Evaluations & Reviews

Human Resources and the Quality of Emergency Obstetric Care in Developing Countries: a Systematic Review of the Literature

This paper reports on a systematic literature review exploring the importance of human resources in the quality of emergency obstetric care and thus in the reduction of maternal deaths. [from abstract]

Assessment of the Multidisciplinary Education for a Major Change in Clinical Practice: a Prospective Cohort Study

This study documents and assesses the impact of a major educational and support program on a change in the health service provision of a neonatal intensive care unit. [adapted from abstract]

Remuneration of General Practitioners and Specialists in 14 OECD Countries: What are the Factors Influencing Variations across Countries?

This paper provides a descriptive analysis of the remuneration of doctors in 14 OECD countries for which reasonably comparable data were available in OECD Health Data 2007 (Austria, Canada, the Czech Republic, Denmark, Finland, France, Germany, Hungary, Iceland, Luxembourg, Netherlands, Switzerland, the United Kingdom and the United States).

Retention Strategies for Swaziland's Health Sector Workforce: Assessing the Role of Non-Financial Incentives

This country study in Swaziland thus sought to map and assess incentives for retaining heath workers, particularly non-financial incentives. Specifically it sought to identify existing policies and measures for incentives for retention of health workers, their relevance to current factors driving exit and retention, and propose inputs for guidelines for introducing and managing incentives for health worker retention to maximize their positive impact. [from summary]

Experience of Virtual Leadership Development for Human Resource Managers

Strong leadership and management skills are crucial to finding solutions to the human resource crisis in health. Health professionals and human resource (HR) managers worldwide who are in charge of addressing HR challenges in health systems often lack formal education in leadership and management. The Virtual Leadership Development Program is a web-based leadership development program that combines face-to-face and distance learning methodologies to strengthen the capacity of teams to identify and address health challenges and produce results. [adapted from abstract]

Barriers to HIV Care and Treatment by Doctors: a Review of the Literature

This paper provides a review of the reported barriers that prevent doctors from managing HIV infected patients. The four most commonly reported barriers were: fear of contagion, fear of losing patients, unwillingness to care, and inadequate knowledge /training about treating HIV patients. [from abstract]

Human Resources for Health (HRH) Action Workshop Assessment

Several high-profile meetings have focused global attention on critical human resources for health (HRH) issues, providing much needed high-level support and calls for action to address the HRH crisis. The Capacity Project’s HRH Action Workshop series was intended to extend this work by focusing on specific HRH actions and experiences, what is being done in countries, what is working and what is not.

US Physician Workforce: Where do we Stand?

This review surveys trends in physician supply in the United States from 1980 to the present. It discusses the composition of the physician workforce; changes in the inflows and outflows of the physician workforce; and how international migration, retirement, part-time practice and alternative employment have impacted the physician workforce. Finally, the paper considers implications of physician shortages and the recruitment of physicians from abroad. [adapted from summary]

Caring for Caregivers: an HIV/AIDS Workplace Intervention for Hospital Staff in Zambia, Evaluation Results

There has been little research on HIV incidence or prevalence among hospital staff worldwide, and even less on modes of transmission among those infected. Recent evidence from South Africa suggests that HIV prevalence among health care personnel may not differ greatly from the general population. This evaluation study describes the significant effect of HIV morbidity and mortality among the workers in Zambia’s health care system. [adapted from introduction]

What Sort of Stewardship and Health System Management is Needed to Tackle Health Inequity, and How Can It Be Developed and Sustained

This paper argues that stronger and values-based public sector management and leadership is essential in building health systems that better address health inequities. It identifies the particular competencies of public sector managers and reviews evidence on how these competencies can be developed. Renewing the values base of public health system managers and professionals is an important requirement. [from summary]

Task Shifting: Successes from Mozambique and Rwanda

These reports demonstratre that non-physician clinicians and nurses can take over many of the tasks in providing HIV care and treatment (including ART) in some resource-limited settings. [from author]

Scaling Up Health Service Delivery: from Pilot Innovations to Policies and Programs

This book considers the topic of scaling up with a focus on ways to increase the impact of health service innovations that have been tested in pilot or experimental projects so as to benefit more people and to foster policy and program development on a lasting, sustainable basis.

Chapter 8 of this book describes an innovative educational approach to capacity building and scaling up reproductive health services in Latin America. It explains how the capacity to provide innovative training was scaled up in public sector reproductive health services in Brazil, Bolivia and Chile. [from introd

Mid-Level Health Workers: the State of the Evidence on Programmes, Activities, Costs and Impact on Health Outcomes

This review aims to support efforts to integrate, plan and manage mid-level health workers by collating what we know about experiences with mid-level cadres in low-income countries in Africa, south-east Asia and the Pacific, regions that heavily rely on them. It interrogates the existing evidence on the evaluation of different types of mid-level workers and their impact on health outcomes and it identifies knowledge gaps. The review focuses specifically on the role of mid-level workers as independent practitioners in areas that suffer from severe shortages of professionals. [adapted from execu

Effect of Community-Based Newborn-Care Intervention Package Implemented Through Two Service-Delivery Strategies in Sylhet District, Bangladesh: a Cluster-Randomized Controlled Trial

Neonatal mortality accounts for a high proportion of deaths in children under the age of 5 years in Bangladesh. This article describes a project for advancing the health of newborns and mothers implementing a community-based intervention package through government and non-government organisation infrastructures to reduce neonatal mortality. [from abstract]

Integrated AIDS Program Thika, Kenya

This case study evaluates a project in Kenya that concentrates on HIV and AIDS care and prevention through support and training of community volunteers to provide PLHA with HBC, widespread and diverse efforts to promote behavior change and raise awareness about HIV and AIDS, improving access to VCT, as well as capacity building efforts and direct material assistance for OVC and PLHA. [adapted from introduction]

