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Migration of Health-Care Workers from Developing Countries: Strategic Approaches to its Management

Medical practitioners and nurses represent a small proportion of the highly skilled workers who migrate, but the loss for developing countries of human resources in the health sector may mean that the capacity of the health system to deliver health care equitably is significantly compromised. The aim of this paper is to examine some key issues related to the international migration of health workers and to discuss strategic approaches to managing migration. [from abstract]

Working Together to Tackle the Crisis in Human Resources for Health

The paper summarizes the rapidly accumulating evidence and growing recognition of the HRH crisis, especially in sub-Saharan Africa. The nature of the crisis is briefly outlined, drawing attention to escalating activities, demand and momentum emerging from Africa and other countries calling for appropriate and effective global and regional support. There are clear needs for quality technical work, stronger regional cooperation, harmonization of health systems and global initiatives, and for sound fiscal and migration policies.

Health Workforce Challenges: Lessons from Country Experiences

This report is aimed at policy makers both in developing country governments and in international agencies. It was a key input to the second meeting of the High Level Forum on the Health Millennium Development Goals held in Abuja in December 2004. It was written to raise awareness of a looming crisis in human resources for health confronting most countries in sub-Saharan Africa, and to help serve as a catalyst for action to avert this crisis.

HIV/AIDS, Equity and Health Sector Personnel in Southern Africa

This paper discusses the implications for health personnel of the HIV epidemic, and health sector responses to it, in southern Africa, using Malawi as a case study. Published and grey literature has been consulted to assess the situation and its implications for equity. [author’s description]

Stopping the Migration of Ghana's Health Workers

Ghana’s health sector has lost many health care workers, including those migrating to other countries. Strategies aimed at keeping personnel have had varied results. This article briefly reviews these strategies. [adapted from author]

Migration of Health Professionals in Six Countries: A Synthesis Report

This report presents findings of a study on the migration of health professionals in Cameroon, Ghana, Senegal, South Africa, Uganda and Zimbabwe. The report provides detailed information about migration patterns and numbers, reasons for migration, effects on the quality of health care and the policies being undertaken in the respective countries to reduce outward migration. [from executive summary]

Guidelines for Implementing Supportive Supervision: A Step-by-Step Guide with Tools for Immunization

This resource guide assists program managers in planning and implementing supervision systems in healthcare settings. Emphasis is placed on clear job expectations, leadership, and communication.

Joint ILO/WHO Guidelines on Health Services and HIV/AIDS

The ILO and the WHO decided to join forces in order to assist health services in building their capacities to provide their workers with a safe, healthy and decent working environment, as the most effective way both to reduce transmission of HIV and other blood-borne pathogens and to improve the delivery of care to patients.

Healers Abroad: Americans Responding to the Human Resource Crisis in HIV/AIDS

This report explores potential strategies for mobilizing U.S. health personnel and technical experts to assist in the battle against HIV/AIDS in 15 African, Caribbean, and Southeast Asian countries highly affected by the disease. Commissioned by the U.S. Department of State as part of a historic global health initiative—the President’s Emergency Plan for AIDS Relief (PEPFAR)—the report presents the results of a study conducted by the Institute of Medicine’s Committee on the Options for Overseas Placement of U.S. Health Professionals. [Description from author]

Note: Online book

Cost Estimates: Doubling the Health Workforce in Sub-Saharan Africa by 2010

An initial investment of an estimated $2.0 billion in 2006, rising to an estimated $7.7 billion annually by 2010, is needed from African governments and the collective donor community to double sub-Saharan Africa’s health workforce while increasing its effectiveness, thus making significant progress towards developing the workforces required for countries in sub-Saharan Africa to achieve national and global health goals. [author’s description]

Plumbing the Brain Drain

The departure of a large proportion of the most competent and innovative individuals from developing nations slows the achievement of the critical mass needed to generate the enabling context in which knowledge creation occurs. To favourably modify the movement and distribution of global talent, developing countries must implement bold and creative strategies that are backed by national policies.

Human Resources Management (HRM) in the Health Sector

Over the last two decades, health sector reform in many countries has been characterized by spirited efforts to bring down costs and reduce gaps in coverage. Various approaches to decentralization and public-private partnerships have been introduced, but there has been hardly any attempt to understand or address the human resources (HR) aspects and implications of such structural changes. This technical brief synthesizes findings from recent publications to help promote general understanding among the various HRM actors, especially advocates and practitioners in developing countries. [from aut

Selecting Partners: Practical Considerations for Forming Partnerships

This handbook, developed for the Consultative Group on International Agricultural Research, describes the nature of successful partnerships: their characteristics, their benefits, their challenges, and provides practical guidance to leaders, managers, and professionals in agricultural research who are using or considering partnerships as a way to achieve greater results. While geared toward the agricultural sector, the material has wide applicability to other sectors.

Development and Strengthening of Human Resources Management in the Health Services

This document summarizes the human resources management situation in the region, its determinants, and the projects for its development. To promote improvements in the human resources management function as part of the sectoral changes under way at the national and regional level, the Pan American Health Organization is proposing a series of strategies, actions, and operational tools through the Observatory of Human Resources in Health Sector Reform initiative. [adapted from author]

Monitoring and Evaluation of Human Resources for Health: An International Perspective

Despite the undoubted importance of human resources to the functions of health systems, there is little consistency between countries in how human resource strategies are monitored and evaluated. This paper presents an integrated approach for developing an evidence base on human resources for health (HRH) to support decision making, drawing on a framework for health systems performance assessment. [from abstract]

Impact of HIV/AIDS on Health Systems and the Health Workforce in Sub-Saharan Africa

The purpose of this paper is to advocate for and guide planners in the collection and use of appropriate information to develop and manage the health workforce in a manner that enables health systems to respond to the service demands created or worsened by HIV/AIDS. The paper also intends to guide the development of tools for assessing impacts of HIV/AIDS on the health sector. Such tools can assist policymakers, planners, and advocacy groups to shape and accelerate the implementation of national HIV/AIDS policies and programs throughout the continent. [Description from author]

Using Mid-level Cadres as Substitutes for Internationally Mobile Health Professionals in Africa: A Desk Review

Substitute health workers are cadres who take on some of the functions and roles normally reserved for internationally recognized health professionals such as doctors, pharmacists and nurses but who usually receive shorter pre-service training and possess lower qualifications. This desk review was conducted on the education, regulation, scopes of practice, specialization, nomenclature, retention and cost-effectiveness of substitute health workers in terms of their utilization.

Equity, Equal Opportunities, Gender and Organization Performance

This review highlighted the fact that employment equity debates and policies largely refer to high-income countries. Even in these countries, there is more rhetorical commitment than hard evidence of successful outcomes. Evaluations have been mainly post hoc and many initiatives have not been evaluated at all. There is a continuing debate about what is the appropriate kind of intervention, a number of competing models being advocated. The most noticeable trend seems to be away from reliance on targeting by numbers (particularly for recruitment) and towards more comprehensive approaches across a range of inter- and intra-organizational interventions and over the whole career of the employee.

Skill-Mix and Policy Change in the Health Workforce: Nurses in Advanced Roles.

This report was commissioned by OECD to examine the evidence on role change and delegation from physicians to advanced practice nurses (APN), nurse practitioners and nurses in other advanced roles in the hospital setting and primary care. The report has three components: a literature review, an assessment of country responses to an OECD questionnaire, and two more detailed country case studies, on England and the US. [author’s description]