This briefing paper explores different ways of addressing the health worker crisis in Africa. It addresses problems of poor training, motivation and retention of health workers, the lack of skilled health workers in remote and hard to reach areas, and poor community engagement with health systems. The authors argue that to tackle the immediate health worker crisis it is important to find models which can quickly deploy and retain workers and ensure they get appropriate training and support. Responses need to expand the cadres of workers with basic clinical and community health competencies, such as enrolled nurses, clinical officers and community health workers.
Human Resources
Developing and scaling up African led solutions to the human resources crisis
Hall S: African Medical and Research Foundation , 2007
Literature review on gender issues amongst health care workers
George A: Women and Gender Equity Knowledge Network, 2007
This paper discusses gender issues manifested within health occupations and across them. It examines gender dynamics in medicine, nursing, community health workers and home carers and explores from a gender perspective issues concerning delegation, migration and violence, which cut across these categories of health workers. Gender plays a critical role in determining the structural location of women and men in the health labour force and their subjective experience of that location. The paper shows that woman are overrepresented in caring, informal, part-time, unskilled and unpaid work and within occupations there are significant gender differences in terms of employment security, promotion, remuneration.
Maternal health workforce crisis
Mridha MK and Koblinsky M: ID21 Health News, August 2007
Providing maternal care requires a viable and effective health workforce. In many countries, and certainly in all countries where maternal mortality is high, the size, skills and infrastructure of the workforce is inadequate. The most visible features of the maternal health workforce crisis are the staggering shortages and imbalances in the distribution of health workers. With insufficient production, downsizing and caps on recruitment under structural adjustment and with frozen salaries and losses to the private sector, migration and HIV and AIDS, filling the supply gap will remain a major challenge for years to come.
Modelling synergy and partnership to tackle regional health issues
ECSACON, 9 August 2007
The East, central and Southern African Health Community College of Nursing (ECSACON) has released a report documenting how health professionals can take the initiative to come together to address regional issues of concern. Documenting the process of developing the ECSACON model also demonstrates how acting together in synergy and partnership can expand the impact of similar networks.
New Law to Stem Worrying Brain Drain
Gaomas S: New Era, 1 August 2007
The Namibian Minister of Health and Social Services, Dr Richard Kamwi, will urgently seek Cabinet approval of an agreement that would oblige doctors at State hospitals to be contracted for a stipulated period of time before going solo. The move is intended to stem the current tide where public sector doctors take advantage of existing loopholes tp migrate out or set up private medical practices while working for the State.
HIV and infant feeding counselling: challenges faced by nurse-counsellors in northern Tanzania
Leshabari SC, Blystad A, de Paoli M, Moland KM: Human Resources for Health 5:18, 24 July 2007
Infant feeding is a subject of worry in prevention of mother to child transmission (PMTCT) programmes in settings where breastfeeding is normative. Nurse-counsellors, expected to counsel HIV-positive women on safer infant feeding methods as defined in national/international guidelines, are faced with a number of challenges. This study aims to explore the experiences and situated concerns of nurses working as infant feeding counsellors to HIV-positive mothers enrolled in PMTCT programmes in the Kilimanjaro region, northern Tanzania.
Is it worth it for Tanzania to invest in community midwives?
White Ribbon Alliance for Safe Motherhood , August 2006
This report by the White Ribbon Alliance for Safe Motherhood in Tanzania, summarises the key points discussed at a forum exploring the issues impacting on the maternal health crisis in Tanzania. Specifically, the forum looked at the current role and feasibility of promoting the use of community midwives to provide support and guidance for women through all stages of pregnancy, to coordinate services between the facility and community, and to manage the basic health of a community.
The contribution of international health volunteers to the health workforce in sub-Saharan Africa
Laleman G, Kegels G, Marchal B, Van der Roost D, Bogaert I, Van Damme W: Human Resources for Health 5:19, 31 July 2007
This paper aims to quantify the contribution of international health volunteers (IHVs) to the health workforce in sub-Saharan Africa and to explore the perceptions of health service managers regarding these volunteers. The paper found that international health volunteers contribute relatively small numbers to the health workforce in sub-Saharan Africa, and it seems unlikely that they will do more in the future. In areas where they play a role, their contribution to service delivery can be significant.
Developing a Nursing Database System in Kenya
Riley PL, Vindigni SM, Arudo J, Waudo AN, Kamenju A, Ngoya J, Oywer EO, Rakuom CP, Salmon ME, Kelley M, Rogers M, St. Louis ME, Marum LH: Health Services Research 42 (3): 1389-1405, June 2007
Creating a national electronic nursing workforce database provides more reliable information on nurse demographics, migration patterns, and workforce capacity. Data analyses are most useful for human resources for health (HRH) planning when workforce capacity data can be linked to worksite staffing requirements. As a result of establishing this database, the Kenya Ministry of Health has improved capability to assess its nursing workforce and document important workforce trends, such as out-migration. Current data identify the United States as the leading recipient country of Kenyan nurses. The overwhelming majority of Kenyan nurses who elect to out-migrate are among Kenya's most qualified.
Health sector reforms and human resources for health in Uganda and Bangladesh: mechanisms of effect
Ssengooba F, Rahman SA, Hongoro C, Rutebemberwa E, Mustafa A, Kielmann T, McPake B: Human Resources for Health 5:3, 1 February 2007
Despite the expanding literature on how reforms may affect health workers and which reactions they may provoke, little research has been conducted on the mechanisms of effect through which health sector reforms either promote or discourage health worker performance. This paper seeks to trace these mechanisms and examines the contextual framework of reform objectives in Uganda and Bangladesh, and health workers' responses to the changes in their working environments by taking a 'realistic evaluation' approach.