Sub-Saharan Africa

Rural Workers' Contribution to the Fight Against HIV/AIDS: a Framework for District and Community Action

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

Role of the Africa Midwives Research Network in Strengthening the Contribution of Nurses and Midwives in Response to HIV/AIDS Epidemic in ECSA Region

This presentation discusses the AMRN role of strengthening nurses and midwives in their responses to HIV/AIDS by improving their knowledge and skills in evidence based practice, research, counseling, advocacy and education. Included is information about the magnitude of the HIV/AIDS problem and some strategies that AMRN has used to address the problem through nurses and midwives.

Southern Africa Capacity Initiative (SACI) Framework

This presentation was part of the Planning, Developing and Supporting the Health Workforce: Human Resources for Health Action Workshop. It gives an overview of the Southern Africa Capacity Initiative (SACI) Framework, provides examples of SACI applications and discusses the Africa HRH agenda.

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What Can We Learn from Country Studies?

This presentation was part of the Planning, Developing and Supporting the Health Workforce: Human Resources for Health Action Workshop. It discusses the review of 11 country HR assessments including: Malawi, Lesotho, Ethiopia, Zambia, Botswana, Swaziland, Mozambique, The Gambia, Ghana and Tanzania. It identifies the challenges faced, the implementation, technical inputs, and the process expertise.

How and Why Public Sector Doctors Engage in Private Practice in Potuguese-Speaking African Countries

The objective of this article is to explore the type of private practice supplementary income-generating activities of public sector doctors in the Portuguese-speaking African countries, and also to discover the motivations and the reasons why doctors have not made a complete move out of public services. [objective]

Health Worker Flight from Sub-Saharan Africa: Patterns, Implications & Mitigating Strategies

This presentation was given at the second annual AAMC Physician Workforce Research Conference, “2020 Vision: Focusing on the Future.” It discusses out migration and brain drain from sub-Saharan Africa and gives an overview of the issues related to this problem, particularly in respect to a project done in Uganda.

Note: This resource is no longer available online

Current HIV/AIDS End-of-Life Care in Sub-Saharan Africa: a Survey of Models, Services, Challenges and Priorities

In response to increased global public health funding initiatives to HIV/AIDS care in Africa, this study aimed to describe practice models, strategies and challenges to delivering end-of-life care in sub-Saharan Africa. A survey end-of-life care programs was conducted, addressing the domains of service aims and configuration, barriers to pain control, governmental endorsement and strategies, funding, monitoring and evaluation, and research. Both closed and qualitative responses were sought. [author’s description]

Palliative Care in Sub-Saharan Africa: an Appraisal

Palliative care aims to maximise quality of life and relieve the suffering of patients with life-limiting incurable disease, and to support their families and carers. It is provided through specialist services such as hospices and palliative care teams and in general settings. The HIV/AIDS pandemic and rising cancer rates in Africa have increased the need for well-developed and integrated palliative care services. In sub-Saharan Africa, the concept of palliative care is not well developed and palliative care is largely confined to isolated specialist centres. Services have developed, but in very varied ways. In order to inform future developments, this review aimed to identify and appraise activities, opportunities and evidence of the status of palliative care in Africa.

New Database of Health Professional Emigration from Africa

The migration of doctors and nurses from Africa to rich countries has raised fears of an African medical brain drain. But empirical research on the issue has been hampered by lack of data. How many doctors and nurses have left Africa? Which countries did they leave? Where have they settled? As part of a larger study of the consequences of the international migration of African health professionals, we compiled a database of the cumulative bilateral net flows of African-born physicians and nurses to the nine most important destination countries. It is the first database of net bilateral migration flows specific to a skilled profession collected systematically for a large number of developing countries.

Nursing Workforce in Sub-Saharan Africa

This paper examines various aspects of the nursing and midwifery workforce in Africa, looking at education and supply systems; recruitment, retention and motivation and career systems. It further investigates attrition from migration and HIV/AIDS, as well as other factors and makes some recommendations on how to move forward using examples of experiences from countries. These experiences, albeit on a small scale, show promise of good results after being scaled up. [author’s description]

One Million More: Mobilising the African Diaspora Healthcare Professionals for Capacity Building in Africa

One Million More presents some of the interventions, debates, discussions and conclusions of a conference held in London.