Payment for Performance (P4P): International Experience and a Cautionary Proposal for Estonia

Incentives such as P4P can be very powerful in their effects. Caution in their design and deployment is essential. However, ignoring their potential would be unwise, as they offer the possibility of improving value for money for taxpayers and patients. The first section of the paper will review evidence of common provider problems in all health care systems and their implications for introducing a P4P system. This will be followed by a review of P4P reforms in the United Kingdom and United States in particular. [from author]

Scaling Up Kangaroo Mother Care in South Africa: On-site Versus Off-site Educational Facilitation

Scaling up the implementation of new health care interventions can be challenging and demand intensive training or retraining of health workers. This paper reports on the results of testing the effectiveness of two different kinds of face-to-face facilitation used in conjunction with a well-designed educational package in the scaling up of kangaroo mother care. [from abstract]

Mid-Term Evaluation of the Kenya Emergency Hiring Plan

This mid-term evaluation report focuses on Capacity Project support to the Government of Kenya’s Emergency Hiring Plan. It assesses the main achievements, challenges and impact on service delivery and health systems improvement, from the plan’s inception through the November 2007 mid-point. The report outlines all aspects of the approach used, providing clear recommendations on how the Ministry of Health may strengthen its existing human resource systems on the basis of lessons learned, and provides additional insights to the process, which may be useful for informing similar country contexts.

Ghana: Implementing a National Human Resources for Health Plan

Ghana addresses its serious health workforce shortage and consequent issues with health service delivery through a new human resources strategic plan developed to guide scale-up from 2007 to 2011. [from abstract]

Monitoring the Performance of a Reproductive Health Franchise in Nepal

This study examines the experience of the Sewa nurse and paramedic franchise in Nepal and assesses whether there were changes in the perceived quality of services approximately one year after the formation of the network. This study also examines the extent to which there was an increase in the use of reproductive health services during this period. [from introduction]

Can Working with the Private For-Profit Sector Improve Utilization of Quality Health Services by the Poor?: A Systematic Review of the Literature

This paper is a systematic literature review on the effectiveness of working with private for-profit providers to reach the poor. [adapted from abstract]

Networking Collaboratively: the Brazilian Observatorio on Human Resources for Health

This case study looks at the contribution of the Observatório and its members to the development of the public health sector in Brazil. [from introduction]

Guidelines and Mindlines: Why Do Clinical Staff Over-Diagnose Malaria in Tanzania? A Qualitative Study

Malaria over-diagnosis in Africa is widespread and costly both financially and in terms of morbidity and mortality from missed diagnoses. An understanding of the reasons behind malaria over-diagnosis is urgently needed to inform strategies for better targeting of antimalarials. [from abstract]

Faith-Based Models for Improving Maternal and Newborn Health

This document explores some FBO health networks and facility-based services in Uganda and Tanzania. A pilot project in the Kasese District of Uganda illustrates how protestant, catholic and muslim health care providers and communities can work together from household-to-hospital levels to improve health outcomes. [from author]

Scaling Up, Saving Lives

This report calls for a rapid and significant scaling up of the education and training of health workers as part of a broader effort to strengthen health systems. It highlights the importance of training to meet a country’s own health needs and the great opportunity represented by the increased use of community- and mid-level workers. [from foreword]

There are also case studies from Ghana, Malawi, Pakistan, Ethiopia and Bangladesh on strategic implementation of health worker training plans.

Introducing Family Planning Services into Antiretroviral Program in Ghana: an Evaluation of a Pilot Intervention

This report documents the assessment of a family planning training program for providers to enable them to offer family planning counseling and methods, and make referrals where needed as part of antiretroviral therapy services in Ghana. [from summary]

Mapping of Community Based Distribution Programs in Uganda

The mapping exercise illustrated in this report was conducted to inform and support the efforts of the Ugandan Ministry of Health to increase the contraceptive prevalence through enhanced community-based distribution (CBD) of family planning. The specific objectives of the exercise were to determine the historical and current coverage of CBD of family planning services in Uganda, by both governmental and nongovernmental programs, and to identify potential districts for scaling up these services. [adapted from summary]

Community-Based HIV/AIDS Prevention Care and Support Project (COPHIA)

The emphasis of the COPHIA program is the provision of home-based care and support services by multi-purpose community-based health workers to vulnerable households in the geographic focus areas that are coping with the burden of caring for seriously ill family members or caring for orphans and vulnerable children. The COPHIA community-based health workers, with the support of clinical and non-clinical supervisors, provide the direct physical and emotional care and support services to PLWHA and orphans and vulnerable children in the project catchment area with the support of trained primary caregivers.

Myths, Masks and Stark Realities: Traditional African Healers, HIV/AIDS Narratives and Patterns of HIV/AIDS Avoidance

This paper presents field narratives selected as illustrations of mythologising and masking in popular responses to HIV/AIDS in South Africa. The stories appear in the context of traditional health practitioners and the testimony of the healers is used to demonstrate the ways in which they interpret these narratives, and seek to challenge them.2 The examination then re-assesses these accounts, and the healers’ responses to them, in relation to the antipathy that exists between western medicine and traditional healing in the context of HIV/AIDS. [introduction]

Involving Traditional Health Practitioners in HIV/AIDS Interventions: Lessons from the Western Cape Province

This paper documents the results of the second year of operation of the HOPE Cape Town (HIV Outreach Program and Education) Pilot Traditional Healer Project, an innovative HIV/AIDS collaboration between traditional health practitioners and western medicine in the Western Cape Province. The paper identifies the project’s achievements, and explores key problems in operation and management, including recommendations for the design and implementation of future initiatives. [from introduction]