Human Resources

Improve our conditions to attract the young - Midwives
Daily Graphic, 15 November 2007

Speakers at a two-day international conference in Africa on midwifery have called for more incentives to attract young people into the midwifery profession. They said the midwives of today were fast ageing and that unless immediate measures were put in place to attract more young ones into the profession, the fight for the reduction in maternal and infant mortality and morbidity would be a mirage. The speakers made the call at a two-day international conference of midwives on the theme, "African Midwives: Uniting to address the reduction of maternal and infant mortality and morbidity".

'I believe that the staff have reduced their closeness to patients': An exploratory study on the impact of HIV/AIDS on staff in four rural hospitals in Uganda
Dieleman N, Bwete V, Maniple E, Bakker M, Namaganda G, Odaga J and van der Wilt GJ: BMC Health Services Research 7(205), 18 December 2007

Staff shortages could harm the provision and quality of health care in Uganda, so staff retention and motivation are crucial. Understanding the impact of HIV/AIDS on staff contributes to designing appropriate retention and motivation strategies. This research aimed 'to identify the influence of HIV/AIDS on staff working in general hospitals at district level in rural areas and to explore support required and offered to deal with HIV/AIDS in the workplace'. Its results were to inform strategies to mitigate the impact of HIV on hospital staff. Organisational responses should be integrated into responses to other problematic working conditions and adapted to the local context. Opportunities already exist, such as better use of supervision, educational sessions and staff meetings. However, exchanges on interventions to improve staff motivation and address HIV in the health sector are urgently required, including information on results and details of the context and implementation process.

Health supply chain personnel: An integral part of the health workforce
Cometto G, Babar Z, Brown A, Hedman L, Campbell J: Journal of Pharmaceutical Policy and Practice 7 (Suppl 1), DOI:10.7196/samj.9301, 2014

Approximately a third of the world population – and about half in the most underdeveloped settings – have been estimated to lack access to essential medicines and diagnostics. Effective supply chains are vital to deliver essential health commodities. In high-income countries the availability of medicines in the public and private sector is taken as a given: quality assurance is managed by robust national regulatory agencies; supply and distribution are increasingly privatised, with performance measured against timeliness and cost. Conversely, in many low- and middle-income countries, stock-outs of essential commodities are commonplace, with a mean availability of core medicines in the public sector ranging from 38.2% in sub-Saharan Africa to 57.7 % in Latin America and the Caribbean. Vulnerability of supply chain functions also increases the potential for the entry of counterfeit and substandard products.

New data on African health professionals abroad
Center for Global Development Working Paper 95, 8 November 2006

The migration of doctors and nurses from Africa to developed countries has raised fears of an African medical brain drain. But empirical research on the causes and effects of the phenomenon has been hampered by a lack of systematic data on the extent of African health workers’ international movements. We use destination-country census data to estimate the number of African-born doctors and professional nurses working abroad in a developed country circa 2000, and compare this to the stocks of these workers in each country of origin. Approximately 65,000 African-born physicians and 70,000 African-born professional nurses were working overseas in a developed country in the year 2000. This represents about one fifth of African-born physicians in the world, and about one tenth of African-born professional nurses. The fraction of health professionals abroad varies enormously across African countries, from 1% to over 70% according to the occupation and country. These numbers are the first standardized, systematic, occupation-specific measure of skilled professionals working in developed countries and born in a large number of developing countries.

Understaffing hampers hospital operations

Botswana: The departure of Cuban volunteer doctors and a shortage of health personnel have seriously affected operations at Maun General Hospital. Patients now wait long hours in queues at the hospital and the situation has been made worse by a faulty computer network and an overburdened laboratory, North West District Council (NWDC) chairman John Benn has said.

