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.
Human Resources
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.
The WHO Secretariat held a global, web-based public hearing between 1 September and 3 October 2008 to obtain inputs on the first draft of the WHO code of practice from as wide a group of stakeholders as possible. Member States, national institutions, health professional organisations, nongovernmental organisations, academic institutions, international organisations and other stakeholders submitted more than 90 contributions to the public hearings. Some expressed the view that Article 4 should be revised to provide greater emphasis on the legal responsibilities of health personnel to source and destination countries, such as those to protect the public health interest. Others felt that Article 4 should recommend that states prohibit all active recruitment of health personnel from countries experiencing a health workforce crisis.
Ugandan radiography, medical, nursing, dentistry and pharmacy students are sent to community health facilities where they are expected to participate in community services and other primary healthcare activities for training (COBES). This study was designed to obtain the opinions of radiography teachers and students of the significance and relevance of this community-based training to radiography training. Both students and teachers (91.4%) affirmed the community training to be significant and relevant to radiography training. In total, 71.4% of the students had participated in X-ray services and 39.2% in ultrasound services during COBES; and 68.6% of the students reported the need to be better prepared for the COBES training. They confirmed community-based training to be relevant to Ugandan radiography training.
This study systematically reviewed and consolidated existing evidence of the impact of financial and non-financial incentives on the motivation and retention of health workers. Four literature databases were searched, as well as grey literature studies and informational papers. Twenty qualitative and quantitative studies were selected. There was some evidence to suggest that the use of initiatives to improve motivation had been effective in helping retention. While motivational factors are undoubtedly country specific, financial incentives, career development and management issues are core factors. Nevertheless, financial incentives alone are not enough to motivate health workers. Workplace recognition and adequate resources and infrastructure can also improve morale significantly.
The main objective of this study was to evaluate acceptability and feasibility of reinforcing the role of traditional birth attendants (TBAs) in family and child health services through their participation in prevention of mother-to-child transmission (PMTCT) programmes in Zimbabwe. A community based cross-sectional survey was undertaken in two rural districts through interviews and focus group discussions among women who delivered at home with a TBA and who had an institutional delivery and TBAs. More than 85% of women agreed that TBAs could participate in all activities related to a PMTCT programme with the exception of performing a blood test for HIV. There is a need to reinforce the knowledge of TBAs on MTCT prevention measures and better integrate them into the health system.
Underlining the Alliance vision that 'All people everywhere will have access to a skilled, motivated and supported health worker, within a robust health system', the strategic directions and priorities 2009-2011 confirmed the two main objectives within which the Alliance operates: to enable country leadership in national planning and management to improve the human resources for health (HRH) situation and respond to shortages of skilled and motivated health workers; and to address global policy challenges through evidence-informed actions to tackle trans-national problems in areas such as insufficient and inefficient use of resources, fiscal restraints on health sector spending, migration, priority research and cooperation among all stakeholders.
On 2 December, the first meeting of the enlarged Health Cluster was held at the WHO office in Harare. Afterwards, a working group met with the Ministry of Health and Child Welfare (MoHCW) to work out details of a plan to disburse a £500,000 grant from the UK Department for Development Funding DFID to attract health workers back to their posts. This money could be used to kick-start the planned incentive scheme for health workers to be launched in January 2009. Immediate aims include ensuring effective coordination among all health partners providing cholera-related interventions; increasing capacity to provide more clean drinking water in health facilities; strengthening disease reporting, monitoring and assessment under WHO leadership; and procuring more supplies. This will be followed by longer-term support for the health sector’s revitalisation.