Americas & Caribbean

Provider Selection of Evidence-Based Contraception Guidelines in Service Provision: a Study in India, Peru, and Rwanda

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]

Within Our Grasp: Healthy Workplace Action Strategy for Success and Sustainability in Canada's Healthcare System

The health and well-being of the health workforce and the quality of the healthcare work environment has a profound impact on the effectiveness and efficiency of healthcare services. This resource identifies priority actions that are known to improve the workplace and that can be implemented quickly and efficiently. The actions focus on both system wide and organizational performance improvement on specific areas relating to quality work life. [from executive summary]

Cuba and Guatemala: Innovations in Physician Training

This article describes the experience of Guatemalan students at Cuba’s Latin American Medical School. The students’ education emphasizes health problems and diseases characterizing the epidemiological situation in their home country and in-depth courses in disaster management, as well as clinical experience in Guatemala. [adapted from author]

Joining Forces to Develop Human Resources for Health

This article describes the efforts within the Cuban medical system to collaborate with health authorities around the globe to develop medical education programs to train such urgently-needed professionals with curricula formulated to meet international standards and local health needs. Special emphasis is placed on the assistance that Cuba provided to Gambia in establishing a medical school in that country. [from author]

Doctors for the (Developing) World

This article describes the Cuban medical education system. The role of Cuban physicians internationally is discussed, as well as the placement of international students in Cuban medical schools.

Cuba’s Piece in the Global Health Workforce Puzzle

The world’s 1,691 medical schools and 5,492 nursing schools are not producing enough graduates to cover the massive global deficit of doctors, nurses, and midwives. One scaling-up initiative addressing these critical shortages is Cuba’s Latin American Medical School. This article describes those efforts. [adapted from introduction]

Natural and Traditional Medicine in Cuba: Lessons For U.S. Medical Education

The Institute of Medicine’s Academy of Science has recommended that medical schools incorporate information on CAM (complementary and alternative medicine) into required medical school curricula so that graduates will be able to competently advise their patients in the use of CAM. The report states a need to study models of systems that integrate CAM and allopathic medicine. The authors present Cuba’s health care system as one such model and describe how CAM (or natural and traditional medicine) is integrated into all levels of clinical care and medical education in Cuba. The authors conclude that there is much to learn from the Cuban experience to inform U.S.

Selecting Effective Incentive Structures in Health Care: a Decision Framework to Support Health Care Purchasers in Finding the Right Incentives to Drive Performance

This article discusses the development of a decision framework to assist policymakers in choosing and designing effective incentive systems. The researchers identified several models that have proven to be effective in changing or enabling a health provider’s performance.

Regional Goals for Human Resources for Health 2007 - 2015

This document outlines the issues for human resources for health in the Americas and what the Pan American Health Organization resolves should be done to address them.

Educating and Training Health Workforce to Consolidate a Universal Health System

This presentation was given at the First Forum on Human Resources for Health in Kampala. It discusses educational strategies for training health workers to scale up service delivery in Brazil.

Regional Core Health Data Initiative: Table Generator System

This database can be used to produce tables of health indicator data according to year, country within the Americas, and indicator type. Human Resources for Health indicators are included in the “Resources, services, and coverage” section. The available data is from 1995-2007.

Health Human Resources Modelling: Challenging the Past, Creating the Future

This document reports on the findings of three projects in Canada that link population health needs to health human resource planning, to illustrate the value and challenges in using health human resource data to inform policy decisions on nursing productivity and to generate evidence based retention policies to guide nursing workforce sustainability. [adapted from summary]

Health Human Resources Planning: an Examination of Relationships Among Nursing Service Utilization, an Estimate of Population Health and Overall Health Status Outcomes in the Province of Ontario

The goal of this study was to develop and test a way to establish, monitor, and predict the need for nursing services by using the health needs of the population. This study explored the relationship between the health needs of Ontarians, their use of community and hospital nursing services, and variations in outcomes. The findings suggest that decisions about the deployment of nursing resources are associated with differences in outcomes. [adapted from author]

Impact of Health-Management Training Programs in Latin America on Job Performance

A study was undertaken in Mexico, Colombia, and El Salvador to determine the impact of a management training program on health managers’ job performance. Factors associated with a successful training outcome were training techniques, strengthening of enabling factors, and reinforcement mechanisms. [adapted from abstract]

Nurse Wages and Their Context: Database Summary (North America, Western Europe and Japan)

These yearly summary reports provide information on nurse wages and the comparitive buying power of these wages in select countries in North America, Western Europe and Japan. The data are results from a survey of 10 National Nurses’ Associations. [from introduction]

Teamwork in Healthcare: Promoting Effective Teamwork in Healthcare in Canada

A healthcare system that supports effective teamwork can improve the quality of patient care, enhance patient safety, and reduce workload issues that cause burnout among healthcare professionals. To support the movement to make teamwork a reality, this report was commissioned to outline the characteristics of an effective team, how to measure its effectiveness, what interventions have been successful in implementing and sustaining teamwork in healthcare, lessons from other settings and countries, and the barriers to implementation in Canada. [adapted from executive summary]

