East Asia & Pacific

This video resource shows how midwives and community volunteers are helping more Cambodian women to increase the time between births, thereby contributing to healthier pregnancies, infants and families as well as to a better chance of escaping poverty. [adapted from synopsis]

This article reports on research that assessed international and national best practice in the selection of students for graduate entry medical courses in order to investigate correlations between medical student selection procedures and exposure to rural medical practice during medical training with choice of careers in rural medicine. Central to the study was the issue of the medical workforce shortage in Australia’s rural communities. [from introduction]

Rural township health centres and urban community health centres play a crucial role in the delivery of primary health care in China. The limited availability and low qualifications of human resources in health are among the main challenges facing lower-level health facilities. This paper aims to analyse the mobility of health workers in township and community health centres. [from abstract]

In the face of medical workforce shortages, governments are looking to displace doctors with alternative health care providers like nurse practitioners, physician assistants, and other health professionals such as psychologists and pharmacists to relieve bottlenecks in health care delivery. Displacing doctors in this way, or role or task substitution as it is also termed, has been actively pursued in the United Kingdom and United States. How should the medical profession react to these developments? [from author]

The Trauma Management Program (TMP) was developed to improve the capacity of local health workers to deliver effective trauma care. This report illustrates a method to increase the capacity of indigenous health workers to manage traumatic injuries. These health workers are able to provide trauma care for otherwise inaccessible populations in remote and conflicted regions. The principles learnt during the implementation of the TMP might be applied in similar settings. [from introduction]

Losses of graduates from the Fiji School of Medicine to overseas migration and to the local private sector prompted exploration of the reasons for these losses from the Fiji public workforce. This study provides some support for the view that local or regional postgraduate training may increase retention of doctors. Attention to career pathways and other sources of frustration, in addition to encouragement to complete training, should increase the likelihood of such programs reaching their full potentials. [adapted from abstract]

Population size is often correlated with the number of physicians in a community, and is conventionally considered to represent the power of communities to attract physicians. However, associations between other demographic/economic variables and the number of physicians in a community have not been fully evaluated. This study seeks other parameters that correlate with the physician population and show which characteristics of a community determine its attractiveness to physicians. [adapted from abstract]

This study documents and assesses the impact of a major educational and support program on a change in the health service provision of a neonatal intensive care unit. [adapted from abstract]

Since the early 1990s Indonesia has attempted to increase the level of skilled attendance at birth by placing rural midwives in every village in an effort to reduce persistently high levels of maternal mortality. Yet evidence suggests that there remains insufficient incentive to ensure an equal distribution across areas while the poor in all areas continue to access skilled attendance much less than those in richer groups.

The objective of this article is to determine the stock of human resources for health in 15 districts, their service status and primary place of work. It also assesses the effect of decentralization on management of human resources and the implications for the future. [from abstract]

This document discusses China’s long struggle with rural coverage for health care through the barefoot doctors program, which was introduced as a national policy focused on quickly training paramedics to meet rural needs. [adapted from author]

This is the first study to systematically review the available published literature describing innovative models of comprehensive primary health care (PHC) in rural and remote Australia since the development of the first National Rural Health Strategy (1993-2006). The study aimed to describe what health service models were reported to work, where they worked and why. [from abstract]

The two main objectives of this study were to examine aspects of the acculturation of overseas-born and Australian-trained health professionals in the Australian health discourse and identify key coping strategies used by them when in working in the rural context. [from abstract]

This article reports on an initiative in a rural New Zealand community to meet the need for after hours care. First contact for patients is with a community nursing team operating from the local health centre, complemented by on-call advice from GPs and GP clinics twice daily at weekends. The article reports on the demand for after hours services generated by a geographically defined community in New Zealand. [from introduction]

Well-functioning health information systems are required to ensure the production, analysis, dissemination and use of reliable and timely essential human resources for health (HRH) information needed for workforce planning, management and evaluation. This project aims to produce a set of indicators and domains with definitions and associated fact-sheets to establish a minimum data set to record, share, analyse and apply HRH data.

