Evaluations & Reviews

Role of Community Involvement in Improving Youth Reproductive Health and Preventing HIV Among Young People: Report of a Technical Consultation

This report of a two-day technical consultation summarizes challenges, lessons learned from promising projects, knowledge and practice gaps, and recommendations for future practice. It suggests guidelines for community involvement in youth reproductive health and HIV prevention at all stages of a project cycle. [publisher’s description]

Health Systems in Transition: Learning from Experience

The paper outlines a conceptual framework that integrates the key strategies that must be addressed and linked if policy-makers are to create the kinds of health care system to which the citizens of [central and eastern Europe and Eurasia] are entitled. It examines how financing, coordinated service delivery and quality measures matter independently, and it highlights the need to interweave them effectively with citizen and community participation mechanisms and a far-reaching concern for public health. It also reviews the complex issues that hinder or help the implementation of reforms and suggests how an understanding of context, stakeholders and capacity will be critical to delivering change.

HIV Antiretroviral Therapy: Can Franchising Expand Coverage?

This paper reviews the experiences of franchising and discusses the opportunities and implications for governments and donors of franchising for HIV and AIDS services. [from author]

Medical Leave: the Exodus of Health Professionals from Zimbabwe

The study aimed to establish the magnitude of migration of health professionals, its causes and to document the associated impacts on service delivery. [author’s description]

Ghana Case Study: Staff Performance Management in Reforming Health Systems

This study seeks to describe the existing systems for measuring and monitoring staff performance in the clinical setting and covered public and para-statal hospitals in Ghana. [author’s description]

Comprehensive Assessment of Human Resources for Health in Cote d'Ivoire

Partners for Health Reformplus conducted a comprehensive assessment of the public health sector in Côte d’Ivoire to quantify HR available and what is needed to maintain basic health services while scaling up HIV/AIDS services to reach targets at the national level and at the global level through initiatives such as the President’s Emergency Plan for AIDS Relief, the World Health Organization’s 3 by 5 Initiative, and the Millennium Development Goals. [from abstract]

President's Emergency Plan for AIDS Relief Report on Work Force Capacity and HIV/AIDS

This report identifies innovative approaches countries are using to address the shortages of health care workers and describes efforts to achieve long-term sustainability. [author’s description]

Survival and Retention Strategies for Malawian Health Professionals

The broad objective of this paper is to contribute to the retention of health workers in Malawi by providing an enhanced understanding of health workers’ coping strategies, together with the identification of possible strategies that could impact on their retention. [from author]

Progress on Global Access to HIV Antiretroviral Therapy: A Report on "3 by 5" and Beyond

This report describes global progress on the “3 by 5” (Treating 3 million by 2005: making it happen) project in scaling up access to [HIV/AIDS] antiretroviral therapy and outlines the areas in which important progress has been made and lessons learned. It also outlines the remaining challenges and roadblocks to treatment access. [author’s description]

Chapter 2 (Strengthening Health Systems) provides an overview of HRH related approaches and progress.

Abundant for the Few, Shortage for the Majority: the Inequitable Distribution of Doctors in Thailand

This paper reviews the situation and trend in human resources for health and its priority problems in Thailand. It also highlights the issue of the inequitable distribution of doctors. Through several brainstorming sessions among stakeholders, it summarizes a package of recommendations for the future continuous and sustainable knowledge-based human resources for health development. [from abstract]

Coverage and Skill Mix Balance of Human Resources for Health in Myanmar

The township health system in Myanmar is regarded as means to achieve the end of an equitable, efficient and effective health system based on the principles of primary health care approach. A township hospital caters medical care at the second referral level. Under the leadership and management of a Township Medical Officer in each township, para-professionals deployed at Rural Health Centers (RHCs) and Sub-centers under each RHC’s jurisdiction play key roles for providing primary health care services for rural population.