Managing Health Professional Migration from Sub-Saharan Africa to Canada: a Stakeholder Inquiry into Policy Options

Canada is a major recipient of foreign-trained health professionals, notably physicians from South Africa and other sub-Saharan African countries. Nurse migration from these countries, while comparatively small, is rising. African countries, meanwhile, have a critical shortage of professionals and a disproportionate burden of disease. What policy options could Canada pursue that balanced the right to health of Africans losing their health workers with the right of these workers to seek migration to countries such as Canada? [author’s description]

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]

Planning, Developing and Supporting the Faith-Based Health Workforce: African Church Health Associations' Human Resources for Health Mini-Forum

The African Church Health Associations’ Human Resources for Health Mini-Forum was held to re-energize the CHA’s human resources working group. The objectives of the forum were to: expand the HRH knowledge base; help develop a critical mass of faith-based HRH advocates; clarify the “Terms of Reference” for an HRH working group and plan for sustainability and next steps; and to generate action plans for HRH practices and identify technical assistance needs. [adapted from author]

Brain Drain and Retention of Health Professionals in Africa

The numbers of health professionals joining the brain drain has reached a peak in recent years in apparent response to huge demands emanating from the developed countries. The brain drain of professionals, combined with the health crisis, threatens the entire development process in Africa. The crisis in health intensifies with the advent of the HIV/AIDS crisis. The loss of health workers simply serves to worsen a dire situation.

Guidelines for Human Resources for Health Policy and Plan Development at Country Level (Draft)

The main aim of these guidelines is to support countries in the Human Resource Development and management process of assessing the human resource for health situation, policy and plan development with the view of achieving some level of comprehensiveness and consistency country level. The guidelines will discuss HRH processes, situation analysis, policy and plan development with reference to the overall context of national health policies and strategies. These guidelines describe how to formulate, develop, review HRH situations, policies and plans with the flexibility necessary for each country context.

Dual Job Holding by Public Sector Health Professionals in Highly Resource-Constrained Settings: Problem or Solution?

This paper examines the policy options for the regulation of dual job holding by medical professionals in highly resource-constrained settings. It draws on the limited evidence available on this topic to assess a number of regulatory options in relation to the objectives of quality of care and access to services, as well as some of the policy constraints that can undermine implementation in resource-poor settings. [from abstract]

Retention of Health Care Workers in Low-Resource Settings: Challenges and Responses

The number of health workers employed is an indicator of a country’s ability to meet the health care needs of its people, especially the poorest and most vulnerable. Resource-constrained countries committed to the Millennium Development Goals are facing up to the reality that shortages and uneven distribution of health workers threaten their capacity to tackle the HIV/AIDS pandemic, as well as the resurgence of tuberculosis and malaria. Worker shortages are linked to three factors: 1) decreasing student enrollment in health training institutions, 2) delays or freezes in the hiring of qualified professionals and 3) high turnover among those already employed.

HRH Action Workshop: Methodology and Highlights: Planning, Developing and Supporting the Health Workforce

As a key contribution toward increasing human capacity in national health systems, the Capacity Project is hosting a series of Human Resources for Health (HRH) Action Workshops. The initial workshop—held in Johannesburg in partnership with the United Nations Development Programme/Southern Africa Capacity Initiative (UNDP/SACI)—facilitated the exchange of knowledge and best practices in planning, developing and supporting the health workforce. The three and one-half day workshop brought together 38 HRH leaders from 11 countries (Kenya, Lesotho, Malawi, Namibia, Rwanda, Sudan, South Africa, Swaziland, Tanzania, Uganda and Zambia). Almost all of the participants are senior HRH directors or practitioners working at the operational level within the Ministry of Health in their respective countries. Two representatives from faith-based organizations also attended.

Planning, Developing and Supporting the Health Workforce: Human Resources for Health Action Workshop, January 17-20, 2006, Johannesburg, South Africa (CD)

As a key contribution toward increasing human capacity in national health systems, the Capacity Project is hosting a series of Human Resources for Health (HRH) Action Workshops. The initial workshop—held in Johannesburg in partnership with the United Nations Development Programme/Southern Africa Capacity Initiative (UNDP/SACI)—facilitated the exchange of knowledge and best practices in planning, developing and supporting the health workforce.

