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In this paper, we focus on those policy instruments with monetary incentives that are used to contain public health expenditure in high-income countries.

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]

This guide is designed for managers, supervisors, educators, planners, and evaluators. Its purpose is to discuss ways to improve decisions that affect how human resources are used to provide health services. Improved decisions require up-to-date and detailed information about three components of human resources for health: (1) the workforce, (2) the work performed and (3) the work settings. This guide discusses how to establish an information system that links these three components to form a unified model of human resources planning, training, and utilization. [from overview]

Establishing a salary policy is a critical function of human resource administration which serves to support the organization’s most valuable asset, its human resources. A salary policy should be equitable, structured and clearly understood. By following these components of a salary policy and answering the questions posed, an organization can reflect on its past and present salary policy and establish a salary policy that is sound. [author’s description]

The problem of training human resources in health is a real concern in public health in Central Africa. What can be changed in order to train more competent health professionals? This is of utmost importance in primary health care.

The aim of the code of practice is to promote high standards of practice in the international recruitment and employment of healthcare professionals. [author’s description]

In an effort to understand the flows of funds throughout the health system, the Government of Rwanda (GoR) conducted, for the second time, a National Health Accounts (NHA) estimation. NHA is an internationally recognized tool for measuring health expenditures in a comprehensive manner — one that includes the public, private and donor sectors. By doing so, NHA offers a financial perspective on who is paying for health care, who is managing health care funds and their allocation, and where the funds are going — by type of provider and service. In short, NHA aims to inform policymakers on resource flows for the entire health system so as to assist in making good policy decisions and averting potentially adverse ones.

This report presents findings from a survey of 252 primary health facilities and 30 local governments carried out in the states of Kogi and Lagos in Nigeria in the latter part of 2002. Nigeria is one of the few countries in the developing world to systematically decentralize the delivery of basic health and education services to locally elected governments. Its health policy has also been guided by the Bamako Initiative to encourage and sustain community participation in primary health care services. The survey data provide systematic evidence on how these institutions of decentralization are functioning at the level local—governments and community based organizations—to deliver primary health service.

Whilst the issue of international migration of health workers is sometimes presented as a one-way linear ‘brain drain,’ the dynamics of international mobility, migration and recruitment of health workers are complex.

To provide good quality health care services, it is important to develop strategies influencing staff motivation for better performance. An exploratory qualitative research was carried out among health workers in two provinces in North Viet Nam so as to identify entry points for developing strategies that improve staff performance in rural areas. [from abstract]

This document intends to provide a policy and strategic framework for management of health information, use of information in planning and management of health services and monitoring health sector performance. [from preface]

This paper combines the literature on public health, on economics of health and on economics of technological innovation to discuss the peculiarities of labour in the health care sector. The health care system has a distinctive characteristic from other economic sectors: it is the intersection between social welfare and innovation systems. The relationship between technological innovation and cost in the health care sector is surveyed. Finally, the Brazilian case is discussed as an example of a developing country. The peculiarities of labour in the health care sector suggest the need to recognize the worth of sectoral labour and to cease to treat it separately.

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]

There has been a lively debate in the media about working conditions in rural South African Hospitals, with a particular focus on staffing and quality of care. From a medical perspective, it has been stated that poorly equipped and managed hospitals, inappropriate training and an excessive workload are significant contributors to the problem. This study was conducted to investigate the experiences of medical practitioners in performing their professional duties in rural district hospitals in the Western Cape. [from abstract]

Imbalance in the health workforce is a major concern in both developed and developing countries. It is a complex issue that encompasses a wide range of possible situations. This paper aims to contribute not only to a better understanding of the issues related to imbalance through a critical review of its definition and nature, but also to the development of an analytical framework. [from abstract]

When health care workers participating in training are able to transfer their newly acquired knowledge and skills to their jobs, higher levels of performance and sustained improvements in service delivery are likely to result. A joint publication of PRIME II and JHPIEGO, Transfer of Learning uses a dynamic matrix to outline specific steps for supervisors, trainers, learners and co-workers to follow before, during and after a learning intervention to promote the transfer of learning. PRIME II has also created an interactive website based on Transfer of Learning.

