This is a series of facility-based surveys using a common approach in six countries, including Mozambique and Zimbabwe. The objectives were twofold: to inform the development and monitoring of human resources for health (HRH) policy within the countries; and to test and validate the use of standardised facility-based human resources assessment tools across different contexts. The findings revealed that, with increasing experience in health facility assessments for HRH monitoring comes greater need to establish and promote best practices regarding methods and tools for their implementation, as well as dissemination and use of the results for evidence-informed decision-making. The overall findings of multi-country facility-based survey should help countries and partners develop greater capacity to identify and measure indicators of HRH performance via this approach, and eventually contribute to better understanding of health workforce dynamics at the national and international levels.
Human Resources
Heads and implementing workers of fifty HIV and AIDS programs and institutions accredited to offer antiretroviral services in Uganda, Kenya, Tanzania and Rwanda were key informants in face-to- face interviews guided by structured questionnaires. Inadequate human resource capacity including, inability to select, quantify and distribute ARVs and related commodities, and irrational prescribing and dispensing were some of the problems identified. A competence gap existed in all the four countries with a variety of healthcare professionals involved in the supply and distribution of ARVs. There is inadequate capacity for managing medicines and related commodities in East Africa. There is an urgent need for training in aspects of pharmaceutical management to different categories of health workers. Skills building activities that do not take healthcare workers from their places of work are preferred.
Human resources for health (HRH) is a critical component of health systems Many governments of our member states have expressed the need to determine the status HRH in relation to supply, utilization and management systems. The DJCC meeting of July 2003 recommended the establishment of the Human Resources for Health Technical Advisory Group to oversee the implementation ofthe many recommendations and the resolutions of health ministers at their 38thRegional Health Minister’s Conference of November 2003, all aimed at addressing the HRH Crisis in ECSA. To address this resolution, ECSA Health Community has conducted a series ofrelated studies addressing the issue of HRH in the region. Three studies have been on the impact of HIV/AIDS on the health workforce and this study focused on establishing the situation of HRH in the region. The findings of this study will assist not only in identifying further areas of research in relation to HRH but aid in developing both regional and national level strategies on training, deployment and retention.
Worldwide mobility of health professionals is a growing phenomenon, impacting the health systems of receiving, transit, and sending countries, so the need to develop European policies to adequately address these issues is urgent. At the same time, reliable and differentiated knowledge and findings as a basis for such policy are lacking. MoHProf will contribute to improving this knowledge base and facilitate European policy on human resource planning. The general objective of the project is to research current trends of mobility of health professionals to, from and within the EU. The project comprises four phases over a three-year period starting from November 2008. There will be four project meetings, starting with a kick-off meeting and project launch and concluding with an international conference, and roundtables as appropriate.
In Malawi, mid-level cadres of health workers provide the bulk of emergency obstetric and neonatal care. These cadres undertake roles and tasks that are more usually the province of internationally recognised cadres, such as doctors and nurses. While several studies address retention factors for doctors and registered nurses, data and studies addressing the perceptions of these mid-level cadres on the factors that influence their performance and retention within health care systems are scarce. This exploratory qualitative study undertook focus group discussions and semi-structured interviews at in four rural mission hospitals in Malawi among mid-level providers of emergency obstetric and neonatal care. Participants confirmed the difficulties of their working conditions and the clear commitment they have to serving the rural Malawian population. Although insufficient financial remuneration had a negative impact on retention and performance, the main factors identified were limited opportunities for career development and further education (particularly for clinical officers) and inadequate or non-existent human resources management systems. The lack of performance-related rewards and recognition were perceived to be particularly demotivating. For optimal performance and quality of care mid-level cadres need to be supported and properly motivated. A structured system of continuing professional development and functioning human resources management would show commitment to these cadres and support them as professionals. Action needs to be taken to prevent staff members from leaving the health sector for less stressful, more financially rewarding alternatives.
South Africa is failing to produce more nurses to deal with its health demands, according to the Democratic Nursing Organisation of South Africa (Denosa). The closure of some nursing colleges by the government, citing 'funding' as a reason, did not assist in the production of nurses, it reported. Denosa called on government to re-open the training colleges that were closed, to accommodate those who were interested in pursuing this career. The union said one of the contributing factors to the shortage was that school-leavers lacked interest in becoming nurses because of the unsavoury working environments that nurses face daily. Poor salaries also drive nurses away from the profession and the country. Denosa called on the state to improve health services nationwide.
The aim of this paper is to give an overview of the development process of a computer-based job task analysis instrument for real-time observations to quantify the job tasks performed by physicians working in different medical settings. First, lists comprising tasks performed by physicians in different care settings were classified. Then, content validity of task lists was proved. After establishing the final task categories, computer software was programmed and implemented in a mobile personal computer. Finally, inter-observer reliability was evaluated. Content validity of the task lists was confirmed by observations and experienced specialists of each medical area. Development process of the job task analysis instrument was completed successfully. Simultaneous records showed adequate interrater reliability. Based on results using this method, possible improvements for health professionals' work organisation can be identified.
Drawing on IntraHealth International's lessons learned in designing reproductive health and HIV/AIDS training and performance improvement programmes, this commentary discusses promising practices for strengthening human resources for health through more efficient and effective training and learning programmes that avoid the same old traps. These promising practices include the following: assessing performance gaps and opportunities before designing a training initiative; addressing performance factors other than skills and knowledge that health workers need to perform well; applying a ‘learning for performance’ approach; standardising curricula throughout a country; linking pre-service education, in-service training and professional associations; enhancing traditional education; strengthening human resources information systems to improve workforce planning, policies and management; and applying technology to meet training needs.
This study aimed to determine the prevalence and associated factors of psychological distress among attendees of traditional healing practices in two districts in Uganda. Face-to-face interviews with the Lusoga version of the self-reporting questionnaire (SRQ-20) were carried out with 400 patients over the age of 18 years attending traditional healing in Iganga and Jinja districts in Eastern Uganda. Three hundred and eighty-seven questionnaire responses were analysed. The study found that a substantial proportion of attendees (61%) of traditional healing practices suffered from psychological distress. Among the socioeconomic indicators, lack of food and having debts were significantly associated with psychological distress. These findings may be useful for policy makers and biomedical health workers for engagement with traditional healers.
In this article, the authors describe health care workers (HCWs') experiences and perceptions of meeting clients exposed to intimate partner violence. Qualitative content analysis of in-depth interviews from 16 informants resulted in four main themes. The first, Internalising women's suffering and powerlessness’, describes HCWs' perceptions of violence, relating it to gender relations. The second, ’Caught between encouraging disclosure and lack of support tools, refers to views on possibilities for transparency and openness. The third, ’Why bother? A struggle to manage with limited resources’, illustrates the consequences of a heavy workload. Last, ‘Striving to make a difference’, emphasises a desire to improve abilities to support clients and advocate for prevention.