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This publication is a companion document to the Workforce Trends of Regulated Nurses in Canada series of publications. The Workforce Trends series organizes and presents data by nursing profession, with separate publications for each of the licensed practical nurse (LPN), registered nurse (RN) and registered psychiatric nurse (RPN) workforces. This publication, in contrast, organizes and presents data by province or territory.

Case management maps (CMMs) are a type of job aid: a sheet of paper with information that guides healthcare providers in treating patients. Each patient has his or her own condition-related CMM, which is maintained in the patient’s chart or on the wall near the patient’s hospital bed to inform providers of the treatment protocol, what treatment was provided when and by whom, what to do should a critical event occur, etc. This report describes a study that implemented two CMMs that were introduced about a year apart in a 500-bed hospital where such job aids had not previously been used.

This study sought to better understand how to sustain provider compliance with standards, using local (Mali) standards (on care for fever and structural quality). The intervention had two parts: a self-assessment instrument that providers used weekly to assess their performance with a feverish client and a review of that performance by a colleague who had observed the consultation. The study found that when used regularly, such an intervention can have a significant effect on compliance.

Research on the Integrated Management of Childhood Illness (IMCI) shows that it is a scientifically sound way to treat sick children, but ways to ensure that it is implemented properly are lacking. This 1997-98 study examined and compared three implementation approaches: structured feedback of performance data, structured feedback of performance data where quality improvement (QI) teams were in place, and the formal World Health Organization training in districts with QI teams.

London is more reliant than other parts of England on the international recruitment of health professionals. This raises several questions. How can employers support and develop such a diverse workforce? How can they retain hard-won international health care staff in the face of increasing international competition? And is it ethical to recruit workers from developing countries experiencing their own shortages? This research summary profiles the capital’s international health care workforce for the first time, with case studies detailing the experiences of three London NHS trusts.

The main objectives of this paper are to report on the country and demographic profile, motivations, experiences and career plans of recently recruited international nurses working in London, and to give a detailed insight into why they have come to the UK, and what are their future intentions. In order to put these findings in context, the paper also outlines the overall trends in numbers of nurses coming to the UK, and examines the policy context in which international recruitment activity has been conducted. [from introduction]

Since 2000, [National Health Service] NHS workforce policy has focused on increasing the size of the health care workforce. However, as financial investment in the NHS slows down, expanding capacity by simply increasing workforce numbers is no longer viable. Instead, alternative approaches are needed to develop a sustainable workforce that is flexible enough in its work practices to manage the complex changes facing the NHS. ‘Grow-your-own’ workforce approaches have the potential to address some of these challenges.

This report documents the efforts of the Institute for Reproductive Health (IRH) to integrate natural family planning methods into the health delivery system in the Phillipines. It discusses the venues used for implementation such as government and NGO partnerships as well as IRH’s training resources and activities for nurses and midwives on family planning. Finally, the report details best practices and lessons learned from the multi-year project.

HIV/AIDS mainstreaming has traditionally been equated with adjusting programs to be more relevant to beneficiaries affected by HIV/AIDS. Bitter experience is demonstrating, however, that civil society organizations (CSOs) are not immune to the impacts of AIDS within their own organizations. Few local CSOs are responding adequately to this threat, partly because they simply do not know the extent of these costs. This paper suggests how CSOs in sub-Saharan Africa can build organizational resilience in order to survive the loss of valuable staff, time and money that HIV/AIDS will cause. It also concludes with practical recommendations for their donors in how they can move beyond being concerned bystanders. [publisher’s description]

The Gender Policy Guidelines have been established in order to support the Department of Health in meeting not only its constitutional commitment to promoting gender equity and equality, but also its own commitments to equity, meeting the needs of those who have been previously marginalized and improving its productivity and quality of care within the health services.

There is no doubt that one of the most effective ways of improving quality of health care at district level, is by means of clinic supervision. To that end, the Clinic Supervisor’s Manual is being used to implement supervision throughout health districts in South Africa. This booklet is a simple tool which guides the effective use of the Clinic Supervisor’s Manual in addition to guiding the day to day activities involved in supervision towards successful and improved outcomes.

This resolution, enacted by the Department of Health in South Africa, details the management and conditions of an allowance designed to attract and retain health workers in rural areas.