This study indicates that healthcare professionals are using mostly clinical handover meetings, seminars and workshops for their continued professional development (CPD). There is need to improve access to relevant professional journals. The regulatory or licensing boards for healthcare professionals in Malawi should seriously consider mandatory CPD credits for re-certification. [author’s description]

This document outlines five key areas requiring intervention: human resources planning and capacity building, management of personnel, evidence-based practice, education, and stewardship. It provides a tangible response to resolution WHA54.12, which was adopted by the World Health Assembly in May 2001, and facilitates the achievement of WHO’s four strategic directions as well as the United Nations Millennium Development Goals. The document consists of two sections. Part I introduces the Strategic Directions, Key Result Areas and Objectives with the Expected Results to achieve them.

Academic medicine has the opportunity to improve the quantity and quality of the health workforce as a means of strengthening the broader health system. However, it must address the gender dimensions of enrollment, curriculum, and promotion to have a positive impact on human resources for health around the world. [author’s description]

The overall objective of this paper is to provide some insights into the effects of the HIV epidemic on human capital in sub-Saharan Africa through a discussion of some of the factors that are operating. It is not intended as a compendium of data on the problem but aims instead to provide an analytical framework for understanding the policy and programming issues. There is an analysis of the impact on the public services in Malawi, a detailed presentation of the impact on education and health and a discussion of issues relating to the measurement of the impact on different productive sectors and the role of different social partners in adjusting to, and managing, the impact.

This issue outlines the connections between work climate, employee motivation, and performance. It describes how managers can assess the climate in their work group and shows how they can use the results to make changes in leadership and management practices that will motivate their group to do the best work possible and improve results. [editor’s description]

UniNet is an Internet-based thematic network for a virtual community of users. It supports a virtual multidisciplinary community for physicians, focused on the improvement of clinical practice. This is a study of the effects of a thematic network such as UniNet on primary care medicine in a rural area, specifically as a platform of communication between specialists at the hospital and doctors in the rural area. [from abstract]

The Global Alliance for Vaccines and Immunization (GAVI) was established in 1999 to finance and speed the delivery of new and improved vaccines for children in the developing world. Through collaborative leadership and international funding, GAVI aims to improve health in developing countries, increase international public health equity, and serve as a model for others in the global health community. However, this paper questions the extent to which GAVI can actually achieve its goals.

This paper analyses in detail the changing international health paradigms and the situations that challenge international mechanisms existing globally and in Thailand. Human resources development on international health and negotiation skills constitute the core responses. The initial success of the recent development in Thailand is also reviewed. Finally, the conceptual framework, possible strategies and priority activities are proposed to be carried out for future international health development. [from abstract]

This report examines trends and policy issues relating to international mobility of nurses. The increase in knowledge worker migration, which is partly a result of industrialized countries trying to solve skill shortages by recruiting from developing countries, is a key component of current international migration patterns. [author’s description]

We develop a principal-agent model to analyze how the behavior of a physician in the
public sector is affected by his activities in the private sector. We show that the physician will have incentives to over-provide medical services when he uses his public activity as a way of increasing his prestige as a private doctor. The health authority only benefits from the physician’s dual practice when it is interested in ensuring a very accurate treatment for the patient. Our analysis provides a theoretical framework in which some actual policies implemented to regulate physicians’ dual practice can be addressed.

Some 60 participants from ministries of health, multilateral and bilateral international agencies, foundations, nongovernmental organizations (NGOs) and professional organizations discussed and debated a range of issues in order to contribute to the objectives of this workshop, which were to: further the development of an HRH framework for policies; identify policy questions and agree upon an agenda for development of policy options; identify gaps in evidence and priorities for obtaining evidence on which to base policy; build capacity and partnership for action at country level. [author’s des

This study estimates the personnel cost implications of implementing the newly proposed Integrated Management of Childhood Illness (IMCI) algorithm in the first level health care facilities in rural Bangladesh. Policy makers need to know the additional resource requirements for IMCI before its actual implementation so that appropriate levels and combinations of personnel and drugs can be allocated. [abstract]

In the last few years, increasing attention has been paid to the development of health policies. But side by side with the presumed benefits of policy, many analysts share the opinion that a major drawback of health policies is their failure to make room for issues of human resources.

Triple-drug combination antiretroviral (ARV) therapy has yielded remarkable results in affluent countries and some middle-income countries such as Brazil. Lessons can be learned from these examples, but this publication reviews the experiences of ARV programmes already underway in countries with very severe HIV epidemics but severely constrained resources, as in most of Africa and part of the Caribbean. The publication aims to show how some of the key policy issues for scaling up HIV/AIDS treatment have been dealt with and to identify common elements that should be considered by everyone seeking to provide HIV/AIDS care on a significant scale.