Browse by Subject

This paper looks at the successes and failures of today’s health care workforce. Hargadon and Plsek argue that our current solutions to the problems in the health workforce are insufficient. To overcome these insufficiencies, they believe that we need to better understand the complexities of the workforce. However, this is not an easy feat, because these problems challenge our traditional mental models of how things should work. [abstract]

This booklet has been prepared to assist policy makers in international organizations, governments and civil society. The authors hope that it will help design, introduce and implement public service and health sector reforms in the most effective and sustainable way, taking into account human resource policies. At the heart of the booklet are a set of critical questions which aim to help policy makers, including all social partners, to construct an effective path through the complex process of reform and restructuring. [author’s description]

The overall aim of the workshop was to identify and agree on priorities for coordinated action in improving human resources for health (HRH) policy and practice, based on a timetable for strategic work involving the agreed participation of different stakeholders. Specific objectives were to improve the performance of health workers/health workforce by: improving understanding of the determinants of successful approaches to workforce development and HRH; developing strategies and the evidence base in relation to the first point; and achieving consensus among stakeholders on a strategy for research, development of knowledge tools, and implementation mechanisms for HRH.

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]

This brief report describes four different accreditation programs in South Africa: one is nationwide and addresses hospitals; the second accredits privately financed healthcare programs; the third is a provincial program accrediting all public healthcare facilities, and the fourth assesses clinics providing adolescent reproductive health. This operations research study interviewed stakeholders of the South Africa healthcare system to elicit their views of the best possible options for South Africa and of the strengths and weaknesses of the four existing programs. [author’s description]

Chapter 1 of this document describes the environment that affects the health workforce. Chapter 2 presents an overview of what lessons can be learned from priority programmes that have already struggled with the consequences of HRH limitations. Chapter 3 discusses possible strategies that can help to overcome HRH constraints. The last chapter proposes an agenda for action. [Adapted from authors]

This study provides an overview of existing information on the migration of health workers, with an emphasis on related social and labour issues. It considers trends in migration, the working conditions of migrants, migration policies and recruitment practices, and the impact of international standards and trade agreements on conditions of migrant health workers. The study also outlines policies and practices associated with more socially acceptable forms of managed migration. It focuses on nurses and doctors, who have been in the forefront of current debate about health worker migration. [author’s description]

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.

Public-Private health sector Interactions (PPI) are on the increase in South Africa. However, there are few mechanisms for the two sectors to routinely engage with each other. Such mechanisms are necessary to allow all stakeholders to understand better the motivations of, and the challenges that face, each sector and are a key part of the process of building trust between the sectors. The overall purpose of PPIs, and therefore of engagement between the public and private sectors, is to strengthen the overall health system for the benefit of all South Africans. [author’s description]

The purpose of this strategy is to guide the planning, management and development of human resources for health in Eritrea for the period 2006 - 2014. Whilst much progress has been made with the staffing of the health services in the health sector, there is still more work to be done. There is a general shortage of health professionals, particularly amongst more highly skilled groups. Although geographic distribution is relatively good compared to many countries in Africa, there are still health stations and health centres that are under-staffed. There is a major shortage of midwives, exacerbating the high rate of maternal mortality. [from author]

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.

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 presents findings from a nationwide Expenditure Tracking and Service Delivery Survey implemented in Mozambique between August and October 2002. The study focuses on the primary health care system, which is frequently the only source of health care for most Mozambicans. The report covers a broad set of issues, including institutional context, budget management, cost recovery, allocation and distribution of drugs, human resources, infrastructure and equipment, and service outputs. [from abstract]

This is the fourth of a series of policy briefs produced by the Community Health Department of the Aga Khan Health Service in Kenya. It focuses on a number of issues related to the management of health facilities: the rational for decentralisation of health services, the role of the community in the management of health facilities, the membership of local management committees, selection criteria and, finally, the involvement of local politicians.

These briefs are primarily intended for directors and managers of community-based health care programmes — whether working within ministries of health, international donor agencies or non-government organisations.

