This paper reviews the challenges facing the public health workforce in developing countries and the main policy issues that need to be addressed in order to strengthen the public health workforce. The public health workforce is diverse and includes all those whose prime responsibility is the provision of core public health activities, irrespective of their organizational base. Although the public health workforce is central to the performance of health systems, very little is known about the composition, training or performance of the workforce. The key policy question is: Should governments invest more in building and supporting the public health workforce and infrastructure to ensure the more effective functioning of health systems?
Human Resources
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, published in the journal Human Resources for Health, 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. It concludes that evidence-based information is needed to better understand trends in HRH. Although a range of sources exist that can potentially be used for HRH assessment, the information that can be derived from many of these individual sources precludes refined analysis. A variety of data sources and analytical approaches, each with its own strengths and limitations, is required to reflect the complexity of HRH issues.
About 3% of the South African workforce - or about 500 000 people -could have full-blown Aids by 2010, Department of Labour guidelines on HIV/Aids have forecast, reports the Mail and Guardian newspaper. The projected rate of 2,9% in the terminal stage of the illness represents a three-fold increase since 2001, when it stood at 0,93%. Statistics South Africa estimates the current economically active population at 16,5-million, including a million in the informal sector.
One in three countries in Africa and South East Asia has only one medical school for every 10 million people or more, a rate poorer than anywhere in Europe or the Americas, says a new report by researchers from the World Health Organisation. Nine out of 10 countries in the same two regions have fewer than 50 doctors per 100000 inhabitants, and about half of the countries have a similar density of nurses and midwives. The report outlines a series of major new WHO initiatives, which aim to provide better information to allow more meaningful international comparisons. "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," say the authors, from WHO's department of health service provision. "In many countries there is no regular recording of the numbers and activities of all health personnel, and some emphasize only the public sector or can have variable accuracy for rural areas."
SAfAIDS offers technical assistance to institutions, the private sector and NGOs in the southern Africa region in developing workplace policies that address HIV and AIDS. To date they have worked with several organisations on this using participatory methods that help to create staff ownership of their policy. These policies can assist in preventing new infections, mitigating the impact of AIDS and giving guidelines on how to manage HIV in the world of work. One of the key lessons learnt is that there is a general reluctance to disclose HIV status by employees for fear of victimisation, making it difficult for them to get support from their employers. Stigma and discrimination are still prevalent in the world of work both in the formal and informal sectors. To support their current work and also to disseminate information in the area of policy development they have written a brochure on " Steps in developing a workplace policy that addresses HIV/AIDS." The brochure is currently available in hard copy but SAfAIDS are planning to post it on our website soon (www.safaids.org.zw). To be included on the mailing list for this particular brochure please contact info@safaids.org.zw
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. Major variations in the supply of health personnel and training opportunities are found to occur by region. However, certain discrepancies are also observed in measuring the same indicator from different sources, possibly related to the occupational classification or to the sources’ representation.
Conservative estimates by Wilma Meeus and David Sanders at the University of the Western Cape’s School of Public Health show that the United States has saved at least U$3,86-million(R30,9 million) in training fees by employing doctors from Nigeria, which has lost 21 000 doctors to the superpower.
While Malawi's health sector is already hurt by shortages of drugs due to a constrained government budget, and a rising death toll because of HIV/AIDS, an exodus of medical personnel to richer western nations is threatening to cripple the already ailing sector.
As the economic burden of HIV/AIDS increases in sub-Saharan Africa, allocation of the burden among levels and sectors of society is changing. The private sector has more scope to avoid the economic burden of AIDS than governments, households, or nongovernmental organisations, and the burden is being systematically shifted away from the private sector. Common practices that transfer the burden to households and government include: Pre-employment screening; Reductions in employee benefits; Restructured employment contracts; Outsourcing of low skilled jobs; Selective retrenchments; and Changes in production technologies. This paper was produced by the Department of International Health at Boston School of Public Health.
This paper from the Department of International Health at Boston School of Public Health is to summarizes what is known about the internal costs of HIV/AIDS, such as increasing absenteeism, higher pension payouts, and breakdowns in worker discipline and morale, to companies in Commonwealth countries in sub-Saharan Africa. The authors identify a dozen different types of workforce costs that HIV/AIDS will impose on African companies in the coming years. After briefly reviewing existing estimates of the costs of HIV/AIDS to business, they present a model for assessing these costs and describe some of the strategies companies are adopting to reduce the costs.