Summary Report: Distribution and Internal Migration of Canada's Health Care Workforce

This report summarizes studies that examined the geographical distribution or mobility of a wide variety of health care providers in Canada. [adapted from introduction]

Taking the Next Step: Options and Support for a Pan-Canadian, Multi-Professional HHR Planning Mechanism

This study proposes potential options for creating a pan-Canadian HHR planning mechanism or mechanisms to better serve the process of coordinated HHR planning across jurisdictions and among multiple professions. The second goal is to assess the current level of support among both government actors at the federal, provincial and territorial levels and stakeholder organizations for creating a pan-Canadian HHR planning. The study examines the current HHR planning infrastructure in the country, recent international developments in HHR planning and the attitudes of key informants in governmental and non-governmental communities.

Distance Education in Health and Environmental Health: an Option - Now Let's Strengthen Its Viability

The experience of the Training in Health and Environmental Health in the Caribbean Community project has demonstrated that distance education techniques is an effective medium through which participants in more than eleven countries can be brought together to be educated on topics that are significant to both the region and to individual countries. This paper examines the means through which individuals are educated and meaningful communication among them facilitated.

Barriers to Training Family Physicians in the Caribbean: Distance Education as a Promising Prescription

The peculiarities of the scattered small states of the Caribbean region call for a model of training practitioners that is effective, relevant and sustainable. Distance education (DE) as an approach offers advantages that meet some of the challenges inherent in training family physicians for the region. This paper examines some of these challenges and shows where DE is being used to structure delivery of the programme. In particular, the need for context-specific training, managing time strictures and the cost issues of training are discussed. [from abstract]

Excessive Work Hours of Physicians in Training in El Salvador: Putting Patients at Risk

Recent studies involving physicians in training have shown that excessive work hours are associated with an increased rate of medical errors and adverse events. The problem of excessive work hours of physicians in training in El Salvador has political and economic roots that need to be addressed by politicians and public health policy makers. [adapted from author]

Expansion of the Role of Nurse Auxiliaries in the Delivery of Reproductive Health Services in Honduras

The nurse auxiliaries who work at the rural health centers (CESARs) of the Honduran Ministry of Health (MOH) are frequently the only source of reproductive health services in the communities they serve. In order to increase access to long-term family planning methods, the MOH and the Population Council’s INOPAL III Project conducted an operations research study from 1997 to 1998 to see if nurse auxiliaries could provide good quality IUD, Depo-Provera and vaginal cytology services without health risks for their clients.

Creating High-Quality Health Care Workplaces

The question guiding the paper is: “What are the key ingredients of a high-quality work environment in Canada’s health care sector and how can this goal be achieved?” Synthesizing insights from a variety of research streams, the paper identifies many ingredients needed to create a high-quality workplace. We take a multidisciplinary and holistic approach, which complements other research initiatives on health human resources. [from abstract]

Hospital Nurse Staffing and Quality of Care

This report summarizes the findings of AHRQ-funded and other research on the relationship of nurse staffing levels to adverse patient outcomes. This valuable information can be used by decisionmakers to make more informed choices in terms of adjusting nurse staffing levels and increasing nurse recruitment while optimizing quality of care and improving nurse satisfaction. [author’s description]

Impact of the Manager’s Span of Control on Leadership and Performance

The purpose and objectives of this study are to examine the extent to which the manager’s span of control influences nurse, patient, and unit outcomes; and investigate which particular leadership style contributes to optimum nurse, patient, and unit outcomes under differing spans of control. [author’s description]

Health Human Resources Policy Initiatives for Physicians, Nurses and Pharmacists

This document is an environmental policy scan of activity in three areas related to physicians, nurses and pharmacists: education and training initiatives; recruitment and retention and work place initiatives; and capacity to do national health human resource planning. [adapted from introduction]

Human Resource Planning and the Production of Health: a Needs-Based Analytical Framework

Traditional approaches to health human resource planning emphasize the effects of demographic change on the needs for health human resources. Planning requirements are largely based on the size and demographic mix of the population applied to simple population-provider or population-utilization ratios. We develop an extended analytical framework based on the production of heal care services and the multiple determinants of health human resource requirements. [from abstract]

Managed Migration: The Caribbean Approach to Addressing Nursing Services Capacity

This article intends to provide a contextual analysis of the Caribbean region with respect to forces shaping the current and emerging nursing workforce picture in the region; discuss country-specific case(s) within the Caribbean; and describe the Managed Migration Program as a potential framework for addressing regional and global nurse migration issues. [from abstract]

Nurse Migration: a Canadian Case Study

The objective of this article is to synthesize information about nurse migration in and out of Canada and analyze its role as a policy lever to address the Canadian nursing shortage. [from abstract]

U.S. Nurse Labor Market Dynamics Are Key to Global Nurse Sufficiency

This article reviews estimates of U.S. nurse supply and demand, documents trends in nurse immigration to the United States and their impact on nursing shortage, and considers strategies for resolving the shortage of nurses in the United States without adversely affecting health care in lower-income countries. [from abstract]