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Model for Analysis, Systemic Planning and Strategic Synthesis for Health Science Teaching in the Democratic Republic of the Congo

The problem of training human resources in health is a real concern in public health in Central Africa. What can be changed in order to train more competent health professionals? This is of utmost importance in primary health care.

State of the Health Workforce in Sub-Saharan Africa: Evidence of Crisis and Analysis of Contributing Factors

This report is an attempt to systematically document and evaluate the state of the health workforce in Africa. It draws on academic published literature (which is limited), the WHO statistical database (which is incomplete and only sporadically updated), studies of bilateral donors, national documents, and newspaper articles. The report shows clearly that for more than a decade HR issues have received very little attention. [from foreword]

National Health Accounts Rwanda 2002

In an effort to understand the flows of funds throughout the health system, the Government of Rwanda (GoR) conducted, for the second time, a National Health Accounts (NHA) estimation. NHA is an internationally recognized tool for measuring health expenditures in a comprehensive manner — one that includes the public, private and donor sectors. By doing so, NHA offers a financial perspective on who is paying for health care, who is managing health care funds and their allocation, and where the funds are going — by type of provider and service. In short, NHA aims to inform policymakers on resource flows for the entire health system so as to assist in making good policy decisions and averting potentially adverse ones.

Selecting and Applying Methods for Estimating the Size and Mix of Nursing Teams: A Systematic Review of the Literature Commissioned by the Department of Health

The aims of this summary and the main report are to help make sense of the complex and uncertain world of nursing workforce planning and to make better decisions about cost-effective numbers and mixes of nurses. Consequently, five commonly used workforce planning methods are reviewed and described: 1. Professional judgement approach, 2. Nurses per occupied bed method, 3. Acuity-quality method, 4. Timed-task/activity approaches, and 5. Regression-based systems. [From introduction]

Department of Health Annual Report 2003/2004 (South Africa)

An annual review done against the priorities set in the South Africa Health Sector Strategic Framework, 1999 to 2004, and in the Strategic Plan of the National Department for 2003/04 to 2005/06. Section 2 is devoted to Human Resource Management Data.

International Recruitment of Health Workers to the UK: A Report for DFID: Final Report

Whilst the issue of international migration of health workers is sometimes presented as a one-way linear ‘brain drain,’ the dynamics of international mobility, migration and recruitment of health workers are complex.

Antiretroviral Treatment in Developing Countries: The Peril of Neglecting Private Providers

Action is underway to increase access to antiretroviral drugs, especially in countries with high rates of HIV. The role of private providers is largely ignored, although they are an important source of care for stigmatizing diseases in many poor countries. Evidence is emerging that antiretroviral drugs are leaking into formal and informal private markets. Uncontrolled use of drugs in the private sector will lead to rapid development of HIV resistance. Countries require guidance and support from international policy makers and pharmaceutical companies to implement strategies for working with private providers.

What is Required to Retain Registered Nurses in the Public Health Sector in Malawi?

This study was carried out in order to determine factors that may facilitate the poor retention of registered nurses in the Malawian public health sector.

Health Information System: National Policy and Strategy

This document intends to provide a policy and strategic framework for management of health information, use of information in planning and management of health services and monitoring health sector performance. [from preface]

Ghana Community-Based Health Planning and Services Initiative for Scaling Up Service Delivery Innovation

The Community-based Health Planning and Services (CHPS) Initiative has employed strategies tested in the successful Navrongo experiment to guide national health reforms that mobilize volunteerism, resources and cultural institutions for supporting community-based primary health care. This paper reviews the development of the CHPS initiative, describes the processes of implementation and relates the initiative to the principles of scaling up organizational change which it embraces.

Imbalance in the Health Workforce

Imbalance in the health workforce is a major concern in both developed and developing countries. It is a complex issue that encompasses a wide range of possible situations. This paper aims to contribute not only to a better understanding of the issues related to imbalance through a critical review of its definition and nature, but also to the development of an analytical framework. [from abstract]

Recent Innovations in Education of Human Resources for Health

This paper reviews recent innovations in education for human resources for health (HRH). The paper outlines the rationale for HRH education, identifies shortcomings in HRH education, and addresses the global contents of educational programs and trends. Recent changes in didactic approaches used in HRH educational programs are analyzed. The paper concludes with an evaluation of innovations and a set of recommendations. [adapted from author]

What is the Access to Continued Professional Education among Health Workers in Blantyre, Malawi?

