Human Resources Management

Knowledge and Skills Gap of Medical Practitioners Delivering District Hospital Services in the Western Cape, South Africa

Health service managers in the Western Cape requested a skills audit of medical officers in district hospitals to identify a possible gap in competencies that may impact on service delivery. The aim of this study was thus to identify the knowledge and skills of medical practitioners delivering these services in the Western Cape and to compare them with service needs in order to make recommendations for education and training. This article reports on the results of the knowledge and skills gap analysis, while the results of the district hospital performance data and in-depth interviews are reported elsewhere.

Involvement of Private General Practitioners in Visiting Primary Healthcare Clinics

The primary healthcare system was adopted as the vehicle of healthcare delivery and a means of reaching the larger part of the population in South Africa in 1994. One of the strategies employed in providing a comprehensive service is the incorporation of visits to clinics by doctors in support of other members of the primary healthcare team, particularly nurses. A successful collaboration at this level brings benefit to everyone involved, particularly patients. Clear expectations and a confusion of roles leads to lack of teamwork, thus it is important to have clearly established models for such involvement. [abstract]

Supporting Staff Through Effective Supervision: How to Assess, Plan and Implement More Effective Clinic Supervision

This Kwik-Skwiz addresses the important area of clinic supervision. This document is aimed at district management teams; clinic supervisors and program managers may find it especially useful. Key areas of effective supervision are presented with the aim of assisting district management teams to critically assess clinic supervision in your district. [author’s description]

Defining a Performance Improvement Intervention for Kenya Reproductive Health Supervisors: Results of a Performance Analysis

The competency-based approach used in JHPIEGO-supported training improves performance by ensuring that trainees go back to their worksites with the knowledge and skills required to provide FP services. Once back at the workplace, however, participants often face constraints that limit their ability to provide quality services. Factors that can affect the performance of the healthcare provider include: job expectations, performance feedback, supplies and equipment, motivation, possessing the knowledge and skills to provide services, and supervision.

High-Performing Reproductive Healthcare Facilities in Kenya: Why They Exceed Expectations

This report summarizes findings from Phase 2 of a two-phase case study to determine why certain reproductive healthcare facilities in low-resource settings perform better than others. The study examined the characteristics, behaviors, and coping strategies of high-performing reproductive healthcare facilities in Kenya, exploring elements of resilience and factors influencing performance.

COPE for Child Health in Kenya and Guinea: an Analysis of Service Quality

This report presents the results of a longitudinal, quasi-experimental study evaluating the introduction and use of COPE and the resulting changes in service quality in two countries, Kenya and Guinea. At the end of a 15-month period, providers’ attitudes, providers’ ability to solve problems, service quality, and client satisfaction were assessed at eight intervention sites and at eight matched control sites, using both qualitative and quantitative methods. [author’s description]

Performance Improvement: Developing a Strategy for Reproductive Health Services

During the past several years there has been a global trend in business and industry to move from training to performance improvement. This paper presents a review of selected performance improvement and training literature that has been helpful to JHPIEGO in identifying issues related to this trend and in shaping our performance improvement strategy. [author’s description]

Performance Improvement

The Performance Improvement approach gives organizations the tools they need to find out which essential components of good performance are missing, and then match interventions to root causes, closing the gaps between the performance they are experiencing and the performance they desire.

This document is in English, French and Spanish.

COPE Handbook: a Process for Improving Quality in Health Services, Revised Edition

COPE, which stands for “client-oriented, provider-efficient” services, is a process that helps health care staff continuously improve the quality and efficiency of services provided at their facility and make services more responsive to clients’ needs. COPE provides staff with practical, easy-to-use tools to identify problems and develop solutions using local resources, and it encourages all levels of staff and supervisors to work together as a team and to involve clients in assessing services. Through COPE, staff develop a customer focus, learning to define quality in concrete terms by putting themselves in their clients’ shoes.

Reproductive Health and Services in Azerbaijan, 2005: Results of a Baseline Survey in Five Districts

To identify problems and barriers to [family planning] services specific to each district, to provide data that could assist with project implementation, and to allow determination of benchmarks and targets to measure success, the project started with a baseline assessment of facilities, providers, and community members in the five core districts. The objectives of the assessment were to evaluate factors contributing to the current use of FP services, including: the supply of FP in the public and private sectors: the availability and quality of facilities providing FP services, including the availability of contraceptive methods, IEC materials, and trained providers; and the demand for FP: the population’s knowledge of, attitudes toward, and practice of pregnancy prevention.

Improving Client-Provider Interaction

In family planning programs, good face-to-face interaction between the client and providers is key to meeting clients’ needs and program goals. Programs can best improve client-provider interaction (CPI) when they move beyond just training providers and strengthen CPI continuously in multiple ways. [summary]

What Makes a Good Employer?

This document summarises underlying evidence and issues related to good human resource management (HRM)in the health sector with reference to: (a) indicators of performance and measurement of nursing outcomes; (b) performance issues related to individuals and teams; and (c) employee engagement, commitment and organisational citizenship behaviour (OCB). There are two key themes: What are the interventions and indicators associated with good HRM outcomes, and how can these be measured? [author’s description]

Scaling up Health and Education Workers: Increasing the Performance and Productivity of an Existing Stock of Health Workers

This review paper…looks at strategies that have been undertaken to increase the productivity of health workers. It examines the evidence to support or reject the hypothesis that short term training, incentives, better equipment, supplies and conditions and other things can be employed that improve outputs and health outcomes without increasing the numbers of health workers. The review provides an overview of key aspects and options for improving productivity, with country illustrative examples. [author’s description]

Rapid Assessment of Community Health Worker Knowledge Compared with Knowledge of Doctors and Nurses

This study analyzed and compared the knowledge base of trained community health workers with that of doctors and nurses in Afghanistan to determine the differences in their abilities to provide healthcare and health information to patients.

