Evaluations & Reviews

Increasing interest has been shown in the use of lay health workers (LHWs) for the delivery of a wide range of maternal and child health (MCH) services in low and middle income countries. However, robust evidence of the effects of LHW interventions in improving MCH delivery is limited. The objective of this document is to review evidence from randomized controlled trials on the effects of LHW interventions in improving MCH and addressing key high burden diseases. [adapted from abstract]

Paying for performance (P4P) provides financial incentives for providers to increase the use and quality of care. This paper evaluates the impact of P4P on the use and quality of prenatal, institutional delivery, and child preventive care using data produced from a prospective quasi-experimental evaluation nested into the national rollout of P4P in Rwanda. [from abstract]

This study uses data from the Demographic and Health Surveys and AIDS Indicators Surveys from 12 countries in Africa, Asia, and Latin America and the Caribbean to explore use of HIV testing and sexually transimitted infections care from the private for-profit sector, and its association with household wealth status. [adapted from abstract]

In 2008, Malawi piloted the distribution of depo-medroxy progesterone acetate (DMPA), an injectable contraceptive, to the community by Health Surveillance Assistants. This report presents lessons learned during the initial implementation, from gaining stakeholder buy-in to curriculum development, and the initial three months after the training and implementation roll-out. [from abstract]

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]

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 report documents the efficiency of the Learning for Performance approach in the implementation of new pre-service reproductive health/family planning and child health training modules aimed at local health technicians working in Northern Mali. [adapted from introduction]

The Capacity Project used the Learning for Performance (LFP) approach to develop the family planning (FP), HIV/AIDS and gender components included in the competency-based A1 nursing and midwifery pre-service curricula. LFP was also used to adapt the Rwanda national FP curriculum to an on-the-job training approach. This study documents the implementation of the and the lessons learned from its application in preservice education and in-service training in Rwanda. [from summary]

In direct response to the country’s human resources for health needs, the Capacity Project helped to develop the capacity of the district hospital clinical workforce to expand access to a full range of quality family planning methods through a pilot vasectomy in-service training program for physicians and nurses at two district hospitals. [adapted from introduction]

This evaluation presents the results of a Kenyan emergency hiring plan (EHP) to quickly hire, train and deploy workers to high-need areas. The report presents the tracked hiring, training and deployment of all new hires compared to identified gaps. It also contains facility statistics and new hire and coworker feedback in a sample of ten facilities at baseline and every six months for period of three years. [adapted from summary]

The Capacity Project worked to strengthen HRIS in several low-resource countries to assist decision-makers and human resources managers in identifying and responding to critical gaps in HRH. The findings and recommendations in this report cover the Capacity Project’s implementation of HRIS in Swaziland, Rwanda and Uganda. [from summary]

The objective of this document was to conduct a systematic review of the evidence on characteristics of community health workers (CHWs) and CHW interventions, outcomes of such interventions, costs and cost-effectiveness of CHW interventions, and characteristics of CHW training. [from abstract]

This report outlines a rapid descriptive assessment to gain an initial understanding of the management workforce for service delivery in Ethipia, Ghana and Tanzania and to test selected criteria for assessing managers as part of the health workforce. [adapted from summary]

This evaluation focused on the relevance of the health sector strategic and implementation plans to the achievement of the the MDGs in health; the extent of progress and achievements in the health sector reform process; achievements in improving acces, service quality and health outcomes; and changes in partnership activities. Section 8 examines how effectively the health sector has dealt with important issues in HRH during the evaluation period. [adapted from author]

The goal of this paper is twofold. It uses the recent experience of Brazil’s Family Health Program to assess the effectiveness of community based health interventions as instruments for improvements in health conditions in less developed areas. It also evaluates whether the health improvements associated with the program also brought about the changes in household behavior predicted by economic theory and noticed in other contexts. [adapted from author]

Because of increased demand for injectable contraception coupled with an overburdened clinical health system, countries, particularly in sub-Saharan Africa, have recently expanded the use of non-clinic based approaches in providing this method. In this first review of the available evidence of these efforts, this consultation concluded that there is sufficient evidence to support expansion of community-based health workers providing progestin-only injectable contraceptives, especially DMPA. [from author]

This technical brief focuses on issues around health worker motivation, job satisfaction, incentives, retention and performance. [from author]

The Capacity Project has made specific technical contributions to shape and advance the human resources management professional development agenda at the global, regional and country level since 2005. This brief describes the rationale, process, methodology and some of the results of key approaches that the Project and its collaborating partners developed and implemented in sub-Saharan Africa. [from author]

This brief provides a retrospective view of the Project’s contributions and recommendations in the area of global partnering. [from author]

This brief includes the results of the Project’s performance support (PS) interventions, and discusses factors that contributed to those results. The brief shares the common intervention model, analyzes the variations in content, context and methods of the interventions and discusses how similarities and differences played a role in the results. Finally, the brief includes recommendations for implementing and scaling up PS interventions. [from author]

As the global community wrestles with human resources for health issues, faith-based organizations (FBOs) are a vital source of health worker production and promising practices. This brief describes how during the past five years the Capacity Project has worked to increase the number of countries in which FBOs are building national capacity in HRH. [adapted from author]

The goals of the Capacity Project’s Strengthening Health Professional Associations Initiative were: to promote high standards of practice; to help provide the skills for associations to advocate more effectively for the needs of clients and providers;and to form networks among professionals and professional associations. [from author]

This brief provides an overview of results from a qualitative evaluation study of the Capacity Project’s HRIS strengthening in Swaziland, Uganda and Rwanda. In addition, it draws on results from a regional workshop on data-driven decision-making in Tanzania hosted by the Capacity Project in collaboration with ECSA-HC and WHO. [from author]

The Learning for Performance (LFP) approach is a systematic instructional design process and set of practical tools designed to yield more efficient training that focuses on what is essential for health workers to do their jobs, while addressing the factors that ensure application of new skills on the job. [from author]

This brief reviews how the Capacity Project addressed gender discrimination and inequality in HRH through its institutional mechanisms, approaches and tools as well as in country-level implementation. [from author]

This report outlines the work done by the Capacity Project to strengthen human resources to implement quality health programming in developing countries, focusing on: improving workforce planning and leadership; developing better education and training programs; and strengthening systems to support workforce performance. [adapted from author]

The objective of this study was to analyse in what way HRH recruitment, deployment and retention at the district level are influenced by external funding; and to what extent this is in line with national and district policies and strategies. [from abstract]

Anecdotal evidence suggests that there is severe competition for personnel and staff time between various health programmes and between public and private providers. Such competition is reinforced by the vertical nature of various funding mechanisms supported by bilateral donors, international NGOs and global initiatives. The objective of this study was to analyse in what way HRH recruitment, deployment and retention at the district level are influenced by externally funded programmes. [from summary]

We carried out a literature review of studies using discrete choice experiments to investigate human resources issues related to health workers, both in developed and developing countries. Ten studies were found that used discrete choice experiments to investigate the job preferences of health care providers. The use of discrete choice experiments techniques enabled researchers to determine the relative importance of different factors influencing health workers’ choices. [from abstract]

This review provides a comprehensive overview of the most important studies addressing the recruitment and retention of doctors to rural and remote areas of Australia. [adapted from abstract]