This paper analyzes China’s current health workforce in terms of quantity, quality, and distribution. Unlike most countries, China has more doctors than nurses. Doctor density in urban areas was more than twice that in rural areas, with nurse density showing more than a three-fold difference. Over the past decade there has been a massive expansion of medical education, with an excess in the production of health workers over absorption into the health workforce.

The objectives of this paper are to highlight the situation of health workers in Pacific and Asian countries to gain a better understanding of the contributing factors to health worker motivation, dissatisfaction and migration; examine the regional and global evidence on initiatives to retain a competent and motivated health workforce, especially in rural and remote areas; and suggest ways to address the shortages of health workers in Pacific and Asian countries by using incentives. [from abstract]

Rural nurses describe the nature of their practice as being embedded in working as a team where belonging is central to the success of the team and the individual nurse. As a result they form close professional and personal ties. The challenge for nursing students is to develop a sense of belonging to the rural hospital team so that preceptorship is successful. The objective of this article is to describe the cultural theme of a sense of belonging that nursing students develop during a rural hospital preceptorship. [adapted from abstract]

Care for most women before, during and after delivery can be provided within a well equipped primary care setting. Since the 1980s Indonesia has attempted to improve women’s access to maternal health care by assigning professional midwives to each village. Despite an increase in the number of midwives, maternal mortality remains high compared to other countries with similar Gross Domestic Product per capita. [from introduction]

This article reports on the findings of a study into enrolled nurse (EN) to registered nurse (RN) transition in South Australian rural settings. Rural RNs are required to be multi-skilled generalists capable of providing a wide range of nursing services to a diverse range of clients. This frequently occurs in situations without medical or specialist assistance. The objective of this study was to gain an understanding of the EN to RN transition process within this unique context. [from abstract]

Preparing nurse graduates for practice is challenging because of the diversity of skills expected of them. The objective of this study is to identify the attributes a rural community expect in new graduate nurses in order for them to provide quality care. [from abstract]

This presentation discusses the roles and challenges of private sector midwives and how they can benefit community health care.

Contracting NGOs to manage the primary health care system was found to be an effective means to increase service coverage and achieve a more pro-poor distribution of services in rural areas of Cambodia. The Ministry of Health (MOH) proposed contracting NGOs to manage the public health care system at the district level using a results-based contract to monitor progress.

A study of private-sector immunization services was undertaken to assess scope of practice and quality of care and to identify opportunities for the development of models of collaboration between the public and the private health sector. A questionnaire survey was conducted with health providers at 127 private facili¬ties; clinical practices were directly observed; and a policy forum was held for government representatives, private healthcare providers, and international partners. [from abstract]

This paper examines health workforce and migration policies in New Zealand, with a special focus on the international recruitment of doctors and nurses. [from abstract]

Interprofessional education (IPE) has been suggested as an answer to improving the effectiveness of health professional teamwork, which in turn is regarded as a key strategy for improving the delivery and outcomes of increasingly complex healthcare approaches. There is a strong theoretical base to support the implementation of IPE for all health professionals, and in response many training programs now do this. This article presents some theory-based but practical advice for how to develop effective IPE activities. [from abstract]

This brief describes PATH’s project to implement supportive supervision techniques to improve health worker training in Indonesia.

The WHO Regional Office for the Eastern Mediterranean held a regional consultation on the accreditation of health professions education. The objectives of the meeting were to enable countries of the Eastern Mediterranean Region to exchange experience in establishing national systems of accreditation, identifying strengths and constraints, and to formulate region- and country-specific plans of action for establishing accreditation of health professions education. [from author]

This paper aims to present the existing HRH problems exemplified by migration in the light of other related issues such as the nurse medic phenomenon, foreign doctors taking up residency training, quality of nursing education, paradoxical enrollment trends in nursing and medicine and the effects of migration on health service delivery.

This study aims to project the supply and demand for pharmacists between 2000 and 2010. On the supply side, these include the latest information on student intake and projected graduations. On the demand side, they include a consideration of the impact of the Third Community Pharmacy Agreement, the increasing focus on safety and quality of medicines use across the continuum of care and a host of clinical governance and Commonwealth and State/Territory government policies which impact on the demand for pharmacists. [from summary]