South Asia

The toolkit is a collection of participatory educational exercises for educating health care providers on the issues of stigma and gender-based violence. It was developed for and with health care providers in Andhra Pradesh, India. The goal is to facilitate open discussion on HIV stigma and gender violence, and on what health workers can do to promote a change in attitude and practice. [from publisher]

Female Community Health Volunteers (FCHVs) act as a bridge between the government and the community and serve as a frontline for local health resources. The objectives of this study of FCHV in Twenty Districts of Nepal was to see the existing condition of the FCHVs working in the communities of Nepal. The survey collected information on basic health services provided by FCHVs to the community in terms of the provision of specific commodities and the provision of information, communication, counseling, and other support to the rural community. [adapted from summary]

Pakistan has introduced female health workers to make sure that women are able to receive the health care they need. However, these health workers face the same cultural constraints as other women in their society. Male colleagues and managers must be more supportive to female health workers, whilst formal structures should be provided for training and effective complaints procedures. [from author]

In response to recent findings regarding migration of health workers out of Africa, we provide data from a survey of Indian nurses suggesting that up to one fifth of the nursing labour force may be lost to wealthier countries through circular migration. [abstract]

There is increasing consensus that training programmes should focus on know-how instead of know-all. IntraHealth International’s Learning for performance: a guide and toolkit for health worker training and education programs offers a step-by-step, customizable approach designed to develop the right skills linked to job responsibilities. Using Learning for Performance yields more efficient training that focuses on what is essential for health workers to do their jobs and on effective learning methods.

This article suggests that India’s maternal mortality rate is so high due to political, administrative and managerial issues such as the lack of exclusive midwifery training and professional midwives. [adapted from author]

This article profiles three leaders from Afghanistan, South Africa, and Southern Sudan who have made a significant difference in those countries’ HR situations. By taking a comprehensive approach and working in partnership with stakeholders, these leaders demonstrate that strengthening health workforce planning, management, and training can have a positive effect on the performance of the health sector. [from author]

The report aims to document the present health workforce in the country in order to find out their strengths and weaknesses and put forward recommendations for improvement. It lays special emphasis on the profile and density of healthcare providers, quality of services provided by selected groups of providers, training, and production and future challenges for healthcare providers. [adapted from author]

India has traditionally had a bureaucratic approach to regulating its health service. Research suggests that this approach has failed to protect the interests of poor and vulnerable groups and has not gained the trust of providers or the public. So are there any other ways to make India’s health systems more accountable? [from author]

Neonatal mortality accounts for a high proportion of deaths in children under the age of 5 years in Bangladesh. This article describes a project for advancing the health of newborns and mothers implementing a community-based intervention package through government and non-government organisation infrastructures to reduce neonatal mortality. [from abstract]

This presentation addresses the role and impact of traditional health service providers in India and how they help fill the gaps in health worker coverage. [from author]

This paper reports on AIDS-related stigma baseline findings from a study to evaluate the impact of a stigma-reduction intervention in three large hospitals in New Delhi, India. The study highlights issues particular to the health care sector in limited-resource settings. [from abstract]

This paper describes Nepal’s efforts, starting from the mid-1980s, to develop and implement community-based management of pneumonia. [from abstract]

This study examines the experience of the Sewa nurse and paramedic franchise in Nepal and assesses whether there were changes in the perceived quality of services approximately one year after the formation of the network. This study also examines the extent to which there was an increase in the use of reproductive health services during this period. [from introduction]

This study was implemented to develop and evaluate the effectiveness of a home based intervention in reducing caregiver burden, promoting caregiver mental health and reducing behavioural problems in elderly persons with dementia. [from abstract]

The community score card process is a community-based monitoring tool that is a hybrid of the techniques of social audits and citizen report cards.The CSC is an instrument to exact social and public accountability and responsiveness from service providers. By linking service providers to the community, citizens are empowered to provide immediate feedback to service providers. [from author]

In a rural village in India, newborn deaths have been halved not by neonatologists or high-tech interventions but by local villagers trained in simple life-saving practices. Some experts, however, are sceptical about whether this strategy can work everywhere. [from author]

The objective of this research is to explore inequities in utilization of skilled attendance at birth, delivery by caesarean sections and use of postnatal care services, by key socioeconomic factors in two home-based SBA areas of Bangladesh to provide insights for future programming. [from introduction]

This presentation discusses the midwifery gap in Pakistan and the strategies they are using to address it.

