East Asia & Pacific

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.

In 1999, Cambodia contracted out management of government health services to NGOs in five districts that had been randomly made eligible for contracting. The contracts specified targets for maternal and child health service improvement. The program increased the availability of 24-hour service, reduced provider absence, and increased supervisory visits. There is some evidence it improved health. The program involved increased public health funding, but led to roughly offsetting reductions in private expenditure as residents in treated districts switched from unlicensed drug sellers and traditional healers to government clinics.

A seven-point framework was used to analyze retention strategies in four countries: Uganda, the United Kingdom, Canada, and Thailand. This framework draws upon available country data and includes GDP and investment in health, mix of private/public investment, international migration, health policy frameworks, countrywide strategies, provincial/regional strategies, and professional associations/regulatory bodies. Comparison of the countries demonstrated that progress has been made in nurse retention. [from executive summary]

The NSW Department of Health is responsible for managing nurse supply. It needs to identify the extent and nature of shortages and develop ways to attract, retain and best manage nurses working in public hospitals. This audit looks at how nurses are managed in four of our public hospitals and examines how the Department has responded to expected nurse shortages. It also highlights actions that have helped reduce the number of nurses leaving hospitals. [from foreword]

These yearly summary reports provide information on nurse wages and the comparitive buying power of these wages in Hong Kong, Japan, Korea, Macau, Malaysia, Philippines, Singapore, Taiwan and Thailand. The data are results from a survey of 11 National Nurses’ Associations. [from introduction]

This yearly profile is a summary of statistics about the nursing workforce in Canada, Denmark, Germany, Iceland, Ireland, Japan, New Zealand, Norway, Sweden, UK and USA.

Childhood immunization is a major public health concern in Cambodia. Given the high infant and child mortality rates and the low uptake rate of immunizations, a study of knowledge, attitudes and practices (KAP) of communities and health workers was conducted to identify barriers to immunization and inform future information, communication and education (IEC) strategies. Quantitative and qualitative research was conducted to discover the KAP of communities and health workers towards immunization services and the introduction of hepatitis B vaccine.

This research report has been published to illustrate the situation of workplace violence in the health sector in Thailand as well as contributing factors to, the consequences, and management of that violence. [from preface]

This research study gathered baseline information about occupational violence in the health care industry in Australia, to identify the contexts in which violence most commonly occurs, and to provide guidance on high-risk sites and commonly reported patterns of violent incidents. [adapted from author]

The present study reviews and analyses major known national guidelines and strategies for prevention and management of workplace violence. The purpose is to get a detailed picture of strategies recommended, a better knowledge on existing guidance for employers and employees. Another objective is to obtain information on the implementation processes and the impact of the reviewed guidelines. Identification of good practices as well as gaps shall serve as a basis for lessons learnt for the development of future guidance materials.

Human resources for health are non-existent in many parts of the world and the outer islands of Marshall Islands in Micronesia are prime examples. While the more populated islands with hospital facilities are often successful in recruiting qualified health professionals from overseas, the outer islands generally have very limited health resources, and are thus less successful. In an attempt to provide reasonable health services to these islands, indigenous people were trained as Health Assistants (HA) to service their local communities.

This cost analysis is based on QAP research on the effectiveness of two interventions (self-assessment and peer review) in sustaining or increasing the effectiveness of interpersonal communications training that midwives had taken. The research had measured the effectiveness of the interventions in terms of the number of utterances midwives made during family planning consultations, and this case study followed on, measuring the cost of each intervention in terms of the number of utterances generated.

This study tested two low-cost alternatives to supervision-self-assessment and peer review-that may reinforce providers’ skills after training, in this case training in interpersonal communication and counseling (IPC/C). There were three study groups: the control group received no reinforcement after training, a “self-assessment” (SA) group performed SA exercises for 16 weeks after training, and a SA and peer review group also performed SA exercises for 16 weeks and met in small groups to peer review and guide each other in their efforts to improve their IPC/C skills.

The Quality Assurance Project undertook a national assessment of private sector tuberculosis (TB) services in Cambodia to improve understanding of private sector practices and the sector’s willingness to participate in efforts to improve TB services. Over 500 respondents, including doctors, pharmacists, drug sellers, and TB patients, participated. In addition, mystery shoppers visited private pharmacists and drug sellers so that the surveyed groups’ reports could be compared to actual experiences.