This paper reviews recent innovations in education for human resources for health (HRH). The paper outlines the rationale for HRH education, identifies shortcomings in HRH education, and addresses the global contents of educational programs and trends. Recent changes in didactic approaches used in HRH educational programs are analyzed. The paper concludes with an evaluation of innovations and a set of recommendations. [adapted from author]

TEHIP (Tanzania Essential Human Interventions Project) was designed to test how and to what extent evidence can guide decentralized planning of the health sector at District level. From the outset, the evidence set included burden of disease, cost effectiveness, health system capacity, and community voice. The Burden of Disease Tool and the Community Voice Tool have been developed as planned. The Cost-Effectiveness Tool has been designed but left on the shelf due to the need to introduce some new precursor tools that had not been foreseen. These include the District Cost Information Tool, the District Health Expenditure Mapping Tool (both of which have been developed and applied) and a District Intervention Coverage Tool that is under development. Also, for the health system capacity, a number of innovations and new tools have evolved including the District Integrated Management Tool, the District Health Mapping Tool, The Community Ownership Strategy, and Strengthening Health Management and Administration. All together, these tools and strategies can be seen as major “interventions” into the capacities of the TEHIP supported districts and must be understood in that sense when comparing the performance of such districts with those with conventional approaches to planning and resource allocation.

This paper is intended to be the basis for the development of policy options with countries for countries. As such, it has multiple objectives: to provide a guide for the analysis of human resources for health (HRH) as part of health systems performance assessment; to highlight HRH policy questions - derived from analyses and other input from countries — with which policy-makers are often struggling; to integrate HRH policy issues with indicators to assess and monitor HRH performance. [author’s description]

Countries in the Europe and Eurasia region are facing a significant and expanding HIV/AIDS epidemic that is largely concentrated among particularly vulnerable populations. A window of opportunity exists to respond effectively to the epidemic and to halt its spread, both within and beyond vulnerable populations. However, available evidence indicates that this opportunity is being missed. One explanation for this is that significant barriers exist within the region’s health systems that prevent rapid scale–up of effective HIV/AIDS programs.

This study seeks to examine these barriers and ways they can be overcome.

Zambia’s recently developed hospital accreditation program is a major component of ongoing health sector reforms that have taken place in the country during the last decade. Although Zambia previously had several processes in place for evaluating hospital performance, comprehensive performance standards had not been developed and quality measurement was not standardized.

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]

Using preliminary research results from 15 case studies conducted the world over we examine the prerequisites for successful introduction of performance management systems which are appropriate for developing country situations. The key message and conclusion is that it is important to measure and value staff performance, but that this requires levels of organisational management and an external policy environment that are seldom in place in a developing context.

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.

Results of a study of human resources and antiretroviral therapy (ART) at 41 sites in 11 countries, presented in three sections: an overview of service delivery models for ART, a more in-depth account of the systems studied and a report of an international workshop on HRH and ART delivery.

The human capacity-building plan proposes a set of products and services supporting countries in their efforts to plan for, train and sustain the human capacity to achieve 3 by 5.

This report attempts to provide a comprehensive assessment of health outcomes and of the health sector performance in targeting the poor. The report is guided by the Poverty Reduction Strategy Framework on health, nutrition and population and poverty. It also uses the frameworks on accountability and service provision from the World Development Report 2004: Making Services Work for Poor People. The report builds upon a vast literature on the health sector in Uganda and uses available data from surveys and the health information system for its analysis. It provides an in depth examination of inequalities in health outcomes, health behavior and practices and of health system performance and financing from the equity perspective.

OECD countries face a number of challenges in matching the supply to the demand for the services of physicians. These include making the right decisions on the numbers and training of new entrants, on the retention and retirement of the existing stock of physicians, and on migration policies for physicians. It also requires policies to ensure that there is the right specialty mix and geographical distribution of physicians. It will require appropriate decisions on terms and conditions of service and on methods of remuneration — not only to ensure that the right number of individuals is attracted to work in medicine but also to ensure that those who are attracted are motivated to be as productive as possible.

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.

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).

The purpose of this book is to provide information about what works—specifically, the cost-effectiveness of health interventions in a variety of settings. Such information should influence the redesign of programs and the reallocation of resources, thereby helping to achieve the ultimate goal of reducing morbidity and mortality. [from foreword]

Of particular interest are Chapter 3 “Strengthening Health Systems” and Chapter 71 “Health Workers: Building and Motivating the Workforce.”

The objective of this paper is to contribute to a better understanding of the issues related to imbalance through a critical review of its definition, nature and measurement techniques, as well as the development of an analytical framework. [author’s description]