Human Resources on Health (HRH) for Foreign Countries: A Case of Nurse "Surplus" in Indonesia

The nurse program for foreign countries in Indonesia has been carried out since 1996. In the beginning, this program attempted to solve the false ‘surplus’ problem of nurses in Indonesia. Recently, however, the MOH has developed serious concerns with this program. There have been several efforts to promote the nurse program for foreign countries starting with the improvement of education, recruitment and other mechanisms related to nurses for foreign countries. Some achievements, strengths, weaknesses, potentials and threats are discussed in this paper.

Investing in Tanzanian Human Resources for Health

Using Tanzania as a case study, this report advocates that the only effective means of really addressing the HRH challenge inpoor countries is to begin to immediately scale up training capacity, and that approach is relatively inexpensive when compared to its long-term benefits. [adapted from author]

Mapping of Community Home-Based Care Services in Five Regions of the Tanzania Mainland

The study documents the concerns of [People Living with AIDS] PLWHA, Community Health Workers (CHWs), primary care providers, and other stakeholders to inform Pathfinder’s support to national efforts to scale-up [Community Home-Based Care] CHBC. The proposed project aims to replicate Pathfinder’s successful CHBC model for PLWHA in other areas and improve access to HBC for more Tanzanians. [author’s description]

Engaging Local Non-Governmental Organizations (NGOs) in the Response to HIV/AIDS

During the past few years, a number of key donor programs have scaled up their global response to the crisis of HIV and AIDS… The goal of this paper is to begin a discussion among donors, international and local NGOs, and multilateral and U.S. government representatives on how to effectively engage indigenous partners and transfer much-needed resources. [from preface]

Integrating TB and HIV Care in Mozambique: Lessons from an HIV Clinic in Beira

In Mozambique, [Health Alliance International] HAI has been working closely with the MOH for more than fifteen years to support the development and implementation of MOH programs in reproductive health, the response to HIV/AIDS, and malaria control… HAI works with the MOH to implement the nationally designed model of HIV care, and has supported the implementation of voluntary counseling and testing centers, prevention of mother-to-child transmission of HIV (PMTCT) PROGRAMS, and HIV treatment centers integrated into this public sector model of care. [publisher’s description]

Managing HIV/AIDS in the Workplace: Examples of Nine Non-Governmental Organizations in South Africa, Zambia and Zimbabwe

This study aims to examine the range of impacts the [HIV/AIDS] pandemic has had on selected NGO partners of Oxfam operating in South Africa, Zambia, and Zimbabwe, and to make recommendations useful to NGOs, including Oxfam, donors, and policy-makers based on its results. [author’s description]

Human and Financial Resource Requirements for Scaling Up HIV/AIDS Services in Ethiopia

Ethiopia is currently one of the countries most seriously affected by HIV/AIDS, with the sixth highest number of infections in the world. This paper discusses how to combat this epidemic. As the country scales up HIV/AIDS services, increased attention is focused on identifying constraints to program expansion. One of the most important constraints is that of human resources. [from publisher’s abstract]

Can "Pay for Performance" Increase Utilization by the Poor and Improve the Quality of Health Services?

This paper, which was prepared as background for the Working Group on Performance Based Incentives, looks at a particular type of financing intervention that has been applied in several different ways around the world to address the joint problems of underutilization and low quality of health services. The focus is on demand- and supply-side financial and material (examples: food, travel vouchers) incentives that can be used to improve utilization and quality of ambulatory health care services, especially for the poor. [from introduction]

Improving Health Services and Strengthening Health Systems: Adopting and Implementing Innovative Strategies

In recent years, a number of specific strategies for improving health services and strengthening health systems have been consistently advocated. In order to advise governments, WHO commissioned this exploratory study to examine more closely the track record of these strategies in twelve low-income countries. [author’s description]

Contracting-Out Reproductive Health and Family Planning Services: Contracting Management and Operations

This primer introduces key aspects of contracting and summarizes key lessons from countries’ experiences in contracting-out. In doing so, it is intended to serve the practical needs of contracting practicioners in developing countries that are considering contracting as a way to deliver RH/FP services. Intended users include country-level decision makers, contract operation managers, and mission officers and advisers from donor agencies. [publisher’s description]

Involving Young People in the Care and Support of People Living with HIV/AIDS in Zambia

Horizons, in collaboration with CARE International and Family Health Trust, conducted a quasiexperimental intervention study to determine which care and support needs of people living with HIV and AIDS and their families could be met by trained youth, and to establish whether youth engaged in formalized care and support activities would increase their adoption of protective behaviors or reduce the stigma faced by members of AIDS-affected households.