Despite ample evidence that HIV has entered the general population, most HIV awareness programs in India continue to neglect rural areas. Low HIV awareness and high stigma, fueled by low literacy, seasonal migration, gender inequity, spatial dispersion, and cultural taboos pose extra challenges to implement much-needed HIV education programs in rural areas. This paper describes a peer education model developed to educate and empower low-literacy communities in the rural district of Perambalur in India. [from abstract]

This study evaluated biases in guideline untilization of evidence-based practice concerning contraception perscription. It was found that in India, Peru, and Rwanda, health care providers underutilize evidence-based practice guidelines as they prescribe contraceptives. This article ends with recommendations for providers to most effectively utilize evidence-based practice. [adapted from abstract]

This presentation describes the benefits and challenges of structured on-the-job training with evidence from a case study of Nepal.

This article describes an intervention for training traditional birth attendants and integrating them into an improved health care system, which was proven to be achievable and effective in reducing perinatal mortality. This model could result in large improvements in perinatal and maternal health in developing countries. [adapted from abstract]

This article describes the efforts of the Indian government to decrease maternal mortality by improving birthing conditions. The scheme created a partnership with the private sector and an NGO to provide free birth care to poor families through contracts with private obstetricians practicing in rural areas. The authors conclude that public-private partnerships can rapidly scale up the availability of human resources for skilled birth-attendance and emergency obstetric care to the poor in a very short time. [adapted from author]

This study shows that graduates from higher quality institutions account for a disproportionately large share of emigrating physicians in India. Even within high-end institutions, better physicians are more likely to emigrate. Interventions should focus on the highly trained individuals in the top institutions that contribute disproportionately to the loss of human resources for health. The findings suggest that affirmative-action programmes may have an unintended benefit in that they may help retain a subset of such personnel. [adapted from author]

The India Local Initiatives Program adapted a model used in Indonesia and Bangladesh to implement the government’s reproductive and child health strategy. From 1999 to 2003, three Indian nongovernmental organizations (NGOs) provided services for 784,000 people in four northern states. This model proved to be a suitable platform upon which to build health-care service delivery and create behavioral change, and the NGOs quickly found ways to sustain and expand services. [from abstract]

The report aims to share findings from an assessment to explore how access to critical services for populations at risk of HIV and unintended pregnancy can be strengthened by converging HIV and sexual and reproductive health (SRH) services under the National Rural Health Mission (NRHM) and the National Aids Control Programme (NACP). The report provides information on the demand and opportunities for and the challenges of implementing HIV and SRH convergence in four states

The goal of the human resources development policy is to ensure availability of suitably qualified appropriately skilled and motivated human resource for health at appropriate geographic level of pre-defined disciplines, for provision of essential health services of acceptable quality at affordable cost to the community. [author’s description]

The objective of this paper is to explore the context of sexual harassment of women in the health sector in Kolkata, West Bengal. Specifically, it explores women’s perceptions of the occurrence of sexual harassment in hospital settings, and probes women’s own experiences of sexual harassment and incidents of sexual harassment in the hospital environment about which women are aware. The study also investigates the nature of action taken to seek redress, and the extent to which working women are aware of the complaint mechanism outlined by the Supreme Court. [from introduction]

Programs and services need to be sensitively designed to facilitate women’s access to physical and social needs. This paper narrates the experience of working with health providers from public and private sectors, community, local government representatives and community-based organizations. Through transformative learning, this endeavour focused on initiating a process of sensitization on gender related health issues for women. [from abstract]