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This report evaluates the success of a program to improve family planning services in Malawi. It discusses the importance of community-based distribution, i.e. mobile clinics and community health workers, to the success of family planning in the country since so much of the population is rural.

This report evaluates the BHAPP project including an analysis of its service and communication activities for outreach and capacity strengthening of personnel in 23 health centers to diagnose and treat STIs and use STI case management as a referral point for HIV testing. It also discusses the effectiveness of the project’s policy work at the central level.

The objective of this study was to assess whether adding a training intervention for clinic staff to the usual DOTS strategy (the internationally recommended control strategy for tuberculosis (TB)) would affect the outcomes of TB treatement in primary care clinics with treatemet success rates below 70%. [from abstract]

This report provides a comprehensive picture of HRH in Nova Scotia, a snapshot of the number of people working in each health occupation and health care setting; education and training characteristics; age, gender and other demographics, and wokplace injury and illness informatio.

In order to help improve Royal College of Nursing understanding of the employment experiences of internationally recruited nurses and UK trained black and minority ethnic (BME) nurses, the RCN commissioned a secondary analysis to draw together commentary and analysis from previous surveys.

The RCN commissioned a survey of 6,000 members in 2000 to explore nurses’ wellbeing and working lives. The results subsequently helped shape RCN policy and materials for members on topics such as bullying and harassment, violence, needlestick injury and employee-friendly working practices. Five years later, the RCN has commissioned a second survey looking at a similar range of issues. This report documents the findings of that survey, and describes differences between the 2000 and 2005 survey findings. [introduction]

This report is the result of a regional meeting held March 17-19 in Arusha, Tanzania and presents the regional context for work on migration and retention; an overview of the current situation, integrating evidence from background papers and country experiences; and summarizes the discussions held on follow-up work on migration and retention. [adapted from introduction]

The intent of the report is to stimulate creative discussions among [British Colubia’s] health system stakeholders about opportunities for coordinated action on employee and workplace health. The best available evidence suggests that the scope and depth of workplace health challenges today require solutions that go beyond traditional workplace health promotion programs.

This best practice guideline focuses on nursing teams and processes that foster healthy work environments. The focus for the development of this guideline was collaborative practice among nursing teams with the view that this may be a first stage in a multi-staged process that could eventually result in interprofessional guidelines. A healthy work environment for nurses is a practice setting that maximizes the health and well being of nurses, quality patient outcomes and organizational performance. Effective nursing teamwork is essential to the work in health care organizations. [from purpose]

This report outlines information from a literature review and field research pertaining to the key differences and similarities between the hospice ICHC model and other home-based care models used in South Africa; reviews the core elements of the ICHC model; and highlights best practices of the model. [adapted from introduction]

The main objections to the use of [antiretroviral therapies] in less-developed countries have been their high cost and the lack of health infrastructure necessary to use them. We have shown that it is possible to carry out an HIV treatment programme in a poor community in rural Haiti, the poorest country in the western hemisphere.

This report presents the finding from an study to determine the impact of HIV/AIDS on the public sector in Malawi. Section E, 3 establishes the impacts of HIV/AIDS on the Ministry of Health and Population and on health workers including statistics of attrition by occupational category in the health sector, morbidity and absenteesim, vacancy levels. It also analyzes effect on health worker workload, discusses the impact on productivity and performance, the financial implications, impact on service provision, and institutional vulnurability to HIV/AIDS.

A growing body of evidence suggests that the quality of a health system depends greatly on highly motivated health workers who are satisfied with their jobs, and therefore stay at their stations and work. This paper reviewed evidence from published and grey literature on the use of non-financial incentives for health worker retention in sixteen countries in east and southern Africa. [adapted from author]

The development of the delivery of reproductive health services is continually confronted by challenges from a changing environment, an important element of which is health sector reform, in particular decentralization, which is being undertaken by most governments in Africa. The general objective of this research is to make health sector decentralisation more effective in the development of appropriate reproductive health services. In Chapter 8 human resource management and development as it has been affected by decentralization is discussed. [adapted from introduction]

Violence in the social services work place in general, and the developmental services in particular, has increased in the last several years. Findings from an ethnographic study suggests that new, lean forms of work organization remove opportunities to use or learn many of the tacit or practice skills workers previously used to keep themselves and their clients safer in the work place. This article describes many of these skills and the new management schemes that remove the possibility to develop or transmit these praxis skills.