The study was conducted in semi-urban and rural communities in two provinces of northern Zambia located 700 to 1,000 kilometers from Lusaka.

Improving Female Recruitment, Participation, and Retention Among Peer Educators in the Geração BIZ Program in Mozambique

In response to the under-representation of female peer educators in the Geração BIZ Program (GBP), an adolescent sexual and reproductive health program in Mozambique, an operational research study was used to test new strategies for improving recruitment, participation, and retention of female peer educators. The study tested an intervention model to increase the involvement and performance of girls in the GBP.

Gender Issues in Safety and Health at Work: A Review

The aim of this report is not only to give a clear overview of gender differences in safety and health at work and how they arise, but also to provide information about what this means for prevention and how a gender-sensitive approach can be taken in occupational safety and health. [from preface]

Quality of Care in Contracted-out and Directly Provided Public Hospital Services in South Africa: Evaluation of Structural Aspects

This paper evaluates structural quality of hospital care in the context of an evaluation of contracting out district hospital services in South Africa. Three contractor hospitals, run by a private company and paid by public purchasers to provide district hospital care to a rural catchment population, were matched with three adjacent public hospitals and three private hospitals serving largely insured patients. A structured instrument was used to provide a quantitative measure of structural quality. Private hospitals scored highest overall, followed by public and then contractor hospitals.

Health Systems Strengthening and HIV/AIDS: Annotated Bibliography and Resources

Over the past few years, a united battle against HIV/AIDS has gained momentum worldwide. Non-governmental and community-based programs, national and international organizations—all are confronting the myriad of challenges posed by the HIV/AIDS pandemic. In an effort to provide policymakers, technical personnel, and other stakeholders comprehensive information on the costs of interventions and the impact of HIV/AIDS on health systems, PHRplus has prepared this annotated bibliography. The documents described focus on those aspects of the pandemic most related to the work of the project issues of economic impact, financing and resource allocation, costing, health system strengthening, scaling up antiretroviral therapy, surveillance systems, and program monitoring and evaluation.

Equity in the Distribution of Health Personnel: Draft Discussion Paper

In 2003 the Network published a discussion paper reviewing available literature and identifying key issues in need of further work, which this paper summarizes. In Southern Africa there are inadequate ratios of personnel to population for key skilled health personnel. There are a variety of push and pull factors that impact on the movement of healthcare workers. A more rigorous policy analysis is needed to stimulate innovation and to avoid measures and incentives counteracting each other. It is important to provide clearer policy analysis on production of health workers, on availability and distribution, and on movement and migration.

Helping Healthcare Providers Perform According to Standards

This paper reviews several theoretical perspectives to increase understanding of the key determinants of health worker performance, including theories of behavior change, diffusion of innovation, health education, and social influence. The main types of interventions that have been used to encourage health workers to perform in accordance with standards are described, and evidence from empirical research for their effectiveness is summarized. [author’s description]

Uses of Population Census Data for Monitoring Geographical Imbalance in the Health Workforce: Snapshots from Three Developing Countries

This study investigated the uses of demographic census data for monitoring geographical imbalance in the health workforce for three developing countries, as a basis for formulation of evidence-based health policy options. [from abstract]

Integrated Strategies to Tackle the Inequitable Distribution of Doctors in Thailand: Four Decades of Experience

This paper aims to summarize strategies to solve inequitable distribution of human resources for health (HRH) between urban and rural areas, by using four decades of experience in Thailand as a case study for analysis. [from abstract]