South Asia

AAAH Brief Country Reports on HRH Development Activities 2008

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

Achieving Millennium Development Goal 5: Is India Serious?

This article suggests that India’s maternal mortality rate is so high due to political, administrative and managerial issues such as the lack of exclusive midwifery training and professional midwives. [adapted from author]

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]

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.

Assessment of the Health System in Nepal with a Special Focus on Immunization

In an effort to improve the health gain that might be achieved from allocated resources, a sector wide framework has been developed for planning, choosing priorities, and committing funds in accordance with agreed priorities. In order to support this effort, any proposed support to the health sector should be programmed through the planning and financial framework. This process should include an assessment of the medium to long term financial and programmatic implications of the proposal.

Human resources management has been characterised by very frequent changes in staff, at all levels. The MoH has taken measures to address this.

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.

Case Study of Community Health Workers Engaged in Primary Health Care in Sri Lanka

The paper describes the primary health care achievements of the country with respect to the current status of the community health care workers, factors which contributed to their achievements and how their roles and responsibilities can be modified to face the future challenges. [from abstract]

Challenges and Successes in Family Planning in Afghanistan

Although misconceptions about family planning and cultural factors such as son preference presented some obstacles to progress, [two MSH] projects found that religion in Afghanistan is not a barrier to expanding family planning services. It was critical to engage clinicians and communities in culturally sensitive ways. Emphasizing the use of birth spacing to protect the health of mothers and children was especially effective. Activities to empower women—including a health-oriented literacy program—and increase the number of female community workers supported rapid scale-up of contraceptive use.

Chiranjeevi: Involving Private Obstetricians to Reduce Maternal Mortality in Gujarat (India)

This PowerPoint was presented at the 2007 GHC expert panel “Making it Work: Private Sector Partnerships to Improve Women’s Health.” It discusses the challenges, costs and results of a program to use private practitioners for improving maternal and child survival.

Collaboration Between Open Universities in the Commonwealth: Successful Production of the First Ever Sri Lankan Nursing Graduates at the Open University of Sri Lanka by Distance Education

This paper discusses a collaborative effort between two universities in Sri Lanka and Canada to create a distance education program to train nurses in Sri Lanka.

Common Competencies for Registered Nurses in Western Pacific and South East Asian Region (WPSEAR)

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]

Communication Action Groups: Promoting Broader Discussion of Reproductive Health

In 1996, the REWARD Project identified a need for effective interventions to increase women’s communication about reproductive health among themselves and with their husbands. Project staff formed women’s groups, called Communication Action Groups (CAGs), in three rural districts. The project provides group leaders with training on communication, leadership, group dynamics, condom use, condom negotiating skills, and HIV/AIDS and sexually transmitted infections (STIs). This study was designed to evaluate the effectiveness of the CAG program so that achievements and problems could be identified and program activities strengthened.

Community Development and Its Impact on Health: South Asian Experience

Most South Asian governments have concentrated on emulating a Western style of healthcare service, with the result that an elite few are overmedicalised whereas the majority are neglected. However, community participation in the development of local health services could provide a solution. [abstract]

Community Health Worker Incentives and Disincentives: How They Affect Motivation, Retention and Sustainability

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.

Community Health Workers: Scaling Up Programmes

The author focuses on a community health worker (CHW) intervention in India, where state-wide CHW programmes are under way as part of the National Rural Health Mission. The Mitanin programme of Chhattisgarh state in India highlights the many dilemmas and possibilities in the scaling-up of such programmes. [adapted from author]

Community Involvement Saves Newborn Infants in India

In a rural village in India, newborn deaths have been halved not by neonatologists or high-tech interventions but by local villagers trained in simple life-saving practices. Some experts, however, are sceptical about whether this strategy can work everywhere. [from author]

Comparing Maternal Health Services in Four Countries

While the availability and use of trained midwives can shape the quality of care received in pregnancy and childbirth, a number of other underlying health systems structures and processes are important. The management of health workforces, the mix of public and private provision and the impact of reforms affect quality of care across countries…[This study] examined how the structure and operation of a health system influences maternal health care provision and outcomes in Bangladesh, Russia, South Africa and Uganda. [author’s description]