This study indicates that healthcare professionals are using mostly clinical handover meetings, seminars and workshops for their continued professional development (CPD). There is need to improve access to relevant professional journals. The regulatory or licensing boards for healthcare professionals in Malawi should seriously consider mandatory CPD credits for re-certification. [author’s description]

Ghost Doctors: Absenteeism in Bangladeshi Health Facilities

The authors report on a study in which unannounced visits were made to health clinics in Bangladesh with the intention of discovering what fraction of medical professionals were present at their assigned post. This survey represents the first attempt to quantify the extent of the problem on a nationally representative scale. [from abstract]

Making Supervision Supportive and Sustainable: New Approaches to Old Problems

This paper distills lessons from recent efforts to improve the supervision of family planning and health programs in developing countries and identifies approaches that may be more effective and sustainable. It describes supportive supervision, an approach to supervision that emphasizes joint problem-solving, mentoring, and two-way communication between supervisors and those being supervised.

Human Resources for Health: Developing Policy Options for Change

This paper is intended to be the basis for the development of policy options with countries for countries. As such, it has multiple objectives: to provide a guide for the analysis of human resources for health (HRH) as part of health systems performance assessment; to highlight HRH policy questions - derived from analyses and other input from countries — with which policy-makers are often struggling; to integrate HRH policy issues with indicators to assess and monitor HRH performance. [author’s description]

Utility of a Thematic Network in Primary Health Care: A Controlled Interventional Study in a Rural Area

UniNet is an Internet-based thematic network for a virtual community of users. It supports a virtual multidisciplinary community for physicians, focused on the improvement of clinical practice. This is a study of the effects of a thematic network such as UniNet on primary care medicine in a rural area, specifically as a platform of communication between specialists at the hospital and doctors in the rural area. [from abstract]

Effect of Performance-Related Pay of Hospital Doctors on Hospital Behaviour: A Case Study From Shandong, China

With the recognition that public hospitals are often productively inefficient, reforms have taken place worldwide to increase their administrative autonomy and financial responsibility. Reforms in China have been some of the most radical: the government budget for public hospitals was fixed, and hospitals had to rely on charges to fill their financing gap. Accompanying these changes was the widespread introduction of performance-related pay for hospital doctors, termed the “bonus” system. While the policy objective was to improve productivity and cost recovery, it is likely that the incentive to increase the quantity of care provided would operate regardless of whether the care was medically necessary.

Achieving the Right Balance: The Role of Policy-Making Processes in Managing Human Resources for Health Problems

This document presents a framework for analyzing factors affecting the development and implementation of HRH policies and strategies.

Human Resources for Emergency Obstetric Care in Northern Tanzania: Distribution of Quantity or Quality?

The goal of this article is to evaluate the current status of human resources quality, availability and distribution in Northern Tanzania in order to provide emergency obstetric care services to specific districts in this area. It also discusses the usefulness of distribution indicators for describing equity in the decision-making process. [from abstract]

Effective Teaching: A Guide for Educating Healthcare Providers

This reference manual, part of a learning package developed through a collaboration between the World Health Organization and JHPIEGO, contains 12 modules on topics such as facilitating group learning, managing clinical practice, and preparing and using knowledge and skills assessments. The modules include examples related to maternal, reproductive and child health.

Impact of Accreditation on the Quality of Hospital Care: KwaZulu-Natal Province, Republic of South Africa

QAP implemented the first randomized control trial to measure the impact of accreditation in a developing country setting and reports its findings in this Operations Research Results report. The central issue to the report addresses the extent to which accreditation, known to favorably impact measurable indicators relating to the quality of care, actually improves patient outcomes. While exploring this issue, the report also sheds light on the importance of careful planning and communication in implementing complex research and would serve as a guide to others in undertaking similar efforts.

