Developing mid-level health professionals who can complement existing staff is an additional strategy that has been debated since 1994 and incorporated into the government’s recent human resources policy. Yet progress in the production of mid-level health workers has been slow. Reasons for this are likely to include competing priorities, the practical difficulties associated with setting up and implementing new training programmes, constraints on absorbing new cadres into the existing health system, tensions between different cadres over role definition and working conditions, and the brain drain into the private sector. More fundamentally, concerns remain about whether mid-level workers are the correct choice for South Africa’s health system. The author discusses how the design and early implementation of a new programme to develop South Africa’s first mid-level medical health professionals took account of these concerns and realities. Also highlighted are the issues that need to be addressed by government in order to ensure that this new programme has a substantial impact on the quality of care delivered in public hospitals. The author concludes that clinical associates have the potential to bring good quality hospital care closer to communities in a way that is affordable for the country.
The challenges in the health workforce are well known and clearly documented. What is not so clearly understood is how to address these issues in a comprehensive and integrated manner that will lead to solutions. This editorial presents – and invites comments on – a technical framework intended to raise awareness among donors and multisector organisations outside ministries of health and to guide planning and strategy development at the country level.
Many developing countries suffer from critical shortages of trained health workers, but Malawi’s shortage is severe even by African standards. Measures to recruit and retain more staff are urgently needed.This paper reports on the employment preferences of public sector registered nurses in Malawi to help design incentives to encourage them to remain in Malawi's public health sector. Improved pay was the single most important attribute identified that might improve job satisfaction, followed by opportunities for further education and the provision of basic housing. Improvements in the quality of housing provided would have little impact on how nurses value their employment. Establishing the relationship between pay increases and retention of registered nurses would require additional research.
This paper addresses an important practical challenge to staff management. In 2000 the United Nations committed themselves to the ambitious targets embodied in the Millennium Development Goals (MDGs). Only five years later, it was clear that poor countries were not on track to achieve them. It was also clear that achieving the three out of the eight MDGs that concern health would only be possible if the appropriate human resources (HR) were in place.
Absence of current reliable human resources data for health workers at the country level limits the ability to monitor and improve HRH leadership, management, policy and planning. Responding to this health workforce crisis, about 90 participants from fifteen African countries and international organizations have joined forces for the African Health Workforce Observatory. The East, Central and Southern African Health Community (ECSA), the World Health Organisation, World Bank and USAID/Capacity Project have partnered to accelerate the establishment of Africa Health Workforce Observatory. This three-day meeting focussed on developing mechanisms to create up-to-date reliable information that enables evidence-based decision making for human resources for health.
At least 100,000 health workers are needed to distribute anti-AIDS drugs in Africa, where 70 percent of the world's HIV/AIDS sufferers live, the head of the World Health OrganiSation said Wednesday. "It's difficult to grasp the magnitude of the problem," Dr. Lee Jong-Wook said while visiting Singapore. "The 8,000 people dying every day from AIDS is equivalent to 30 jumbo jets crashing every day." The WHO's aim to provide 3 million HIV-infected people in Africa with the latest available drugs by the end of 2005 was achievable if workers are found to deliver the drugs, Lee said.
Africa is losing its brightest to the First World. Less than 10% of doctors trained in Zambia since its independence in 1964 are still in the country: the other 90% have migrated, mainly to Europe and the United States. No less staggeringly, there are more Sierra Leonean-trained doctors in Chicago alone than in the country itself. These medical examples are merely one facet of the massive loss of skills Africa as a whole continues to suffer. In effect, one-third of the continent’s university resources are serving the manpower needs of Western nations and not those of Africa itself. United Nations estimates suggest that Africa is spending a staggering $4-billion a year training professionals for developed countries. Why this is happening, and what African universities need to do to counter the problem, came under the spotlight in the Libyan capital of Tripoli, which hosted the Association of African Universities’ (AAU) two-yearly conference of rectors, vice-chancellors and university presidents.
Africa lacks a system for defining, co-ordinating and growing the human resources for health research (HRHR) needed to support its health systems development, according to this review. The authors found that research consists of unco-ordinated, small-scale activities, primarily driven from outside Africa. They present examples of ongoing HRHR capacity building initiatives in Africa. There is no overarching framework, strategy or body for African countries to optimise research support and capacity in HRHR. A simple model is presented to help countries plan and strategise for a comprehensive approach to research capacity strengthening. Everyone engaged with global, regional and national research for health enterprises must proactively address human resource planning for health research in Africa, the authors argue. Unless this is made explicit in global and national agendas, Africa will remain only an interested spectator in the decisions, prioritisation, funding allocations, conduct and interpretation, and in the institutional, economic and social benefits of health research, rather than owning and driving its own health research agendas.
More than half of all healthcare workers in the developing world, including Africa, are unknowingly infected with latent tuberculosis, according to a report available on the open-access Science and Development Network website. The study, published in the online journal Medicine by the open-source Public Library of Science, highlights the risk of tuberculosis transmission from patients to healthcare workers - and onward into the general community.
Migration of health workers is a hotly debated issue. It has contributed to shortages of medical staff in many regions of Africa, causing additional strain on already overstretched health systems. This article adresses the issue by discussing key arguments presented in several different published papers on the topic.