The three and one-half day workshop brought together 38 HRH leaders from 11 countries (Kenya, Lesotho, Malawi, Namibia, Rwanda, Sudan, South Africa, Swaziland, Tanzania, Uganda and Zambia).

Is There any Solution to the "Brain Drain" of Health Professionals and Knowledge from Africa?

African public health care systems suffer from significant brain drain of its health care professionals and knowledge as health workers migrate to wealthier countries. In this paper, the brain drain is defined as both a loss of health workers (hard brain drain) and unavailability of research results to users in Africa (soft brain drain).

Training of Human Resources for Health in Africa

Traditionally, training institutions have in the main adopted the training programmes of rich countries. Graduates from these programmes have not usually been suitably adapted to the needs of the communities where the vast majority of people live. As such, their practice has not been based on an appropriate consideration of the social determinants of health. Graduates have offered services which have neglected key aspects of people’s living and working circumstances and lifestyles as well as the health implications of economic policies. [from abstract]

Crafting Institutional Responses to HIV/AIDS: Guidelines and Resources for Tertiary Institutions in Sub-Saharan Africa

Four articles by separate authors on institutional responses and policies for managing HIV/AIDS in Africa, with specific emphasis on the role of tertiary institutions, such as schools and colleges. The articles are not specific to health training institutions, but are relevant to this context.

Whose Charity? Africa's Aid to the NHS

Health services in the UK are benefiting from the collapse of health services in some of the poorest countries of the world due to the widespread and increasing migration of health professionals. Children in these countries are unable to obtain the most basic health services and many die as a consequence. Research summarised in this briefing reveals that current UK policy in this area is ineffective in tackling this inequality. Using Ghana as a case study, it sets out a range of practical suggestions for how the UK Government should respond. [From author]

Analysis of Adequacy Levels for Human Resources Improvement within Primary Health Care Framework in Africa

Human resources in health care system in sub-Saharan Africa are generally picturing a lack of adequacy between expected skills from the professionals and health care needs expressed by the populations. It is, however, possible to analyse these various lacks of adequacy related to human resource management and their determinants to enhance the effectiveness of the health care system. From two projects focused on nurse professionals within the health care system in Central Africa, we present an analytic grid for adequacy levels. [from abstract]

Migration of Physicians from Sub-Saharan Africa to the United States of America: Measures of the African Brain Drain

The objective of this paper is to describe the numbers, characteristics, and trends in the migration to the United States of physicians trained in sub-Saharan Africa.

Wastage in the Health Workforce: Some Perspectives from African Countries

This paper illustrates that the way human resources for health (HRH) are trained and deployed in Africa does not enhance productivity and that countries are unable to realize the full potential expected from the working life of their health workers.

State of the Health Workforce in Sub-Saharan Africa: Evidence of Crisis and Analysis of Contributing Factors

This report is an attempt to systematically document and evaluate the state of the health workforce in Africa. It draws on academic published literature (which is limited), the WHO statistical database (which is incomplete and only sporadically updated), studies of bilateral donors, national documents, and newspaper articles. The report shows clearly that for more than a decade HR issues have received very little attention. [from foreword]

Impact of HIV/AIDS on the Health Sector in Sub-Saharan Africa: The Issue of Human Resources

This paper reviews data, studies, and other information on HIV/AIDS impacts on human resources in sub-Saharan Africa. The purpose is to guide the development of an instrument to conduct HIV/AIDS human resource assessments in the health sector. Until now, inadequate attention has been devoted to this critical step in responding to the epidemic. Such assessments can assist policy makers and advocacy groups to shape and accelerate the implementation of national HIV/AIDS policies and programs throughout the continent. [Description from author]

Role of Traditional Birth Attendants in Preventing Perinatal Transmission of HIV

Every year a million women infected with HIV deliver babies without professional help. This article suggests that traditional birth attendants could be involved in preventing perinatal transmission of HIV by offering services such as HIV testing and counseling and short courses of antiretroviral drugs. [publisher’s description]