Should Physicians' Dual Practice Be Limited? An Incentive Approach

We develop a principal-agent model to analyze how the behavior of a physician in the
public sector is affected by his activities in the private sector. We show that the physician will have incentives to over-provide medical services when he uses his public activity as a way of increasing his prestige as a private doctor. The health authority only benefits from the physician’s dual practice when it is interested in ensuring a very accurate treatment for the patient. Our analysis provides a theoretical framework in which some actual policies implemented to regulate physicians’ dual practice can be addressed.

Contemporary Specificities of Labour in the Health Care Sector: Introductory Notes for Discussion

This paper combines the literature on public health, on economics of health and on economics of technological innovation to discuss the peculiarities of labour in the health care sector. The health care system has a distinctive characteristic from other economic sectors: it is the intersection between social welfare and innovation systems. The relationship between technological innovation and cost in the health care sector is surveyed. Finally, the Brazilian case is discussed as an example of a developing country. The peculiarities of labour in the health care sector suggest the need to recognize the worth of sectoral labour and to cease to treat it separately.

Human Resources Development and Strategic Plan 2005-2025 (Lesotho)

This document is a combined Human Resources Development Plan and Human Resources Strategic Plan for the health and social welfare sector of Lesotho. The Development Plan is presented in Chapters 2 through 5, and the Strategic Plan is presented in Chapter 6. The essential difference between the two is that the HR Development Plan represents a technical assessment of the total labor supply and training requirements for the sector in the absence of any budget or production constraints. It reflects a technical assessment of what is needed and what should be produced and financed if we faced no constraints.

Health Systems Strengthening and HIV/AIDS: Annotated Bibliography and Resources

Over the past few years, a united battle against HIV/AIDS has gained momentum worldwide. Non-governmental and community-based programs, national and international organizations—all are confronting the myriad of challenges posed by the HIV/AIDS pandemic. In an effort to provide policymakers, technical personnel, and other stakeholders comprehensive information on the costs of interventions and the impact of HIV/AIDS on health systems, PHRplus has prepared this annotated bibliography. The documents described focus on those aspects of the pandemic most related to the work of the project issues of economic impact, financing and resource allocation, costing, health system strengthening, scaling up antiretroviral therapy, surveillance systems, and program monitoring and evaluation.

Migration of Highly Skilled Persons from Developing Countries: Impact and Policy Responses: Synthesis Report

The synthesis report addresses the issues of the impact of high skilled emigration on developing countries, and the policy mixes and options available to both receiving and sending countries to harness its benefits. The study argues that the feedback or indirect effects of skilled migration can often outweigh any initial negative impacts on developing countries. The challenge is to maximize these benefits through appropriate policies relating to encouraging return migration, retention of manpower, tapping diaspora networks, and productive utilization of remittances.

Public Health Approach to Antiretroviral Treatment: Overcoming Constraints

Triple-drug combination antiretroviral (ARV) therapy has yielded remarkable results in affluent countries and some middle-income countries such as Brazil. Lessons can be learned from these examples, but this publication reviews the experiences of ARV programmes already underway in countries with very severe HIV epidemics but severely constrained resources, as in most of Africa and part of the Caribbean. The publication aims to show how some of the key policy issues for scaling up HIV/AIDS treatment have been dealt with and to identify common elements that should be considered by everyone seeking to provide HIV/AIDS care on a significant scale.

HRM Resource Kit

This toolkit includes a collection of HRM resources and links assembled for the Global Health 2005 conference. Most of the resources are in Microsoft Word format and provide guidance on how to develop a variety of HRM documents or processes. Topics covered include supervision, hiring and recruitment, HR policies, and HIV Workplace Programs and training. [publisher’s description]

Determining Skill Mix: Practical Guidelines for Managers and Health Professionals

This paper provides practical guidelines for managers and health professionals looking to skill mix as a potential solution to health service delivery problems. These guidelines emphasise the need to evaluate the problem, and examine the context, before deciding if skill mix is the answer. The guidelines are provided in the knowledge that skill mix is rarely examined in a pure theoretical sense by organisations. They have to adopt a pragmatic approach which takes account of the day-to-day realities of their priorities and resources. [abstract]