To objective of this article was to determine the prevalence and nature of workplace violence against nurses, how nurses deal with such aggression; and to identify the risk factors related to violence in the hospital environment. [author’s description]

This study was done to determine the prevalence of experiences with physical violence and psychological violence that health staff have had in the workplace in Jamaica, and to identify factors associated with those experiences of violence. [from abstract]

The purpose of this policy and guidelines is to ensure that in all violent incidents, appropriate action is consistently taken to protect health service staff, patients and visitors, and health service property from the effects of such behaviour. The guidelines are provided as a reference tool and should be used to develop local policies and procedures that reflect the intent of this document, and that are specifically targeted at and adapted to local workplace cultures, situations and needs. [from introduction]

Although the [critical shortage of health care workers] is not new, recent international efforts to vaccinate children and to fight HIV/AIDS, malaria, tuberculosis, and other diseases have brought it into sharper focus. The worker shortage derives from a combination of underproduction, internal maldistribution, and emigration of trained workers (“brain drain”). Fortunately, many African countries have begun attacking the problem by implementing innovative programs that may serve as models for other countries. Once effective pilot programs have been identified, scaling up will be the next hurdle: programs that are found to work on a small scale or in a particular environment may not be easy to expand or replicate.

This paper reports the findings of the PET/QSDS pertaining to human resources for health in Zambia. The Public Expenditure Tracking and Quality of Service Delivery survey (PET/QSDS) was undertaken in mid-2006 to provide quantitative assessment of the state of health service delivery in the country. One component of the survey focused on the management of health personnel, including staff availability, vacancy, absenteeism, and tardiness; staff turnover; staff workload, use of time, and morale; and staff salary and benefits. [from introduction]

Clinical officers perform much of major emergency surgery in Malawi, in the absence of medical officers. The aim of this study was to validate the advantages and disadvantages of delegation of major obstetric surgery to non-doctors. [abstract]

International medical graduates (IMGs) have been a valuable resource for the United States physician workforce, and their contribution to the United States workforce is likely to increase. This article describes the historical trends and compare the characteristics of IMGs to United States medical graduates in the United States. It also recommends that policymakers consider the consequences for both the United States and source countries. [adapted from abstract]

The goal of this policy is to help management and staff minimize the risk of TB transmission in health care facilities and other facilities where the risk of transmission of TB may be high due to high prevalence of both diagnosed and undiagnosed TB such as prisons.

Malawi has a critical human resources problem particularly in the health sector. The College of Medicine (COM)is the only medical school. For senior staff it heavily depends on expatriates. We explore to what extent a brain drain took place among the COM graduates by investigating their professional development and geographical distribution.

This news article presents a study in Uganda that found HIV-positive Ugandans are twice as likely to quit antiretroviral therapy (ART) if they also use traditional herbal medicine. It suggests that the integration of traditional healers into modern medical practice needs to be handled more cautiously and that rather than shunning traditional healers, the solution is to work closely with them. [adapted from author]

West African-trained physicians have been migrating from the sub-continent to rich countries, primarily the US and the UK, since medical education began in Nigeria and Ghana in the 1960s. In 2003, we visited six medical schools in West Africa to investigate the magnitude, causes and consequences of the migration. We conducted interviews and focus groups with faculty, administrators (deans and provosts), students and post-graduate residents in six medical schools in Ghana and Nigeria. In addition to the migration push and pull factors documented in previous literature, we learned that there is now a well-developed culture of medical migration.

Physician migration from poor to rich countries is considered an important contributor to the growing health workforce crisis in the developing world. This is particularly true for Africa. The perceived magnitude of such migration for each source country might, however, depend on the choice of metrics used in the analysis. This study examined the influence of choice of migration metrics on the rankings of African countries that suffered the most physician migration, and investigated the correlates of physician migration. [from abstract]

This article assesses interventions aimed at improving family planning mechanisms and reviewing the problem-solving processes to build an effective monitoring system of the interventions at the local level of the overall system of the Ministry of Health and Family Welfare of the Government of Bangladesh. [adapted from author]

The report of the Africa Working Group (Joint Learning Initiative) is in 4 main parts covering a situation analysis, opportunities that arise and the preconditions for effective strategies.

This report focuses on the impact of human resource shortages witnessed by MSF teams in four southern African countries - Lesotho, Malawi, Mozambique, and South Africa. While the focus is largely on nurses in rural areas, it should be acknowledged that health staff is lacking across the spectrum - from doctors to laboratory technicians to pharmacists - at all levels of care. In all these cases the need for access to ART, as well as other health needs, is outstripping human resource capacity. [from introduction]