Human Resources

Designing financial-incentive programmes for return of medical service in underserved areas: Seven management functions
Bärnighausen T and Bloom DE: Human Resources for Health, 26 June 2009

This paper draws on studies of financial incentive programmes and other initiatives with similar objectives to discuss seven management functions that are essential for the long-term success of financial incentive programmes aimed at retaining staff in underserved areas: using innovative financing; promoting health as a career; introducing specific selection criteria to ensure programme success and achieve goals; ensuring correct placement of new employees; offering support by staying in close contact with participants throughout enrolment and assigning them mentors; enforcement (programmes may use community-based monitoring or outsource enforcement to existing institutions); and routine performance evaluation of programmes. To improve the strength of the evidence on the effectiveness of financial incentives, controlled experiments should be conducted where feasible.

Determining the competences of community based workers for disability-inclusive development in rural areas of South Africa, Botswana and Malawi
Lorenzo T; van Pletzen E; Booyens M: The International Electronic Journal of Rural and Remote Health Research, Education, Practice and Policy 15(2), 2015

This article analyses the work of community disability workers (CDWs) in three southern African countries to demonstrate the competencies that these workers acquired to make a contribution to social justice for persons with disabilities and their families. It points to some gaps and then argues that these competencies should be consolidated and strengthened in curricula, training and policy. Purposive sampling was used to select and interviews held with 16 CDWs who had at least 5 years experience of disability-related work in a rural area. Three main themes emerged, related to the integrated management of health conditions and impairments within a family focus; disability-inclusive community development and coordinated intersectoral management systems. The CDWs were found to facilitate change and manage the multiple transitions experienced by the families at different stages of the disabled person’s development. Disability-inclusive development is argued to require a workforce equipped with skills to work intersectorally and in a cross-disciplinary manner to operationalise the community-based rehabilitation guidelines that are designed to promote delivery of services in remote and rural areas. The author argues for their recognition as a CDWs as a cross-disciplinary profession.

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.

Developing and scaling up African led solutions to the human resources crisis
Hall S: African Medical and Research Foundation , 2007

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.

Developing evidence-based ethical policies on the migration of health workers
Human Resources for Health 2003

It is estimated that in 2000 almost 175 million people, or 2.9% of the world's population, were living outside their country of birth, compared to 100 million, or 1.8% of the total population, in 1995. As the global labour market strengthens, it is increasingly highly skilled professionals who are migrating. Medical practitioners and nurses represent a small proportion of highly skilled workers who migrate, but the loss of health human resources for developing countries can mean that the capacity of the health system to deliver health care equitably is compromised.

Developing evidence-based ethical policies on the migration of health workers: conceptual and practical challenges
Human Resources for Health 2003

It is estimated that in 2000 almost 175 million people, or 2.9% of the world's population, were living outside their country of birth, compared to 100 million, or 1.8% of the total population, in 1995. As the global labour market strengthens, it is increasingly highly skilled professionals who are migrating. Medical practitioners and nurses represent a small proportion of highly skilled workers who migrate, but the loss of health human resources for developing countries can mean that the capacity of the health system to deliver health care equitably is compromised.

Developing health economics capacity in Africa: Evaluation of HEU’s teaching programmes
Health Economics Unit, University of Cape Town: HEU Policy Brief, May 2012

The objective of this study was to assess the extent to which the Health Economics Unit (HEU) has contributed to the development of health economics capacity in sub-Saharan Africa through the provision of Master’s and PhD programmes since the 1990s. The evaluation was based on a document review and 25 key informant interviews – with Master’s and PhD graduates, HEU staff members with management roles, beneficiaries of HEU’s internal capacity-building initiatives and international experts. The programmes have so far graduated 115 Master’s and 15 PhD graduates in health economics. Feedback from graduates indicated they are largely satisfied with the programmes. Most graduates are retained in the region if not in their home countries and find employment in a post that uses at least some of the skills gained during the programme, although not necessarily strictly in health economics. In terms of overall financial sustainability of HEU’s post-graduate programmes, SIDA funding has come to an end, which means there is a need to pursue financial support from the University in line with the usual funding of post-graduate training. The policy brief also makes some recommendations for improving future programmes.

Developing lay health worker policy in South Africa: A qualitative study
Daniels K, Clarke M and Ringsberg KC: Health Research Policy and Systems 10(8), 12 March 2012

Over the past half decade South Africa has been developing, implementing and redeveloping its lay health worker (LHW) policies. The aim of this study was to explore contemporary LHW policy development processes and the extent to which issues of gender are taken up within this process. Eleven policy actors (policy makers and policy commentators) were interviewed individually. From the interviews it seems that gender as an issue never reached the policy making agenda. Although there was strong recognition that the working conditions of LHWs needed to be improved, poor working conditions were not necessarily seen as a gender concern. On the positive side, the authors note that LHW policy redevelopment was focused on resolving issues of LHW working conditions through an active process involving many actors and strong debates. But, within this process the issue of gender had no champion and never reached the LHW policy agenda.

developing workplace policies that address HIV and AIDS

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

Development and evaluation of a computer-based medical work assessment programme
Mache S, Scutaru C, Vitzthum K, Gerber A, Quarcoo D, Welte T, Bauer TT, Spallek M, Seidler A, Nienhaus A, Klapp BF and Groneberg DA: Journal of Occupational Medicine and Toxicology, 18 December 2008

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.

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