South Asia

Are Village Doctors in Bangladesh a Curse or a Blessing?

This paper investigates the role of various healthcare providers in provision of health services in a remote rural area in Bangladesh. [from abstract]

Motivational Determinants among Physicians in Lahore, Pakistan

This study aimed to identify the determinants of job motivation among physicians, a neglected perspective, especially in developing countries. [from abstract]

Medical Education and Training in Nepal: SWOT Analysis

The goal of this article was to analyse the impact of the medical colleges that have been set up within the last two decades by production of doctors and the effect on the health of the people. [from abstract]

Pay for Performance: Improving Maternal Health Services in Pakistan

This case study thus describes an example of a private sector pay for performance voucher program targeting reproductive health and offers lessons for countries that are considering implementing similar schemes. [from author]

Factors Affecting Recruitment and Retention of Community Health Workers in a Newborn Care Intervention in Bangladesh

This article investigated the reasons for the high rates of community health worker attrition in Bangladesh. [adapted from abstract]

Practical Issues in Contracting for Primary Health Care Delivery: Lessons from Two Large Projects In Bangladesh

There is increasing interest in contracting with the private sector for the delivery of health primary health care services in developing countries. This paper describes the experience with contracting under two large projects in Bangladesh and explores some of the practical issues. [adapted from author]

Mobile-izing Health Workers in Rural India

This article outlines a project that deployed short videos on mobile phones designed to motivate health workers and persuade pregnant village women to use health services. The project also asked health workers to record their own videos. The results show evidence that the creation and use of videos helped engage village women in dialogue, showed positive effects toward health worker motivation and learning, and motivated key community influencers to participate in promoting the health workers. [adapted from abstract]

Private Pharmacists: the Missing Link in TB Control

India has the highest incidence of tuberculosis (TB) in the world. The Government’s TB programme uses Directly Observed Treatment Short course to supervise patients’ treatment. However an estimated 40-50 per cent of TB treatment is accessed through private pharmacists. A challenge is to engage these pharmacists in TB control. [from author]

Community Pharmacy Practice in India: Past, Present and Future

Today, community pharmacists play an important role in any country as they take responsibility for patient’s medicine related needs for access to healthcare. This article seeks to discuss the genesis of Indian community pharmacy, the majority of which are privately owned, and sketches its education, training and future prospects. [from abstract]

Validation of Community Health Workers' Assessment of Neonatal Illness in Rural Bangladesh

Improving neonatal health and survival requires cost-effective interventions at the community level, as well as linkages between the community and the health-care system within the continuum of care for the treatment of severe illness. The primary purpose of this study was to evaluate the performance of CHWs in recognizing signs and symptoms of neonatal illness during routine household surveillance in rural Bangladesh. [from introduction]

Developing Counseling skills through Pre-Recorded Videos and Role Play: a Pre- and Post-Intervention Study in a Pakistani Medical School

Interactive methods like role play, recorded video scenarios and objective structured clinical exam are being regularly used to teach and assess communication skills of medical students in the western world. In developing countries however, they are still in the preliminary phases of execution in most institutes. Our study was conducted in a naive under resourced setup to assess the impact of such teaching methodologies on the counseling skills of medical students. [from abstract]

Is Management Theory Universal? Training Health Professionals in Pakistan

This brief outlines the teaching of management theory in a training centre for government health workers in Peshawar, Pakistan. The study finds that imposing western principles of management is often inappropriate. Training must build on the strengths and address the weaknesses of local management styles in a sensitive manner. [from author]

Estimating the True Shortfall of Medical Practitioners in Rural India

A researcher from the University of Surrey (UK) proposes a basic framework for estimating relative shortages of medical personnel in rural and urban areas of developing countries. The author distinguishes between qualified doctors, trained non-doctors and untrained non-doctors. Using data for Ujjain district in the state of Madhya Pradesh, India, the author then estimates their impact on the quality of health care available. [from author]

Provision of Emergency Contraceptive Services through Paraprofessionals in India

This two-year study to assessed the usefulness and effectiveness of using paraprofessionals in educating and providing emergency contraceptive pill services to potential users. [from summary]

Community-Based Skilled Birth Attendants in Bangladesh: Attending Deliveries at Home

A program to create a cadre of skilled birth attendants for home births was launched by the Government of Bangladesh Bangladesh in 2004. This article suggests that the task-shifting program can only serve as an interim measure rather than a long-term solution as more women decide to seek institutional delivery and professional midwifery care. [adapted from abstract]

Public-Sector Maternal Health Programs and Services for Rural Bangladesh

This paper assesses the development of maternal health services and policies in Bangladesh by reviewing policy and strategy documents since the country's independence in 1971, with primary focus on rural areas where three-fourths of the total population of reside. [adapted from abstract]

Empowering Health Personnel for Decentralized Health Planning in India: the Public Health Resource Network

