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Crisis in Human Resources for Health in the African Region

This edition covers topics such as: migration of skilled health workers, investing in human resources for health, strengthening human resources for health in Africa, and the economic cost of health professionals brain drain in the African region. [author’s description]

Tackling Malawi’s Human Resources Crisis

Since the late 1990s, Malawi’s public health services have appeared to be heading for collapse due to declining staffing levels. The government launched the Essential Health Package in 2004 to help improve the health of the population, which includes scaling-up HIV and AIDS-related services. The biggest challenge facing the initiative is improving human resource levels. [adapted from author]

Decision Criteria in Health Professionals Choosing a Rural Practice Setting: Development of the Careers in Rural Health Tracking Survey (CIRHTS)

Rural background and training have previously been found to increase the likelihood of rural practice. However, practitioners of many health professions remain in shortage in rural and remote Australia. This study builds on previous work in that it includes medical, nursing and allied health professions, considers the role of the health professional’s family in employment decisions, and includes a broader array of factors influencing employment preference and the preferred location of practice. The survey also examines when students might work in a rural area. [introduction]

What Are the Effects of Distance Management on the Retention of Remote Area Nurses in Australia?

Australian remote area nurses (RANs) are specialist advanced practice nurses. They work in unique, challenging and sometimes dangerous environments to provide a diverse range of healthcare services to remote and predominantly Aboriginal communities. There is an emerging skills gap in the remote nursing workforce as experienced and qualified RANs leave this demanding practice. There is a shortage of new nurses interested in working in these areas, and many of those who enter remote practice leave after a short time. Distance management was examined in order to gain a better understanding of its effects on the retention of RANs. Distance management in this context occurs when the health service’s line management team is located geographically distant from the workplace they are managing. [introduction]

Midwives' Competence: Is It Affected by Working in a Rural Location?

Rising health care costs and the need to consolidate expertise in tertiary services have led to the centralisation of services. In the UK, the result has been that many rural maternity units have become midwife-led. A key consideration is that midwives have the skills to competently and confidently provide maternity services in rural areas, which may be geographically isolated and where the midwife may only see a small number of pregnant women each year. Our objective was to compare the views of midwives in rural and urban settings, regarding their competence and confidence with respect to competencies identified as being those which all professionals should have in order to provide effective and safe care for low-risk women.

High Impact of Mobile Units for Mass HIV Testing in Africa

Despite the usefulness of voluntary counselling and testing centres implemented in Africa, their limited capacity does not allow for vast testing of the general population. Therefore, in order to increase the number of individuals tested for HIV with the aim of enhancing the scaling up, we developed a strategy based on bringing the healthcare package much closer to the people, by using mobile HIV testing units. We herein report the Cameroon experience of mobile HIV testing unit strategy, demonstrating its effectiveness in reaching a great number of individuals, including those without usual access to HIV testing facilities. [abstract]

Excessive Work Hours of Physicians in Training in El Salvador: Putting Patients at Risk

Recent studies involving physicians in training have shown that excessive work hours are associated with an increased rate of medical errors and adverse events. The problem of excessive work hours of physicians in training in El Salvador has political and economic roots that need to be addressed by politicians and public health policy makers. [adapted from author]

Health Worker Migration Flows in Europe: Overview and Case Studies in Selected CEE Countries - Romania, Czech Republic, Serbia and Croatia

The ILO Sectoral Activities Department initiated an explorative research project on health worker mobility in Europe with focus on CEE countries. The purpose of the project was to explore and document current knowledge and information available in order to establish the current status, and identify both preliminary trends as well as information gaps and the need for further action.

Migration of Health Workers: Country Case Study Philippines

This study aims to provide in-depth information on the migration of Filipino health workers and the repercussions this has on individual migrants, their families, their professions and the nation as a whole.

Internationally Recruited Nurses in London: a Survey of Career Paths and Plans

The paper reports on a survey of recently arrived international nurses working in London, to assess their demographic profile, motivations, experiences and career plans. [from abstract]

Good Practice in Managing the Use of Temporary Nursing Staff

This good practice guide is intended as a practical guide for trust boards and managers to help them to use temporary nursing staff effectively. The guide comprises a narrative of the salient points in the use and management of temporary nursing staff and includes a number of good practice checklists. It also provides case studies drawn from study visits and the work of the Department of Health’s National Agency Staffing Project. [from preface]

National Workforce Plan 2006

The purpose of this document is primarily to articulate and describe workforce supply. The aim of this is two-fold. First, it will help NHS Boards and other employers to understand where their future workforce is likely to come from and second, it provides a vehicle for setting medical, dental and nursing training numbers and helps inform education providers about future workforce needs and likely supply pathways. This is turn will impact the workforce itself, thus workforce planning and development is a continual cyclical process. [from introduction]

Distribution of Public Sector Health Workers in Zimbabwe: a Challenge for Equity in Health

This study explored the distribution of public sector health workers [in Zimbabwe] to show how its pattern impacts on equity objectives in health care delivery. [from executive summary]

Health Worker Migration in the European Region: Country Case Studies and Policy Implications

This report presents an overview of the policy implications of the international migration of health workers in Europe, based on case studies conducted in five countries – Estonia, Germany, Lithuania, Poland and the United Kingdom – and draws on information from other WHO European Region countries, such as Israel and Latvia. [from introduction]

Policies and Plans for Human Resources for Health: Guidelines for Countries in the WHO African Region

Experience has shown that governments have different kinds of HRH policies, strategies and plans even when they are within the overall context of national health policies and strategies. This document provides guidance on the process with proposals of content for three basic HRH documents: situation analysis, policy, and strategic plan. [from foreword]

Expansion of the Role of Nurse Auxiliaries in the Delivery of Reproductive Health Services in Honduras

The nurse auxiliaries who work at the rural health centers (CESARs) of the Honduran Ministry of Health (MOH) are frequently the only source of reproductive health services in the communities they serve. In order to increase access to long-term family planning methods, the MOH and the Population Council’s INOPAL III Project conducted an operations research study from 1997 to 1998 to see if nurse auxiliaries could provide good quality IUD, Depo-Provera and vaginal cytology services without health risks for their clients.

