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The purpose of this document is to provide Africa 2010’s strategy for strengthening regional and local capacity for adopting effective policies and innovations to improve the health status of Africans. [from introduction]

This document outlines the Programme for Development of Human Resources for Health (HRH) in the WHO South East Asia Region, whose overall aim is to collaborate with the Member Countries to correctly plan, effectively train, efficiently deploy and optimally utilize the types and numbers of health personnel that they require to meet the needs of their health systems. [from introduction]

The effective provision of health services in poor countries is severely hampered by lack of staff. A frequently cited reason for staff shortages is brain drain or moving to greener pastures. Although international migration of health personnel has been occurring since before the 1970s, this has been further facilitated by the recent globalisatioIl of markets and the development offree trade agreements. A summary of an international review was done, to place the South African situation within the international context, and understand the various factors that influence migration. [from executiv

The report provides evidence of inadequate ratios of personnel to population for key skilled health personnel, and a maldistribution of personnel along three different axes, between: public and private heath sectors, urban and rural areas and tertiary and primary levels of the health system. It describes the exodus of healthcare workers from areas of poverty and low socio-economic development, to more highly developed areas. [from executive summary]

One of the challenges of continuing professional development (CPD) is to ensure that members of the medical profession maintain and improve the competencies in medical practice. CPD is an evolving system and different countries in Africa are at different levels of development. This article focuses on the developments and challenges of CPD among medical and dental practitioners in Africa. [abstract]

This is a summary report from the Africa Health Workforce Observatory meeting held September 26-29, 2006, at the ECSA headquarters in Arusha, Tanzania. The meeting focused on developing mechanisms to create up-to-date and reliable information that enables evidence-based decision making for HRH. [adapted from author’s description]

This study evaluates an intervention to raise healthcare provider morale and retention. Two different incentives-cash and a trophy, awarded to facilities rather than individuals-were tested in two districts. The program was implemented district-wide. Health centers and other small health facilities competed for the awards and were scored on the basis of management system indicators. Interviews with staff in both districts measured the effect of the awards on staff motivation and satisfaction. [publisher’s description]

This report examines the workforce issues surrounding HIV/AIDS service delivery. At the request of the Government of Rwanda, data were collected on current health sector staffing and from 20 public and private facilities of various sizes and characteristics on the time required to provide HIV/AIDS services and the quality of those services. The report presents data relative to the numbers of clients needing different types of HIV/AIDS services, providers’ degree of compliance with service delivery standards, and the time it takes to provide services.

There are few cost-minimisation studies in telemedicine. We have compared the actual costs of providing the telepaediatric service to the potential costs if patients had travelled to see the specialist in person. In November 2000, we established a novel telepaediatric service for selected regional hospitals in Queensland. Instead of transferring patients to Brisbane, the majority of referrals to specialists in Brisbane have been dealt with via videoconference.

South African citizens have experienced many inequalities and these have extended to the health care setting. one of the major challenges that needs to be addressed is the accessibility and availability of health care and specialized medical services in rural areas in South Africa. Telemedicine is a potential solution to address some of the challenges within health care in a developing country like South Africa. This article looks at the experiences of developing and implementing a telemedicine solution. [abstract]

Addressing the current state of human resources in health, the paper highlights the critical situation of the health workforce in sub-Saharan Africa. It examines the most recent workforce statistics and trends, including geographical distribution. The factors that have and are influencing the availability of human resources are briefly reviewed, focusing on the workforce motivation, the serious brain drain of health professionals, and the increasing impact of HIV/AIDS.

Typically, provider–client interactions are brief, and providers often behave condescendingly toward clients. As a result, clients are unable to express their concerns or describe the limitations they face in trying to implement the providers’ suggested course of action. A training intervention was developed for providers that focused on addressing the problems inherent in this dynamic. This research was undertaken to assess whether providers in the experimental area delivered services in a different manner than they had prior to the training intervention. [adapted from author]

The objective of this article is to examine in Peru the nature of dual practice (doctors holding two jobs at once - usually public sector doctors with private practices), the factors that influence individuals decisions to undertake dual practice, the conditions faced when doing so and the potential role of regulatory intervention in this area. [from abstract]

The most pressing challenge to achieving universal access to highly active anti-retroviral therapy (HAART) in sub-Saharan Africa is the shortage of trained personnel to handle the increased service requirements of rapid roll-out. Overcoming the human resource challenge requires developing innovative models of care provision that improve efficiency of service delivery and rationalize use of limited resources. We conducted a time-series intervention trial in two HIV clinics in central Mozambique to discern whether expanding the role of basic-level nurses to stage HIV-positive patients using CD4 counts and WHO-defined criteria would lead to more rapid information on patient status (including identification of HAART eligible patients), increased efficiency in the use of higher-level clinical staff, and increased capacity to start HAART-eligible patients on treatment.