Global Shortage of Registered Nurses: An Overview of Issues and Actions

Against the backdrop of growing concern about shortages of health personnel, the report focuses on one of the most critical components of the workforce

Working Together for Health: The World Health Report 2006 Policy Briefs

Intended to complement Working Together for Health: The World Health Report 2006, these policy briefs are intended to assist those who make and carry out health policy worldwide. The briefs address the following, Strengthening information and research on the health workforce: strategies for action; Investing in education for expanded capacity and lifelong learning; Making the most of the existing health workforce; Addressing the complex challenges of health worker migration; Bridging between health workers in separate public health programs; and Financing health workforce development. After describing an issue, the briefs propose ways to address it, many of which have been drawn from experience in countries. [author’s description]

Improving Provider Skills: Strategies for Assisting Health Workers to Modify and Improve Skills, Developing Quality Health Care - a Process of Change

This paper describes strategies for improving the performance of health care workers. Many factors interact to affect the quality of health care. The structure of the health care system, educational opportunities for health practitioners, the administrative system, the pace of change, economic conditions and the technology available may influence the ability of the existing workforce to acquire new skills and implement them in practice. Thus, a comprehensive strategy is needed if the quality of the overall system is to improve, including the development of indicators to measure progress. [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]

Using Mystery Clients: A Guide to Using Mystery Clients

Mystery clients are trained people (usually community members) who visit program facilities in the assumed role of clients, and then report (by completing a survey or through an interview) on their experience. They might be used in an effort to avoid the bias in the service delivery process that often results from having service transactions observed. Mystery clients can also serve to gather a sufficient number of observations of service transactions when the actual volume of service visits is low. [publisher’s description]

Human Resource Development Through Continuous Improvement: a Case Study of Yasothorn Hospital, Thailand

Human Resource Development (HRD)is a very important yet very difficult component for effective health care delivery, especially in the public sector. Bureaucratic barriers, discontinuity, ineffective leadership, and lack of systematic approaches are major reasons for failures. A package of HRD strategies were introduced into Yasothon Hospital. This paper describes the detail of the implementation and evaluation of the results. [from abstract]

Human Resource Indicators and Health Service Performance

This paper examines the use of human resource indicators to support management-led initiatives to improve health service efficiency and effectiveness. [from abstract]

Guide to Rapid Assessment of Human Resources for Health

This rapid-assessment guide is designed to help users arrive at a global overview of a country’s HRH situation. The guide is designed to help users assess current HRH constraints and challenges to “scaling up” health interventions. HRH main issues include: Policy, regulation and planning; Management and performance improvement; Labour market; Education, training and research; HRH and priority health programmes; and Monitoring and evaluation. [author’s description]

Recognising, Understanding and Addressing Performance Problems in Healthcare Organisations Providing Care to NHS Patients

Measuring, managing and improving organisational performance are key considerations for individuals and teams charged with the responsibility for leading and managing NHS organisations. These are issues that are addressed by this resource, which has been developed specifically to support managers and leaders of NHS organisations to identify and act upon signs of performance decline and failure. [from executive summary]

Decentralization of Health Systems in Latin America: A Comparative Analysis of Chile, Colombia, and Bolivia

This comparative study evaluates the implementation of decentralization of health systems in three Latin American countries: Chile, Bolivia, and Colombia. In terms of the relationship between decentralization and system performance in general, the findings support the conclusion that both the die-hard detractors and the fervent advocates for decentralization are wrong. Decentralization appears to be improving some indicators of equity, such as a tendency toward similar per capita expenditures for wealthier and poorer municipalities, and to be associated with increased and more equitable per capita spending on promotion and prevention.

Back to Basics: Does Decentralization Improve Health System Performance? Evidence from Ceará in North-East Brazil

The objective was to examine whether decentralization has improved health system performance in the State of Ceara, north-east Brazil. Decentralization was associated with improved performance, but only for 5 of our 22 performance indicators. Moreover, in the multiple regression, decentralization explained the variance in only one performance indicator; indicators for informal management and political culture appeared to be more important influences. However, some indicators for informal management were themselves associated with decentralization but not any of the political culture indicators.

Validating a Work Group Climate Assessment Tool for Improving the Performance of Public Health Organizations

This article describes the validation of an instrument to measure work group climate in public health organizations in developing countries. The instrument, the Work Group Climate Assessment Tool, was applied in Brazil, Mozambique, and Guinea to assess the intermediate outcomes of a program to develop leadership for performance improvement. [from abstract]

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]

HRM Resource Kit

This toolkit includes a collection of HRM resources and links assembled for the Global Health 2005 conference. Most of the resources are in Microsoft Word format and provide guidance on how to develop a variety of HRM documents or processes. Topics covered include supervision, hiring and recruitment, HR policies, and HIV Workplace Programs and training. [publisher’s description]

Effect of Performance-Related Pay of Hospital Doctors on Hospital Behaviour: A Case Study From Shandong, China

With the recognition that public hospitals are often productively inefficient, reforms have taken place worldwide to increase their administrative autonomy and financial responsibility. Reforms in China have been some of the most radical: the government budget for public hospitals was fixed, and hospitals had to rely on charges to fill their financing gap. Accompanying these changes was the widespread introduction of performance-related pay for hospital doctors, termed the “bonus” system. While the policy objective was to improve productivity and cost recovery, it is likely that the incentive to increase the quantity of care provided would operate regardless of whether the care was medically necessary.

Creating a Work Climate that Motivates Staff and Improves Performance

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]