Human Resources

Zeroing in: AIDS donors and Africa’s health workforce
Oomman N, Wendt D and Droggitis C: Centre for Global Development, 2010

Have AIDS external funders harmed or strengthened health workforce development in countries with severe shortages? This research led to six key findings. First, to staff AIDS programmes, external funders have relied on training existing workers and taskshifting, not on training new health workers. Second, AIDS external funders have swamped countries with in-service training programmes for HIV/AIDS-specific skills. Third, PEPFAR and the Global Fund have relied on task-shifting to lower level health workers without assuring adequate resources or support. Fourth, community health workers are employed as a quick fix without considering their long -term role. Fifth, the incentives that AIDS external funders offer health workers to achieve HIV and AIDS programme targets distort allocations of time and resources to the detriment of other health sector objectives. Finally, AIDS external funders pay health workers through short-term special arrangements without addressing long-term constraints on the public and private health workforce.

Zim doctors on strike

Medical consultants and specialists at all public hospitals throughout Zimbabwe are on an indefinite strike over low salaries and poor working conditions, plunging an already ailing heath sector into deeper crisis. The senior doctors went on strike on Sunday following an ultimatum they issued to the government to address their grievances by last Saturday.

Zim Health Scheme for All Workers On the Cards

THE government, workers and employers have entered into negotiations that could result in the launch of a medical aid scheme to provide health cover for Zimbabwean workers, according to National Social Security Authority (NSSA) general manager Amod Takawira. He said NSSA, the government's main investment arm, was involved in the negotiations but would not indicate how long the consultations had been going on. "The national health insurance scheme is being finalised by the relevant stakeholders and will benefit all employees who meet the required conditions," Takawira told the Financial Gazette.

Zimbabwe: 30 Percent of Teachers HIV-Positive

AT least 30 percent of all school teachers countrywide are HIV-positive, according to Mr Saul Murimba of the Southern Africa Consortium for Monitoring Educational Quality. He told participants at a two-day workshop on management of HIV/Aids at the education district level that the teachers would eventually succumb to the pandemic.

Zimbabwe: Health Services Crippled As Doctors, Nurses Strike

A strike by government doctors and nurses crippled state hospital services in the country's main cities on Wednesday, AP reported. Quoting the Hospital Doctors Association, the agency said about 350 doctors stopped work on Tuesday in the cities of Harare, the capital, and Bulawayo, the second city, demanding better salaries and allowances.

Zimbabwe: Nurses Under Pressure

Stella Zengwa, President of Zimbabwe Nurses Association.
Zimbabwean nurses face difficult decisions in their day-to-day work. Health Services are now client centred and are being provided by a workforce, which is performance driven. A shortage of nurses means that at present all our new nurse graduates are bonded for 3 years, but experienced nurses continue to be lost to neighbouring countries and abroad. Hospital wards are still run with only one or two nurse per shift for a 40-bedded ward with the result that nurses continue to be overworked. Lack of transport has become a critical issue and poses a risk to nurses’ lives when arriving or knocking off duty given the shift work. Lack of accommodation at institutions is making retention of nurses very difficult since in some areas, rented accommodation is not available. Nurses have been pushed out of the traditional nurse’s residences. Inadequate and erratic supplies of drugs, surgical sundries and equipment including protective clothing like gloves are exposing nurses to HIV infection. Burnout syndrome is widespread with nurses overwhelmed with the stress of nursing a full ward of very ill patients with so little support. Unlike other health workers who are visitors to the ward, nurses spend long hours with patients. This requires ways of dealing with burnout so that nurses continue to provide quality health care services.Upholding of nursing ethics is critical building a positive image as desired by the communities that we serve. As a professional association, ZINA aspires to ensure that the services nurses provide in support of public protection and health care are exemplary and community driven.

Further details: /newsletter/id/29251
Zimbabwe: Unemployment Rate to Reach 70%

Zimbabwe's unemployment rate is set to reach an unprecedented 70% in 2002 due to company closures, labour economists said this week. The economic analysts said that it was imminent that failure by the economic stakeholders labour, business and government in creating opportunities to stimulate industrial expansion would lead to increases in unemployment.

Zimbabwe’s unsung heroes
British Medical Journal, editorial, 13 August 2008

From 29 March 2008, when Zimbabweans voted in the presidential and parliamentary elections, to 27 June when the presidential run-off election was held, Zimbabwe was hit by successive waves of gruesome political violence. The greatest intensity was in the rural provinces of east and central Mashonaland, but, as 27 June approached, violence engulfed urban areas and the numbers of victims of political violence increased. The world’s attention was on the political nature of the violence, and little focus was given to medical professionals, who risked their lives to assist the victims of political violence. The latest political violence occurred when Zimbabwe was already in dire economic difficulties that had adversely affected the health sector.

‘Conditional scholarships’ for HIV/AIDS health workers: Educating and retaining the workforce to provide antiretroviral treatment in sub-Saharan Africa
Bärnighausen T and Bloom DE: Social Sciences Medicine: 68(3):544-51, February 2009

Researchers conducted a cost-benefit analysis of a health care education scholarship that is conditional on the recipient committing to work for several years after graduation delivering ART in sub-Saharan Africa. Such a scholarship could address two of the main reasons for the low numbers of health workers in sub-Saharan Africa: low education rates and high emigration rates. Conditional scholarships for a HAHW team sufficient to provide ART for 500 patients have an expected net present value (eNPV) of US$1.24 million per year. The eNPV of the education effect of the scholarships is larger than eNPV of the migration effect. Policy makers should consider implementing ‘conditional scholarships’ for HAHW, especially in countries where health worker education capacity is currently underutilised or needs to be rapidly expanded.

‘I am treated well if I adhere to my HIV medication’: putting patient–provider interactions in context through insights from qualitative research in five sub-Saharan African countries
Ondenge K; Renju J; Bonnington O; et al.: Jo Sexually Transmitted Infections 93 (Issue Supplement 3), doi: http://dx.doi.org/10.1136/sextrans-2016-052973, 2017

The nature of patient–provider interactions and communication is widely documented to significantly impact on patient experiences, treatment adherence and health outcomes. Yet little is known about the broader contextual factors and dynamics that shape patient–provider interactions in high HIV prevalence and limited-resource settings. Drawing on qualitative research from five sub-Saharan African countries, the authors seek to unpack local dynamics that serve to hinder or facilitate productive patient–provider interactions. This qualitative study, conducted in Kisumu (Kenya), Kisesa (Tanzania), Manicaland (Zimbabwe), Karonga (Malawi) and uMkhanyakude (South Africa), draws upon 278 in-depth interviews with purposively sampled people living with HIV with different diagnosis and treatment histories, 29 family members of people who died due to HIV and 38 HIV healthcare workers. Data were collected using topic guides that explored patient testing and antiretroviral therapy treatment journeys. The authors analysis revealed an array of inter-related contextual factors and power dynamics shaping patient–provider interactions. These included participants’ perceptions of roles and identities of ‘self’ and ‘other’; conformity or resistance to the ‘rules of HIV service engagement’ and a ‘patient-persona’; the influence of significant others’ views on service provision; and resources in health services. They observed that these four factors/dynamics were located in the wider context of conceptualisations of power, autonomy and structure. They argue that patient–provider interaction is complex, multidimensional and deeply embedded in wider social dynamics, and that interventions to improve patient experiences and treatment adherence through enhanced interactions need to go beyond the existing focus on patient–provider communication strategies.

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