Comprehensive Family Planning Training Evaluation in Nepal

Nepal’s National Health Training Center (NHTC), the Family Health Division (FHD), USAID/Nepal, and JHPIEGO developed a Comprehensive Family Planning (COFP) course to provide comprehensive and effective training for family planning (FP) service providers in Nepal. Designed to increase training efficiency—by consolidating isolated courses into one complete, standardized course and by introducing competency-based, humanistic training approaches—the COFP course was intended to provide health workers with a complete range of essential FP information and skills necessary to provide quality services to clients. A number of agencies and individuals collaborated to adapt and develop these standardized training materials, and trainers were then specially prepared to deliver this course. [publisher’s description]

Control of Tuberculosis in an Urban Setting in Nepal: Public-Private Partnership

The objective of this document is to implement and evaluate a public–private partnership to deliver the internationally recommended strategy DOTS for the control of tuberculosis (TB) in Lalitpur municipality, Nepal, where it is estimated that 50% of patients with TB are managed in the private sector. [author’s description]

Cost-Effectiveness of Community Health Workers in Tuberculosis Control in Bangladesh

The objective of this article was to compare the cost-effectiveness of the tuberculosis programm run by the Bangladesh Rural Advancement Committee, which uses community health workers (CHWs), with that of the government program which does not use CHWs. [adapted from author]

Costing Adolescent Reproductive Health Intervention Studies: Preliminary Results from A Study in Tamil Nadu, India

This research brief presents results from a cost analysis of an adolescent reproductive health intervention that found that using community health workers was less expensive than using doctors for provision of reproductive health services to young women. [from publisher]

Demographic Implications for Health Human Resources for Bangladesh

This paper is mainly intended to show the demographic implications for Bangladesh’s Health-human resources production in the next two decades as absolute increase in Population is still too high that the economy can cope with. [author’s description]

District Health System: A Challenge that Remains

The health care system in Pakistan has been confronted with problems of inequity, scarcity of resources, inefficient and untrained human resources, gender insensitivity and structural mismanagement. With the precarious health status of the people and poor indicators of health in the region, health care reforms were finally launched by the government in 2001. There are, however, numerous challenges and constraints in the system. The future health of the nation depends on this decentralization initiative. All our efforts should be concerted to support and facilitate the new system, which will mature into institutionalization of the health services at the district level.

Dual Job Holding by Public Sector Health Professionals in Highly Resource-Constrained Settings: Problem or Solution?

This paper examines the policy options for the regulation of dual job holding by medical professionals in highly resource-constrained settings. It draws on the limited evidence available on this topic to assess a number of regulatory options in relation to the objectives of quality of care and access to services, as well as some of the policy constraints that can undermine implementation in resource-poor settings. [from abstract]

Eastern Mediterranean Regional Health Professions Education Directory

The directory enlists all available data on the institutes that award at least a bachelor degree in any of the health professions in the countries of the Eastern Mediterranean Region.

Effect of Community-Based Newborn-Care Intervention Package Implemented Through Two Service-Delivery Strategies in Sylhet District, Bangladesh: a Cluster-Randomized Controlled Trial

Neonatal mortality accounts for a high proportion of deaths in children under the age of 5 years in Bangladesh. This article describes a project for advancing the health of newborns and mothers implementing a community-based intervention package through government and non-government organisation infrastructures to reduce neonatal mortality. [from abstract]

Effectiveness of a Home Care Program for Supporting Caregivers of Persons with Dementia in Developing Countries: A Randomised Controlled Trial from Goa, India

This study was implemented to develop and evaluate the effectiveness of a home based intervention in reducing caregiver burden, promoting caregiver mental health and reducing behavioural problems in elderly persons with dementia. [from abstract]

Empowering the People: Development of an HIV Peer Education Model for Low Literacy Rural Communities in India

Despite ample evidence that HIV has entered the general population, most HIV awareness programs in India continue to neglect rural areas. Low HIV awareness and high stigma, fueled by low literacy, seasonal migration, gender inequity, spatial dispersion, and cultural taboos pose extra challenges to implement much-needed HIV education programs in rural areas. This paper describes a peer education model developed to educate and empower low-literacy communities in the rural district of Perambalur in India. [from abstract]

Enhancing the Greater Involvement of People Living with HIV (GIPA) in NGOs/CBOs in India

The handbook is a resource collection of information sheets and participatory activities for NGOs working on HIV/AIDS who want to work towards a greater involvement of people living with HIV (GIPA) in their work. It aims at sensitising NGOs, building individual skills and organisational capacities so that NGO management, staff and volunteers can discuss and plan together in a participatory way how to meaningfully involve people living with HIV in their organisation. [from introduction]