Human Resources

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 ( To be included on the mailing list for this particular brochure please contact

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.

Development assistance for community health workers in 114 low- and middle-income countries, 2007–2017
Lu C; Palazuelos D; Luan Y; Sachs SE; et al: Bulletin of the World Health Organisation 98(1) 1-76, 2020

This study estimated the level and trend of development assistance for community health worker-related projects in low- and middle- income countries between 2007 and 2017. Data was extracted from the Organisation for Economic Co-operation and Development’s creditor reporting system on aid funding for projects to support community health workers (CHWs) in 114 countries over 2007–2017. Between 2007 and 2017, total development assistance targeting CHW projects was around US$ 5 298 million, accounting for 2.5% of the US$ 209 278 million total development assistance for health. Sub-Saharan Africa received a total US$ 3 718 million, the largest per capita assistance over 11 years. Development assistance to projects that focused on infectious diseases and child and maternal health received most funds during the study period. The share of development assistance invested in the CHW projects was, however, small, unstable and decreasing in recent years.

Development of a core competency model for the Master of Public Health degree
Calhoun JG, Ramiah K, McGean Weist E and Shortell S: American Journal of Public Health 98(9):1598-1607, September 2008

Core competencies have been used to redefine curricula across the major health professions in recent decades. In 2006, the Association of Schools of Public Health identified core competencies for the Master of Public Health degree in graduate schools and programmes of public health. The authors provide an overview of the model development process and a listing of twelve core domains and 119 competencies that can serve as a resource for faculty and students for enhancing the quality and accountability of graduate public health education and training. The primary vision for the initiative is the graduation of professionals who are more fully prepared for the many challenges and opportunities in public health in the forthcoming decade.

Development of human resources for health in the WHO African Region: Current situation and way forward
Awases M, Nyoni J, Bessaoud K, Diarra-Nama AJ, Ngenda CM: African Health Monitor 12: 22–29, April-June 2010

This review of human resources in the health sector indicates that the African Region is faced with severe shortages of doctors and nurses, with only 590,198 health workers against an estimated requirement of 1,408,190 health workers. This situation is compounded by inappropriate skill mixes and gaps in service coverage. The estimated critical shortages of doctors, nurses and midwives is over 800,000. The problem is more severe in rural and remote areas where most people typically live in the countries in the African Region. This review provides information about the efforts and commitments by World Health Organization Member States and the various opportunities created by regional and global partners, including the progress made. The paper also explores issues and challenges related to the underlying factors of the health worker crisis, such as chronic underinvestment in health systems development in general, and specifically in human resources for health development, migration of skilled health personnel as a result of poor working conditions and remuneration, lack of evidence-based strategic planning, insufficient production of health workers and poor management systems.

Do we know enough to prevent occupationally acquired tuberculosis in healthcare workers?
Zungu M and Malotle M: Occupational Health Southern Africa 17(5), September-October 2011

Healthcare workers in South African healthcare facilities work in environments with a high density of tuberculosis patients due to the dual burden of tuberculosis and human immunodeficiency virus in the population, thus predisposing them to contracting tuberculosis. Despite the knowledge of the high tuberculosis incidence and the likelihood of tuberculosis transmission to both health care workers and patients, and the availability of basic infection control measures in our healthcare facilities, there is still inadequate implementation of infection control measures in healthcare facilities, according to this paper. The authors review the knowledge base, instruments for tuberculosis control, the implementation of these tools and the knowledge gaps within the healthcare system in South Africa. A comprehensive review of scholarly literature was conducted based on Internet search engines. The review revealed the availability of adequate knowledge and tools for the control of tuberculosis in healthcare facilities, but inadequate implementation of infection control measures.

Doctors and nurses with HIV and AIDS in sub-Saharan Africa

Much has been written about the impact of the HIV and AIDS pandemic on the healthcare delivery systems and resources in central and southern Africa. The unremitting pressure on hospitals and other healthcare facilities, and the disproportionate use of healthcare resources by the ever increasing numbers of patients, are threatening to undermine the capacity of countries such as South Africa to provide a comprehensive health safety net for the rest of the population, says an article in the British Medical Journal.

Does a code make a difference? Assessing the English code of practice on international recruitment
Buchan J, McPake B, Mensah K and Rae George: Human Resources for Health, 9 April 2009

The paper examines trends in inflow of health professionals to the United Kingdom from other countries, using professional registration data and data on applications for work permits. Available data show a considerable reduction in inflow of health professionals, from the peak years up to 2002 (for nurses) and 2004 (for doctors). There are multiple causes for this decline, including declining demand in the United Kingdom. Regulatory and education changes in the United Kingdom in recent years have also made international entry more difficult. Two lessons were learnt: comprehensive data is needed for proper monitoring of the impact of a code and countries with many independent, private-sector health care employers struggle to implement a code. the authors note therefore the significant challenges in implementing and monitoring a global code.

Doubling the number of health graduates in Zambia: Estimating feasibility and costs
Aaron T, Kapihya M, Libetwa M, Lee J, Pattinson C, McCarthy E and Schroder K: Human Resources for Health 8(22), 22 September 2010

In response to its critical health worker shortages, the Ministry of Health (MoH) in Zambia plans to double the annual number of health training graduates in the next five years to increase the supply of health workers. This study sought to determine the feasibility and costs of doubling training institution output through an individual school assessment framework. Assessment teams consulted faculty, managers and staff in all of Zambia's 39 public and private health training institutions in 2008. The individual school assessments affirmed the MoH's ability to double the graduate output of Zambia's public health training institutions. Lack of infrastructure was determined as a key bottleneck in achieving this increase while meeting national training quality standards. The authors argue that an investment of US$ 58.8 million is required to meet infrastructure needs, and the number of teaching staff must increase by 111% over the next five years.

Down and out in Zomba: the situation and education of orphans in Malawi

What does it mean to be a young orphan? Why and how are numbers burgeoning? Why are orphans socially excluded and how might education support their inclusion? This study investigates the lives of orphans in an area of Malawi, suggests why the numbers of orphans are exploding and indicates how the social unrest that may follow could be avoided. This small project conceives of education in the broadest possible sense to include what the orphans need to know to survive in the short term, to fruitfully participate in their surroundings in the medium term, and to prosper in the long term. It attempts to build a picture of their lives and aspirations, the particular perceptions of female orphans and also of their carers, organised in state registered, community level Orphan Care Groups (OCGs).