This report is from a workshop on HRD for mental health in Pacific island countries. The objectives of the workshop were to evaluate the mental health training needs and resources in the Pacific island countries; to achieve consensus on guiding principles in the developmenet of national mental health education and training programs in the local context; and to identify mechanisms to support countries in developing and strengthening mental health training programs. [from summary]

The 2009 edition of CHIPS comprises the country profiles and the health databanks for each country and area of the WHO Western Pacific Region. It contains crude data that are supplied either by the health ministries/departments or compiled from national databases and reference libraries. Estimates and adjusted data from various published sources are also used. Every effort is made to update the figures and analyses in CHIPS annually in response to ever-growing demands for current data and information. Clearance by the respective governments is also sought prior to publication.

This report documents the efforts of the Institute for Reproductive Health (IRH) to integrate natural family planning methods into the health delivery system in the Phillipines. It discusses the venues used for implementation such as government and NGO partnerships as well as IRH’s training resources and activities for nurses and midwives on family planning. Finally, the report details best practices and lessons learned from the multi-year project.

This study examines the relationship between medical practice and type of clinic ownership in HeBei province in the People’s Republic of China. The objective was to find out whether the kind of clinic ownership affects health care delivery patterns and access to health care. The study was carried out between 1995 and 2000 by a team of researchers from China, Israel and the Netherlands. [from preface]

Maldistribution of human resources for health is a worldwide phenomenon and may appear in different dimensions. The first and greatest concern is the inequitable distribution, particularly of high level professionals like doctors, both among countries in the world and within each country. [author’s description]

From 1987 to 1998, JHPIEGO, through its Training in Reproductive Health (TRH) Project, collaborated with the Association of Deans of Philippine Colleges of Nursing (ADPCN) and the Association of Philippine Schools of Midwifery (APSOM) to strengthen preservice nursing and midwifery education in the Philippines. Between 1987 and 1994, JHPIEGO initiated activities to strengthen family planning/reproductive health (FP/RH) and enhance trainer/faculty development in five nursing schools and five midwifery schools.

There is compelling evidence for the success of the “rural pipeline” (rural student recruitment and rurally based education and professional training) in increasing the rural workforce. The nexus between clinical education and training, sustaining the health care workforce, clinical research, and quality and safety needs greater emphasis in regional areas.

The medical workforce shortage and efforts to maintain the safety and quality of health services are putting acute pressure on the profession. Task transfer or role substitution of medical services is mooted as a potential solution to this pressure. This has the potential to drastically transform the profession. How task transfer will evolve and change medicine depends on the vision and leadership of the profession and a flexible pragmatism that safeguards quality and safety and places patient priorities above those of the profession. [from abstract]

In Thailand, family practice was developed primarily through a small number of self-styled family practitioners, who were dedicated to this professional field without having benefited from formal training in the specific techniques of family practice. In the context of a predominantly hospital-based health care system, much depends on their personal motivation and commitment to this area of medicine. The purpose of this paper is to compare the responsiveness, degree of patient-centredness, adequacy of therapeutic decisions and the cost of care in 37 such self-styled family practices, i.e. practices run by doctors who call themselves family practitioners, but have not been formally trained, and in 37 conventional public hospital outpatient departments (OPDs), 37 private clinics and 37 private hospital OPDs.

This case study documents Indonesia’s family planning experience with a view to understanding the factors and conditions that led to the remarkable growth in the private sector’s role in delivering family planning services. [from abstract]

This paper reviews the situation and trend in human resources for health and its priority problems in Thailand. It also highlights the issue of the inequitable distribution of doctors. Through several brainstorming sessions among stakeholders, it summarizes a package of recommendations for the future continuous and sustainable knowledge-based human resources for health development. [from abstract]

The township health system in Myanmar is regarded as means to achieve the end of an equitable, efficient and effective health system based on the principles of primary health care approach. A township hospital caters medical care at the second referral level. Under the leadership and management of a Township Medical Officer in each township, para-professionals deployed at Rural Health Centers (RHCs) and Sub-centers under each RHC’s jurisdiction play key roles for providing primary health care services for rural population.

This document contains a country analysis on HRH covering situations, trends, and priority problems including issues in undifferentiated strategies of health sector development for remote areas and the shortage and maldistribution of well trained nurses and community nurses. It also includes a discussion on HRH development, strategies and policies in Lao PDR. [adapted from author]

The nurse program for foreign countries in Indonesia has been carried out since 1996. In the beginning, this program attempted to solve the false ‘surplus’ problem of nurses in Indonesia. Recently, however, the MOH has developed serious concerns with this program. There have been several efforts to promote the nurse program for foreign countries starting with the improvement of education, recruitment and other mechanisms related to nurses for foreign countries. Some achievements, strengths, weaknesses, potentials and threats are discussed in this paper.

This document report on the trends of HRH during past fifty years including the issues of unqualified doctors in rural areas, geographical differences in HRH, and the increase in medical school graduates. It also forecasts HRH needs for fifteen years from 2000 to 2015.