This article describes the Public Health Resource Network, an innovative distance-learning course in training, motivating, empowering and building a network of health personnel from government and civil society groups. Its aim is to build human resource capacity for strengthening decentralized health planning, especially at the district level. [from abstract]

Knowledge and Communication Needs Assessment of Community Health Workers in a Developing Country: a Qualitative Study

We conducted this study to document the perceptions of community health workers in Pakistan on their knowledge and communication needs, image building through mass media and mechanisms for continued education. [adapted from abstract]

Role of Pharmacists in Developing Countries: the Current Scenario in Pakistan

The pharmacy profession has expanded significantly in recent years in professional services delivery and now has been recognized as an important profession in the multidisciplinary provision of health care. In contrast to the situation in developed countries, pharmacists in developing countries are still underutilized and their role as health care professionals is not deemed important by either the community or other health care providers.

Traditional Birth Attendants in Rural Nepal: Knowledge, Attitudes and Practices about Maternal and Newborn Health

Efforts to formalize the role of traditional birth attendants (TBAs) in maternal and neonatal health programmes have had limited success. Continued attendance by TBAs at home deliveries suggests the potential to influence maternal and neonatal outcomes. The objective of this qualitative study was to identify and understand the knowledge, attitudes and practices of TBAs in rural Nepal. [adapted from abstract]

Experiences of Districts in Implementing a National Incentive Programme to Promote Safe Delivery in Nepal

Nepal’s Safe Delivery Incentive Programme (SDIP) was introduced nationwide in 2005 with the intention of increasing utilisation of professional care at childbirth. It provided cash to women giving birth in a health facility and an incentive to the health provider for each delivery attended, either at home or in the facility. We explored early implementation of the programme at the district-level to understand the factors that have contributed to its low uptake. [from abstract]

Potential Role of Traditional Birth Attendants in Neonatal Healthcare in Rural Southern Nepal

The potential for traditional birth attendants (TBAs) to improve neonatal health outcomes has largely been overlooked during the current debate regarding the role of TBAs in improving maternal health. Randomly selected TBAs were interviewed to gain a more thorough understanding of their knowledge, attitudes, and practices regarding maternal and newborn care. [from abstract]

Development of Medical Education in Nepal

The last two decades has seen an explosion of institutions involved in the training of health personnel. This is possibly because of the huge demand of human resources of health (HRH) not only in Nepal, but worldwide. Various grades of HRH are going out of the country and seeking their livelihood elsewhere. [from abstract]

Training and Mobility of Nurses: the Bangladesh Case

This presentation was part of the Mobility, Training and Supply of Health Workers Worshop. It discusses the state of nurse training and mobility and the policy considerations in Bangladesh.

Internationally Recruited Nurses from India and the Philippines in the United Kingdom: the Decision to Emigrate

The United Kingdom has recruited nurses from countries with a reported surplus in their nursing workforce, such as India and the Philippines. However, little is known about the decision to emigrate made by nurses from these countries. One theory suggests that individuals weigh the benefits and costs of migration: the push and pull factors. This paper challenges the restricted economic focus of this predominant theory and compares the diverse motivations of nurses from different countries as well as those of nurses with previous migratory experience and first-time migrants. [from abstract]

Delivering Mobile Reproductive Health

This video resource chronicles how after a truce in Nepal's civil war, a mobile reproductive health team is reaching isolated communities that have had no health services for years. [adapted from synopsis]

Improving Provider Performance

This article provides an overview of how new research in India and Nigeria offers innovative strategies to improve health care provider performance.

Bangladesh Trains Health Workers to Reduce Maternal Mortality

Medical doctors and nurses in Bangladesh are concentrated in urban secondary and tertiary hospitals, while 70% of the population lives in rural areas. This situation has created a major challenge for the national health system, particularly for reducing the high maternal mortality rate, with fewer than 20% of births being attended by a skilled birth attendant. The Declaration of Safe Motherhood was desgined to address this issue, supportetd by a number of national programs and strategies. [from summary]

Assessment of Human Resources for Health Using Cross-National Comparison of Facility Surveys in Six Countries

Health facility assessments are being increasingly used to measure and monitor indicators of health workforce performance, but the global evidence base remains weak. The World Health Organization coordinated a series of facility-based surveys using a common approach in six countries: Chad, Cote d’Ivoire, Jamaica, Mozambique, Sri Lanka and Zimbabwe. The objectives were to inform the development and monitoring of human resources for health policy within the countries; and to test and validate the use of standardized facility-based human resources assessment tools across different contexts.

Leveraging Human Capital to Reduce Maternal Mortality in India: Enhanced Public Health System or Public-Private Partnership

This paper will use India as a lens to examine the broader issues surrounding human resources and public health. It will explore some of the HR strategies employed in a variety of settings with mixed results. Finally, it will look at several very contrasting approaches employed by two Indian states, Tamil Nadu and Gujarat, in dealing with human resource shortages as they struggle to reduce maternal mortality. [from author]