength and value and become more effective in the long-term sustainability, recovery and resilience of individuals, families and communities. [publisher's description]

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]