Journal Articles

While there is considerable research on medical workforce supply trends, there is little research examining the determinants of labour supply decisions for the medical workforce. The MABEL study investigates workforce participation patterns and their determinants using a longitudinal survey of Australian doctors. It aims to generate evidence to support developing effective policy responses to workforce issues such as shortages and maldistribution. This paper describes the study protocol and baseline cohort, including an analysis of response rates and response bias. [from abstract]

The objectives of this article were summarise opinion about what supervision of primary health care is by those advocating it; compare these features with reports describing supervision in practice; and to appraise the evidence of the effects of sector performance. [adapted from summary]

This article evaluates a training initiative that has been established to help address the problem of skills shortage in pharmaceutical management in East Africa. [adapted from abstract]

This paper reviews available research evidence that links medical students’ characteristics with human resource imbalances and the contribution of medical schools in perpetuating an inequitable distribution of the health workforce. [from abstract]

Information on health expenditure suggests that most poor countries have a large and growing private medical sector. Surveys indicate that the private sector is an important source of care, even for poor people and even where public services are widely available. Experts believe that private practitioners manage a large proportion of the unreported majority of tuberculosis cases. [adapted from author]

Improving neonatal health and survival requires cost-effective interventions at the community level, as well as linkages between the community and the health-care system within the continuum of care for the treatment of severe illness. The primary purpose of this study was to evaluate the performance of CHWs in recognizing signs and symptoms of neonatal illness during routine household surveillance in rural Bangladesh. [from introduction]

While constrained health budgets and health worker shortages have been blamed for the low rates of surgery, there has been little empirical data on the providers of surgery and cost of surgical services in Africa. This study described the range of providers of surgical care and anesthesia and estimated the resources dedicated to surgery at district hospitals in three African countries. [from abstract]

This study evaluated two models of routine HIV testing of hospitalized children in a high HIV-prevalence resource-constrained African setting. Both models incorporated task shifting, or the allocation of tasks to the least-costly, capable health worker. [from abstract]

This article discusses the evidence for claiming out-migration of health workers impacts health and how to address the issue ethically.

This study focused on a trained health workforce in Northern Uganda. The retention of specifically-trained staff 12-15 months after attending training was examined, as was the relevance and usefulness of the training as perceived by the health workers. [from abstract]

This article posits that out-migration of health workers is not a critical contributor to health workforce shortages in Nigeria’s rural and remote areas and that more important factors include: contraction of government health spending as a percentage of GDP despite deteriorating health conditions, public health management systems that operate by default rather than by design, spartan living conditions outside urban areas, inadequate training of appropriate cadres of health staff, limited facilities and medications for effective delivery of clinical services, and burnout of overworked and unde

This editorial provides a summary of the results of a consultation on the urgent challenges the health workforce is facing. [adapted from author]

Financial incentives have been used for many years internationally to improve quality of care in general practice. The aim of this pilot study was to determine if offering general practitioners a small incentive payment per test would increase chlamydia testing in women aged 16 to 24 years, attending general practice. [from abstract]

This study assessed the knowledge of maternity unit operatives at the primary and secondary levels of care about the concept of emergency obstetric care and investigated the contents of antenatal care counseling services they delivered to clients. It also described the operatives’ preferred strategies and practices for promoting safe motherhood and averting maternal mortality in south-west Nigeria. [from abstract]

In this study, we aimed to determine the cost and cost-effectiveness of involving health extension workers in tuberculosis treatment in Southern Ethiopia. This paper presents an ancillary cost-effectiveness analysis of data from a randomized control trial. [adapted from introduction]

Around the world, only a few health care providers deliver integrated care effectively. Their experiences offer useful lessons for organizations that want to pilot integrated-care programs. [from author]

Interactive methods like role play, recorded video scenarios and objective structured clinical exam are being regularly used to teach and assess communication skills of medical students in the western world. In developing countries however, they are still in the preliminary phases of execution in most institutes. Our study was conducted in a naive under resourced setup to assess the impact of such teaching methodologies on the counseling skills of medical students. [from abstract]

This study presents evaluation findings of two different programs targeting private medicine retailers for malaria control in Kenya. Key components of this evaluation were measurement of program performance, including coverage, knowledge, practices, and utilization based on spatial analysis. [from abstract]

The purpose of this study was to conduct a comparative evaluation of two internet-based continuing medical education delivery formats and the effect on satisfaction, knowledge and confidence outcomes. [from abstract]

This study evaluated whether the provider-initiated HIV testing and counseling approach increased HIV testing amongst patients with a new episode of sexually transmitted infection, as compared to standard voluntary counseling and testing at the primary care level in South Africa, a high prevalence and low resource setting. [from abstract]

This successful program highlights how improving HIV care strengthened the primary health care system and validates several critical areas for task shifting that are being considered by other countries in the region, including nurse-driven ART for adults and children, and lay counsellor supported testing and counselling, adherence and case management. [from abstract]

This study evaluated the effect of an educational program including peer discussions on the providers’ knowledge and reported performance in family planning services. [from abstract]

This article aims to produce theory driven criteria to guide the development and evaluation of internet-based medical courses. [from abstract]

This article reviews the available evidence on private sector utilization and quality of care. It provides a framework for analysing the private sector’s influence on child health outcomes. [from abstract]

The objective of this research was to form a partnership of healthcare providers, managers, and researchers to review randomized controlled trials assessing the effects of computerized decision support for six clinical application areas: primary preventive care, therapeutic drug monitoring and dosing, drug prescribing, chronic disease management, diagnostic test ordering and interpretation, and acute care management; and to identify study characteristics that predict benefit. [from abstract]

This article uses the realist evaluation method to determine the effect of human resource management on hospital performance using a regional facility in Ghana.

In September 2005, a pilot program of nurse-centered antiretroviral treatment (ART) prescription was launched in three rural primary health centers in Rwanda. We retrospectively evaluated the feasibility and effectiveness of this task-shifting model using descriptive data. [from abstract]

In Mozambique, a country with a high HIV burden and a staggering workforce deficit, the Ministry of Health looked to past experience in workforce expansion to rapidly build ART delivery capacity, including reliance on existing nonphysician clinicians (NPC) to prescribe ART and dramatically increasing the output of NPC training. [from abstract]

Problem-based learning (PBL) has been suggested as a key educational method of knowledge acquisition to improve medical education. This study sought to evaluate the differences in medical school education between graduates from PBL-based and conventional curricula and to what extent these curricula fit job requirements. [from abstract]

The Ministry of Health introduced a leadership development program in Aswan Governorate. The program aimed to improve health services in three districts by increasing managers’ ability to create high performing teams and lead them to achieve results. The program introduced leadership and management practices and a methodology for identifying and addressing service delivery challenges. [adapted from abstract]