Report

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

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.

This paper summarizes the importance of improving maternal and reproductive health, the progress made to date and lessons learned, and the major challenges confronting programs today. The paper highlights the progress that some countries, including very poor ones, have made in reducing maternal mortality, but cautions that progress in many countries remains slow. Relying on evidence from the most recent research and survey information, the paper also analyzes the key determinants and evidence on effective interventions for attaining the maternal health MDG. [from abstract]


Section 3 dis

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]

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]

It is widely acknowledged that Africa’s insufficient health workforce will continue to be a major constraint in attaining the millennium development goals (MDGs) for reducing poverty and disease. The High Level Forum (HLF) in January 2004 also recognized the challenges posed in developing Human Resources for Health (HRH) and the need for actions and strategies to accomplish this. At an international meeting on HRH in Cape Town in September, 2004, the need for an urgent action was highlighted to scale up HRH which requires a concerted action of countries and all other partners and an avenue for action emerged building on a number of efforts in the recent years.

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]

The purpose of this toolkit is to assist health professionals, health professional associations, and civil society organizations to develop advocacy strategies to address human resource and health financing issues in their countries. [from introduction]

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.

Pathfinder has provided community-based family planning and reproductive health services to women and men throughout the developing world for over 50 years. Partnerships with local governments and Nongovernmental Organizations (NGOs) allow Pathfinder access into
communities to provide information and services. These local organizations provide a solid, established network through which Pathfinder reaches people. Faith-Based Organizations (FBOs) are a vital extension of this network. [author’s description]


This report provides information on: the process of building relationships; partn

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]

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.

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.

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]

Provider payment methods are important to consider any time a government or a payor wants to improve the efficiency and the quality of health services with the use of its funds. Changes in provider payment methods are often pivotal to broader health reform measures to contain costs and use existing resources effectively, and also to improve quality of care and equitable financial access to care. [author’s description]

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]

The task of improving quality is a demanding job. It requires focusing on clients, using data, working collaboratively with other team members, and maintaining an overarching view of the health system in which we work. Benchmarking is a process for finding, adapting, and applying best practices. [adapted from author]

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]

Improving service delivery for the poor is an important way to help the poor lift themselves out of poverty. This resource presents and evaluates tools and techniques to measure service delivery and increase quality in health and education.

The original purpose of the ADHA scheme was to compensate doctors for hours worked beyond the standard 40 hours per week or 160 hours per month. This study investigated how the scheme impacted a number of human resources (HR) factors associated with health worker recruitment, deployment, retention and performance - specifically, how the significantly higher income levels resulting from the ADHA scheme influenced job satisfaction, motivation, workplace climate and the relationship between clinical and administrative staff, as well as productivity. The study provides a detailed chronology of the ADHA scheme and explores lessons learned from the way in which the GOG implemented and administered the scheme.

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]

The RCN commissioned a survey of 6,000 members in 2000 to explore nurses’ wellbeing and working lives. The results subsequently helped shape RCN policy and materials for members on topics such as bullying and harassment, violence, needlestick injury and employee-friendly working practices. Five years later, the RCN has commissioned a second survey looking at a similar range of issues. This report documents the findings of that survey, and describes differences between the 2000 and 2005 survey findings. [introduction]

This paper focuses on the scheme by the Malawi Ministry of Health (MOH) to retain nurse tutors in collaboration with the Christian Health Association of Malawi (CHAM). It chronicles the scheme’s successful elements for purposes of eventual replication, suggests how to address some of the challenges and identifies effective incentives, including salary supplements. [from executive summary]

This report summarizes key results of the evaluation of a distance learning course in the Standard Days Method. This course responds to a growing demand for low-cost options to training for family planning service providers. This option was considered as a potentially useful alternative to traditional class-room training, which can be both costly and time-consuming. [adapted from abstract]

Addressing the current state of human resources in health, the paper highlights the critical situation of the health workforce in sub-Saharan Africa. It examines the most recent workforce statistics and trends, including geographical distribution. The factors that have and are influencing the availability of human resources are briefly reviewed, focusing on the workforce motivation, the serious brain drain of health professionals, and the increasing impact of HIV/AIDS. The paper suggests that without renewed emphasis on the health workforce crisis, it will be hard for African countries to attain the health-related Millennium Development Goals.

The 2005 Barbados HIV/AIDS Service Provision Assessment (Barbados HSPA) survey report provides baseline information on the capacity of the formal public health sector in Barbados to provide both basic and advanced level HIV and AIDS services and the availability of recordkeeping systems for monitoring HIV and AIDS care and support. Within the Caribbean region, there is a concern for the recent training of health professionals who provide HIV and AIDS services, for health worker attitudes towards people living with HIV (PLHIV) and for patient movement within the region. The Barbados HSPA captured information on these region-specific indicators in addition to the standard HSPA indicators.

The peculiarities of the scattered small states of the Caribbean region call for a model of training practitioners that is effective, relevant and sustainable. Distance education (DE) as an approach offers advantages that meet some of the challenges inherent in training family physicians for the region. This paper examines some of these challenges and shows where DE is being used to structure delivery of the programme. In particular, the need for context-specific training, managing time strictures and the cost issues of training are discussed. [from abstract]

This data creates a profile of the nursing workforce, which is useful for projecting trends and estimating future requirements. At the corporate level, longitudinal examination over a series of years would demonstrate the relationship between the characteristics of the nursing workforce and the overall requirements for patient care. At the unit level, the data is helpful to examine human resource needs and fluctuations in the workforce characteristics. A human resource profile has many data elements and results from the input of a variety of sources and requires high standards of data entry and management.

Understanding the supply and utilization of nurses is critical to maintaining an effective community health system. There has to be sufficient staff and a work environment that builds on the existing strengths of community health nursing to meet emerging needs. This report provides a demographic profile of community health nurses (CHNs) in Ontario and identifies enablers that support optimal practice of their competencies. [from executive summary]

The present report deals with health financing issues in Malawi and analyzes trends in health expenditures in the 1990s, along with the prospects for improving resource mobilization, allocation and use in the health sector of that country. This review highlights the need to further prioritize the activities under the Malawi National Health Plan so that the plan will be a basis for government policy and budgetary commitments and also an instrument to marshal and orchestrate donor support to the sector. [from foreword]