Policy

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 article considers some of the effects of health sector reform on human resources for health (HRH) in developing countries and countries in transition by examining the effect of fiscal reform and the introduction of decentralisation and market mechanisms to the health sector. [adapted from abstract]

This article discusses the reasons that led health workers to oppose reform; the institutional and legal constraints to implementing reform as originally designed; the mismatch between the types of personnel needed for reform and the availability of professionals; the deficiencies of the reform implementation process; and the regulatory weaknesses of the region. The discussion presents workforce strategies that the reforms could have included to achieve the intended goals, and the need to take into account the values and political realities of the countries. [from abstract]

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]

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.

The Code develops a consensus approach to dealing with the problem of international recruitment of health workers, while remaining sensitive to the needs of recipient countries and the migratory rights of individual health professionals. The Code covers issues of transparency, fairness, mutuality of benefits, compensation/reparation/restitution, selection procedures, and registration. [Description from author]

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

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

Many countries are using the strategy of international recruitment to make up for shortages of health professionals. This is often to the detriment of health systems in the poorest parts of the world. Codes of practice on ethical international recruitment or similar instruments are beginning to be introduced at both national and international levels to protect the health systems of vulnerable countries. This study was designed to review the potential impact of existing instruments. [from executive summary]

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 Health Sector Policy is the basis of national health planning and the first point of reference for all actors working in the health sector. It sets the health policy objectives, identifies the priority health interventions for meeting these objectives, outlines the role of each level in the health system, and provides guidelines for improved planning and evaluation of activities in the health sector. One of the priority interventions elaborated is Human Resources. [adapted from introduction]

This paper reviews the challenges facing the public health workforce in developing countries and the main policy issues that must be addressed in order to strengthen the public health workforce.

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]

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.

The aim of this paper is to examine some key issues related to the international migration of health workers in order to better understand its impact and to find entry points to developing policy options with which migration can be managed. [from abstract]

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.

In the face of rising demand for medical services due to ageing populations, physician migration flows are increasingly affecting the supply of physicians in Organisation for Economic Co-operation and Development (OECD) countries. This paper offers an integrated perspective on the impact of physician migration on home and host countries and discusses international regulation and policy approaches governing physician migration. [from abstract]

The synthesis report addresses the issues of the impact of high skilled emigration on developing countries, and the policy mixes and options available to both receiving and sending countries to harness its benefits. The study argues that the feedback or indirect effects of skilled migration can often outweigh any initial negative impacts on developing countries. The challenge is to maximize these benefits through appropriate policies relating to encouraging return migration, retention of manpower, tapping diaspora networks, and productive utilization of remittances.

This document presents a framework for analyzing factors affecting the development and implementation of HRH policies and strategies.

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]

The 10th edition of the South African Health Review has the major theme of Human Resources for Health (HRH). South Africa has made significant progress in producing policies supportive of a good quality of health for all residents. However, there are challenges and gaps in translating these policies into action. Probably the most important of these challenges is the lack of adequate human resources. [Publisher’s description]

Though reforms in the health sector have recently been common around the world, their success has, for a variety of reasons, been mixed. The paper aims to examine and explain the importance of human resources (HR) to the success or failure of health reforms using case studies from Russia, Zambia and the United Kingdom. [from abstract]

This document summarizes the human resources management situation in the region, its determinants, and the projects for its development. To promote improvements in the human resources management function as part of the sectoral changes under way at the national and regional level, the Pan American Health Organization is proposing a series of strategies, actions, and operational tools through the Observatory of Human Resources in Health Sector Reform initiative. [adapted from author]

Physicians for Human Rights testimony before the U.S. House International Relations Committee, April 13, 2005 calling for a second Presidential initiative for health in Africa to accelerate the recruitment, retention, training, and rational deployment of skilled health workers while simultaneously continuing to scale up prevention, care, and treatment of HIV/AIDS.

This policy brief from the World Health Report 2005 argues that it will not be possible to effectively scale up Maternal, Newborn and Child Health (MNCH) care without confronting the global health workforce crisis. It highlights how lack of managerial autonomy, gender discrimination and violence in the workplace, dwindling salaries, poor working conditions and some donor interventions have all contributed to a lack of productivity, as well as the rural to urban, public to private and poor to rich country brain drain and migration. The brief argues the need to plan the expansion of the workforce while implementing corrective measures to rehabilitate productivity and morale.

This paper discusses the implications for health personnel of the HIV epidemic, and health sector responses to it, in southern Africa, using Malawi as a case study. Published and grey literature has been consulted to assess the situation and its implications for equity. [author’s description]

This report was commissioned by OECD to examine the evidence on role change and delegation from physicians to advanced practice nurses (APN), nurse practitioners and nurses in other advanced roles in the hospital setting and primary care. The report has three components: a literature review, an assessment of country responses to an OECD questionnaire, and two more detailed country case studies, on England and the US. [author’s description]