'Danger pay’ for TB staff?
Cullinan K: Health-e News, 23 March 2010

Durban health workers who treat patients with drug-resistant TB are noted to face increase risk of drug resistant TB. According to Dr Iqbal Master, head of clinical services at King George V Hospital in Durban, the province’s specialist hospital for drug-resistant TB, they should be given special incentives to recognise this. King George V Hospital has been trying to get itself declared 'inhospitable', which would mean that staff would get additional incentives for this. Workers at the facility are reported to be six times more likely to get drug-resistant TB than ordinary members of the public. In the last decade, 14 staff members are reported to have died of the TB and one staff member was being treated for drug-resistant (XDR) TB.

'Going private': a qualitative comparison of medical specialists' job satisfaction in the public and private sectors of South Africa
Ashmore J: Human Resources for Health 11(1), 3 January 2013

In this paper, the author elaborates what South African medical specialists find satisfying about working in the public and private sectors, at present, and how to better incentivise retention in the public sector. He conducted 74 qualitative interviews among specialists and key informants in one public and one private urban hospital in South Africa. All qualitative specialist respondents were engaged in dual practice, generally working in both public and private sectors. Results demonstrate that although there are strong financial incentives for specialists to migrate from the public to the private sector, public work provides more of a team environment, more academic opportunities, and greater opportunities to feel 'needed' and 'relevant'. However, public specialists suffer under poor resource availability, lack of trust for the Department of Health, and poor perceived career opportunities. These non-financial issues of public sector dissatisfaction appeared just as important, if not more important, than wage disparities. Policy recommendations centre around boosting public sector resources and building trust of the public sector through including health workers more in decision-making, inter alia. These interventions may be more cost-effective for retention than wage increases, and imply that it is not necessarily just a matter of putting more money into the public sector to increase retention.

** Confronting challenges in health personnel
Abstract of paper presented at the Equinet conference, Durban, 8-9 June 2004, by Antoinette Ntuli, Health Systems Trust, EQUINET theme co-ordinator

The biggest and most important component of any health system is its human resources (HR). The effective, equitable and appropriate production, training and deployment of health workers has been associated with periods of high health gain in southern Africa. Despite this, many health systems in southern Africa now face a variety of HR problems and personnel scarcities have become a critical limiting factor in health interventions. Health worker migration is further compounding inequities and stresses. Responding to economic and social triggers, personnel flow from rural to urban areas, from public to private sectors, from lower to higher income countries within southern Africa and from African countries to industrialized countries, exacerbating inequities and providing a reverse (poor to rich) subsidy. However a new policy momentum exists in relation to human resources for health.

Further details: /newsletter/id/30455
110 Cuban doctors expected in Zimbabwe

At least 110 Cuban doctors are expected to arrive in the country at the end of this month under the Zimbabwe-Cuba Joint Commission. Head of the Cuban Medical Brigade in Zimbabwe Dr Felipe Delgado Bustillo said the doctors would serve in the country for two years. "The doctors will be working under the comprehensive health programme launched by President Fidel Castro in 1998, which is aimed at providing something like a donation to other people specially those in Africa in solving various health related problems," said Dr Bustillo.

3rd Board Meeting of the African Platform on Human Resources for Health (APHRH)
APHRH: Kampala, Uganda, 2016

The Board of the APHRH met on the 30th Nov 2016 in Kampala to discuss key issues that concerning the Health Workforce in Africa. A resolution was made to convene a regional consultation meeting of key stakeholders and networks to develop a consensus on ways to accelerate advocacy for a strengthened health workforce in Africa. The Board made a number of decisions to initiate acceleration of the work of the platform at all levels and enhance lobby and advocate for the prioritization of the Health Workforce agenda in Africa, outlined in this document, including: to request the WHO Regional Director for Africa to urgently consider an enhanced technical support program to African countries to strengthen country level health workforce development and management departments, especially at the ministries of health headquarters of member states; to support African Member states in translating for action key regional and global policies including the African Health Strategy, the Global Health Workforce Strategy and Sustainable Development Goals (SDGs) and to fast track the strengthening of Health Workforce information systems of countries to manage workforce inflows, stock and outflow by implementation of the WHO code on International Recruitment and track progress of strengthening through improved reporting on the code at the 3rd round due in 2018.