East Asia & Pacific

This website contains brief country reports on HRH development activities in 2008 from nations belonging to the Asia-Pacific Action Alliance on HRH.

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]

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 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.

This report presents the findings from an assessment of the contraceptive method mix in Myanmar focusing on birth spacing, the providers of birth spacing services (public, private, NGO) and the information needs of these health pracitioners. [adapted from publisher’s summary]

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.

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]

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 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]

To improve birth spacing services in Cambodia, the development of the communication and counselling skills of all providers is critical. A a large part of this issue focuses on these skills. [editor’s description]

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 paper analyzes China’s current health workforce in terms of quantity, quality, and distribution. Unlike most countries, China has more doctors than nurses. Doctor density in urban areas was more than twice that in rural areas, with nurse density showing more than a three-fold difference. Over the past decade there has been a massive expansion of medical education, with an excess in the production of health workers over absorption into the health workforce.

It is envisaged that these common competencies will support the role of nurses within the region, provide direction for recognition of qualifications and for multi-country licensure programs and guidance for those countries that have not yet developed their specific competencies for nurses. This document details background information, the competency development process, the proposed WPSEAR Common Competencies, suggestions for their application and a glossary of terms. [author’s description]

This paper analyzes the present situation of general practitioners in the Thai health care system and the conditions under which their contribution could be strengthened. [from abstract]

This document evaluates the Continuum of Care service delivery model established to address the problem of proving care and ART treatment to those suffering with HIV. The study documents the elements of the service delivery model including the focus on linkages between clinicians and the community and details the district-based success of the program.

In 1999, Cambodia contracted out management of government health services to NGOs in five districts that had been randomly made eligible for contracting. The contracts specified targets for maternal and child health service improvement. The program increased the availability of 24-hour service, reduced provider absence, and increased supervisory visits. There is some evidence it improved health. The program involved increased public health funding, but led to roughly offsetting reductions in private expenditure as residents in treated districts switched from unlicensed drug sellers and traditional healers to government clinics.

This cost analysis is based on QAP research on the effectiveness of two interventions (self-assessment and peer review) in sustaining or increasing the effectiveness of interpersonal communications training that midwives had taken. The research had measured the effectiveness of the interventions in terms of the number of utterances midwives made during family planning consultations, and this case study followed on, measuring the cost of each intervention in terms of the number of utterances generated. Activities/tools: Sample provider self-assessment form, sources of costs, evaluation of marginal benefit.

There are few cost-minimisation studies in telemedicine. We have compared the actual costs of providing the telepaediatric service to the potential costs if patients had travelled to see the specialist in person. In November 2000, we established a novel telepaediatric service for selected regional hospitals in Queensland. Instead of transferring patients to Brisbane, the majority of referrals to specialists in Brisbane have been dealt with via videoconference. Since the service began, 1499 consultations have been conducted for a broad range of paediatric sub-specialities including burns, cardiology, child development, dermatology, diabetes, endocrinology, gastroenterology, nephrology, neurology, oncology, orthopaedics, paediatric surgery and psychiatry.

This overview paper highlights the key messages and issues presented in the country reports submitted by national nurses’ associations (NNAs) at the 12th International Council of Nurses (ICN) Workforce Forum held in Copenhagen 25-26 September 2006. Participating NNAs submitted written reports on major agenda items: environmental scan; outsourcing; alliances; occupational health and safety; private sector for profit health enterprises; positive practice environments; and future options. [from introduction]

The township health system in Myanmar is regarded as means to achieve the end of an equitable, efficient and effective health system based on the principles of primary health care approach. A township hospital caters medical care at the second referral level. Under the leadership and management of a Township Medical Officer in each township, para-professionals deployed at Rural Health Centers (RHCs) and Sub-centers under each RHC’s jurisdiction play key roles for providing primary health care services for rural population. There had been an expansion of township hospital beds, RHCs and Sub-centers during the past 15 years.

This brief article provides a general introduction to HRH policy and the HRH situation in Myanmar.

Decentralising health workforce management may help local services to coordinate and plan their human resources more effectively to meet health care needs. Health sector decentralisation in China and South Africa is complex, with different forms being implemented within varying timescales and for different purposes. In China decentralisation has taken place alongside the transition to a market economy, whilst post-apartheid South Africa is attempting to establish a new district health system. [author’s description]

This study reviews the experience of decentralization in four developing countries: Ghana, Uganda, Zambia and the Philippines. It uses two analytical frameworks to describe and compare the types and degrees of decentralization in each country. The first framework specifies three types of decentralziation: deconcentration, delegation and devolution. The second framework uses a principle agent approach and innovative maps of decision space to define the range of choice for different functions that is transferred from the centre to the periphery of the system. [from abstract]

Rural background and training have previously been found to increase the likelihood of rural practice. However, practitioners of many health professions remain in shortage in rural and remote Australia. This study builds on previous work in that it includes medical, nursing and allied health professions, considers the role of the health professional’s family in employment decisions, and includes a broader array of factors influencing employment preference and the preferred location of practice. The survey also examines when students might work in a rural area. [introduction]

This research study is a situational analysis and investigation to propose alternative models, including estimation of the quantitative demand for Mobile Emergency Medical Service Units (MEMUs) and the demand for Emergency Medical Technicians (EMTs) in Thailand during the next two decades. Three models of the MEMUs, and three categories of EMTs are proposed. In producing all kind of EMTs, their career development and continuing education should be planned. [from abstract]

Preparing nurse graduates for practice is challenging because of the diversity of skills expected of them. The objective of this study is to identify the attributes a rural community expect in new graduate nurses in order for them to provide quality care. [from abstract]

Many countries around the world are now facing a huge brain drain of highly skilled professionals to well-paid jobs in developed countries. One of the worst affected sectors is healthcare, an area in which developing countries are struggling to keep professionals at home and encourage others to return. [auhor’s description]

This article outlines the development and content of a community-based research capacity building framework for Aboriginal and Torres Strait Islander health workers. The focus is on the major issues that enhance a proactive service delivery model using culturally appropriate research methods. The overall aim of the framework is to supplement current institutionally-based education and training resources for health workers with community-based research training modules. These modules can be tailored to provide research and evaluation skills relevant to health workers taking a more proactive role in facilitating health and wellbeing programs in their own communities.

This article reports a project that investigated the way government policies, health and community services, population characteristics and local peculiarities combined for residents in two small rural towns in New South Wales. Interviews and focus groups with policy makers, health and community service workers and community members identified the felt, expressed, normative and comparative needs of residents in the case-study towns. [from abstract]