Effective teamwork between doctors and clinical nurse practitioners (CNP) is essential to the provision of quality primary care in the South African context. The Worcester Community Health Centre (CHC) created dedicated practice teams offering continuity of care, family-orientated care, and the integration of acute and chronic patients. The teams depended on effective collaboration between the doctors and the CNPs. This inquiry focuses on the question of how more effective teams of doctors and clinical nurse practitioners offering clinical care could be created within a typical CHC. [adapted f

This chapter aims to determine the current demand for medical practitioners and nurses in South Africa by looking at the number of positions that are filled and the number that are currently vacant. It attempts to determine the number of medical practitioners and nursing positions that will be required until 2011, establishes the expected output from higher education over the next ten years, and determines the gap between supply and demand of health professionals. [adapted from introduction]

This study documents the contribution made by religion and religious entities to the struggle for health and wellbeing in Zambia and Lesotho, in a context dominated by poverty, stressed public health systems and the HIV/AIDS pandemic. By mapping and understanding these Religious Health Assets (RHAs), the study calls for a greater appreciation of the potential they have for the struggle against HIV/AIDS and for universal access and offers recommendations for action by both public health and religious leaders at all levels.

The African continent is facing 25% of the world’s morbidity rate with only 3% of its healthcare personnel. This is the result of years of neglect and underinvestment by African governments and the international community, plus harsh IMF restraints on nations’ budgetary expeditures. [author’s descripton]

Many countries around the world are now facing a huge brain drain of highly skilled professionals to well-paid jobs in developed countries. One of the worst affected sectors is healthcare, an area in which developing countries are struggling to keep professionals at home and encourage others to return. [auhor’s description]

This article discusses the issue the brain drain of doctors to more developed countries and Ghana’s efforts to supply an adequate health workforce in the face of this problem.

This consultation was convened jointly by the Global Health Workforce Alliance, the World Health Organization and the Swedish International Development Agency to discuss issues relating to the current crisis in human resources for health. The objectives of the Consultation were: to provide information on the global and regional crisis in human resources for health and propose activities based on the main recommendations of the World Health Report 2006; to share experiences in human resources for health, including issues related to priority programmes such as HIV/AIDS in the countries represented; and to present the African Human Resources for Health Platform and discuss possible solutions to the alleviation of the crisis in the African region.

This Praxis Note provides an overview of the impact of HIV/AIDS on the Malawi health care system and on the organisational capacity of Mulanje Mission Hospital. It describes the experiences and lessons learnt from a capacity building program designed to address capacity deficits and erosion caused by HIV/AIDS attrition. Less emphasis was placed on external training courses and increasing attention given to short-course inputs and distance learning. [from introduction]

This text presents the context and background, the methodology and some of the main results of the regional consultation on the critical challenges for human resources in health in the Americas. This consultation hopefully documents how the countries in the Americas are facing the main challenges to the development of the health workforce. The main results and suggestions by the actors consulted with regard to the role of international cooperation in the countries of the Region are presented, so that the countries and international agencies can better formulate common strategies of development and strengthening of the work force in health.

This presentation gives an outline of the current challenges and opportunities for HRH in the Sub-Saharan Africa AIDS crisis, some possible solutions, key messages and ways forward.

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This presentation focuses on the work MSH has done in Nicaragua, where leadership has been used as the key to address many of the challenges faced by the health sector, using a systems approach. [author’s description]

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Using a representative sample of 478 doctors, nurses, and lab technicians working with people living with HIV/AIDS (PLWHA), a cross-sectional study was conducted to assess the impact of the AIDS epidemic on medical care systems and service providers in China. The study findings suggest that improved institutional support for AIDS care at the facility level and HIV-related stigma reduction intervention are crucial to maintain a high quality performance by the workforce in the health care system. [from publisher’s description]

This article outlines the development and content of a community-based research capacity building framework for Aboriginal and Torres Strait Islander health workers. The focus is on the major issues that enhance a proactive service delivery model using culturally appropriate research methods. The overall aim of the framework is to supplement current institutionally-based education and training resources for health workers with community-based research training modules. These modules can be tailored to provide research and evaluation skills relevant to health workers taking a more proactive role in facilitating health and wellbeing programs in their own communities.

Despite the expanding literature on how reforms may affect health workers and which reactions they may provoke, little research has been conducted on the mechanisms of effect through which health sector reforms either promote or discourage health worker performance. This paper seeks to trace these mechanisms and examines the contextual framework of reform objectives in Uganda and Bangladesh, and health workers responses to the changes in their working environments by taking a realistic evaluation approach. [abstract]

Many countries in Latin America and the Caribbean have too many specialists and too few primary care providers and community health workers. These countries need to overhaul their training and payment practices to address this imbalance, say human resources experts. [author’s description]

Many women choose to use traditional birth attendants in Guatemala to deliver their babies - a fact that can’t be ignored, according to local public-health officials. They hope a new culturally sensitive approach to training traditional birth attendants will help improve their quality of care and save lives. [adapted from author]