Creating High-Quality Health Care Workplaces

The question guiding the paper is: “What are the key ingredients of a high-quality work environment in Canada’s health care sector and how can this goal be achieved?” Synthesizing insights from a variety of research streams, the paper identifies many ingredients needed to create a high-quality workplace. We take a multidisciplinary and holistic approach, which complements other research initiatives on health human resources. [from abstract]

Challenge for Nursing and Midwifery

In this discussion document, the Department of Health and Children identifies key development issues facing nursing and midwifery in the future. This is in order to establish a strong platform for the formulation of a strategic response to these issues. The document contains an insightful analysis of the challenges ahead and identifies a range of possible responses. [from preface]

Hospital Nurse Staffing and Quality of Care

This report summarizes the findings of AHRQ-funded and other research on the relationship of nurse staffing levels to adverse patient outcomes. This valuable information can be used by decisionmakers to make more informed choices in terms of adjusting nurse staffing levels and increasing nurse recruitment while optimizing quality of care and improving nurse satisfaction. [author’s description]

Impact of the Manager’s Span of Control on Leadership and Performance

The purpose and objectives of this study are to examine the extent to which the manager’s span of control influences nurse, patient, and unit outcomes; and investigate which particular leadership style contributes to optimum nurse, patient, and unit outcomes under differing spans of control. [author’s description]

Health Human Resources Policy Initiatives for Physicians, Nurses and Pharmacists

This document is an environmental policy scan of activity in three areas related to physicians, nurses and pharmacists: education and training initiatives; recruitment and retention and work place initiatives; and capacity to do national health human resource planning. [adapted from introduction]

Framework for Developing Nursing Roles

The NHS in Scotland is facing unprecedented change and is looking to transform existing models of health care. It also reinforces that improvements in healthcare will be achieved by new and more efficient ways of working, such as using the skills of nurses and allied health
professionals to take on more roles and give patients more choice. This document presents a generic framework to guide the development of new roles. It can be used to assist in the planning process to ensure that roles are needs led, meet governance requirements, are sustainable, as well as ensuring that the development is supported by the whole team thus ensuring its success.

Outcomes of Variation in Hospital Nurse Staffing in English Hospitals: Cross-Sectional Analysis of Survey Data and Discharge Records

Despite growing evidence in the US, little evidence has been available to evaluate whether internationally, hospitals in which nurses care for fewer patients have better outcomes in terms of patient survival and nurse retention. The objectives of this article are to examine the effects of hospital-wide nurse staffing levels (patient-to-nurse ratios) on patient mortality, failure to rescue (mortality risk for patients with complicated stays) and nurse job dissatisfaction, burnout and nurserated quality of care. [from abstract]

Human Resources for Health Strategic Plan 2006 - 2010

The purpose of this human resource for health (HRH) plan is to provide guidance for the staffing of the health services and the training of health service personnel to the year 2020. It analyzes main issues and dimensions in HRH and proposes strategies to meet the targets for the wellbeing of the population as defined in the vision 2020 for Rwanda The plan provides staffing targets for each of the major categories of health personnel.

Getting Clinicians to Do Their Best: Ability, Altruism and Incentives

By measuring the ability and actual practice of a sample of clinicians in Tanzania and examining the terms of employment for these clinicians, we show that both ability and motivation are important to quality.

Impact of Private Clinic Networks on Client Service Access and Quality: Evidence from Ethiopia, India and Pakistan

This presentation is from PSP-One’s GHC Expert Panel - Expanding Health Service Access, Quality, and Equity in Developing Countries: The Role of the Private Sector. It presents franchise models for delivering family planning and reproductive health services by the private sector.

Skilled Health Professionals' Migration and Its Impact on Health Delivery in Zimbabwe

The paper investigates the magnitude of migration of health professionals from Zimbabwe, the causes of such movements and the associated impacts on health care delivery. International migration of health professionals has led to staff shortages and the situation is worse in public compared to private health institutions. The quality of care given to patients has also declined. The research calls for the adoption of an integrated approach in solving the concerns of health professions. [abstract]

Human Resource Planning and the Production of Health: a Needs-Based Analytical Framework

Traditional approaches to health human resource planning emphasize the effects of demographic change on the needs for health human resources. Planning requirements are largely based on the size and demographic mix of the population applied to simple population-provider or population-utilization ratios. We develop an extended analytical framework based on the production of heal care services and the multiple determinants of health human resource requirements. [from abstract]

UK Wide Workforce Planning Competence Framework

This framework encompasses the healthcare workforce planning skills and competences required at both strategic and operational level, for all types of staff, including chief executives, directors, clinicians, service development managers, ward managers, workforce planners, and contributes to the building of capability in human resource management identified in the HR in the NHS Plan. [publisher’s description]

International Nurse Recruitment in India

This paper describes the practice of international recruitment of Indian nurses in the model of a business process outsourcing of comprehensive training-cum-recruitment-cum-placement for popular destinations like the United Kingdom and United States through an agency system that has acquired growing intensity in India. [from abstract]