The Integrated Management of Childhood Illness (IMCI) strategy seeks to reduce [childhood] deaths through three main components: improving the skills of health workers, improving health systems an improving family and community practices. IMCI has been shown to be associated with improved quality of care, which should result in improved health outcomes. However, concern about the costs of implementing IMCI had been given as a reason why some countries have not adopted it on a large scale. It is important, therefore, to assess whether IMCI does, in practice, cost more than routine care for children who are less than 5 years old, and if so, by how much…Here we present results from the cost components of the MCE study in the United Republic of Tanzania.

Accurate, detailed and up-to-date manpower data is a prerequisite for human resource management. This technical brief describes how the Ministry of Health conducted a human resource mapping exercise of all public health staff in Kenya, and discusses the implications of the findings. The aim is to demonstrate the many practical uses of human resource data. [adapted from author]

To tackle problems of staff shortage and maldistribution, in 2003 the Government of the Republic of Zambia in partnership with the Royal Netherlands Government embarked on a Pilot Zambian Health Workers Retention Scheme (ZHWRS) for health professionals. The scheme had as first objective to replace the Dutch doctors, working under the bilateral agreement between Zambia and the Netherlands. A regular review process was included as part of the scheme. This report is from the Midterm review that took place in January 2005. [from introduction]

The value of accreditation remains uncertain, and this persists as a central legitimacy problem for accreditation providers, policymakers and researchers. The question arises as to how best to research the validity, impact and value of accreditation processes in health care. [from abstract]

In the era of cost containment, managers are constantly pursuing increased organizational performance and productivity by aiming at the obvious target, i.e. the workforce. The health care sector, in which production processes are more complicated compared to other industries, is not an exception. In light of recent legislation in Greece in which efficiency improvement and achievement of specific performance targets are identified as undisputable health system goals, the purpose of this study was to develop a reliable and valid instrument for investigating the attitudes of Greek physicians, nurses and administrative personnel towards job-related aspects, and the extent to which these motivate them to improve performance and increase productivity.

Because the demand for health services outstrips the available resources, priority setting is one of the most difficult issues faced by health policy makers, particularly those in developing countries. The objective of this paper is to describe priority setting in a teaching hospital in Uganda and evaluate the description against an ethical framework for fair priority setting processes. [from abstract]

The aim of this interventional study was to assess, document and improve the Patient-held Record System in the Emtshezi Subdistrict. The study began in 1998 and was conducted using a Quality Assurance Cycle, which focuses on systems and processes and encourages a team approach to problem solving and quality improvement. [from abstract]

In South Africa, the distribution of doctors is skewed in favour of the urban areas, but it is not uncommon to find many peri-urban facilities in short supply of doctors. In 1997, the South African government introduced compulsory community service (CS) to address this uneven distribution of doctors in the country. The CS doctors posted to the Letaba-Sekororo hospital complex in Limpopo Province refused to take up their appointments for various reasons, ranging from lack of supervision to poor basic infrastructure. This study is one of the earliest conducted to understand the perceptions of hospital managers on the impact of the national community service on the health service. [publisher’s description]

There is growing interest in the migration of doctors from Africa to developed nations. Little attention has been made in understanding the flow of doctors into African countries. The objective of this article is to describe the nationality, country of primary qualification as a doctor and specialties of doctors registered in Malawi in 2003. [from abstract]

The checklist described in this document has been developed as a tool to assist those involved in a systematic review of the human resource development component of the NTP. This component is often referred to as “training.” In this document, the term training is used in a broader context than the more traditional interpretation of the term, where training refers to organization and implementation of training courses. Training in this document is often replaced by the term “HR development” to stress the need for a broader and more long-term approach within NTPs. [from introduction]

This strategy paper takes stock of “best practice” experiences in supporting communities in their response to HIV/AIDS in several countries in Africa. It draws lessons from Burkina Faso, Côte d’Ivoire, Guinea, Malawi, Nigeria, and Tanzania and sheds light on methods that a growing number of organizations and individuals use to foster behavior change among people living in rural areas. The success stories presented in this paper prove that it is both possible and promising to implement HIV/AIDS programs that include several components and multiple sectors at the community level. [from forwa

This study examines the relationship between medical practice and type of clinic ownership in HeBei province in the People’s Republic of China. The objective was to find out whether the kind of clinic ownership affects health care delivery patterns and access to health care. The study was carried out between 1995 and 2000 by a team of researchers from China, Israel and the Netherlands. [from preface]

This presentation is from the director of the Department Human Resources for Health of the World Health Organization. It presents information on health workforce issues including shortages and distribution problems, provides a summary of the major projects and initiatives addressing the crisis, and discusses the role of WHO in HRH.