Human Resources

Understanding press coverage of cross border migration in Southern Africa since 2000
Southern African Migration Project (SAMP)

Xenophobia is a distinctive and widespread phenomenon in South and Southern Africa. The print media, in particular, has been accused of exacerbating xenophobic attitudes. This paper discusses press coverage of cross-border migration in Southern Africa from 2000-2003, with a focus on xenophobia. The study revisits research conducted in South Africa by the Southern African Migration Project (SAMP) in the 1990s to
determine what, if any, changes have occurred in that country’s press coverage of the issue.

Understanding the factors influencing health-worker employment decisions in South Africa
George G, Gow J and Bachoo S: Human Resources for Health 11 (15): 1-7, 2013

The provision of health care in South Africa has been compromised by the loss of trained health workers (HWs) over the past 20 years. The public-sector workforce is overburdened. There is a large disparity in service levels and workloads between the private and public sectors. There is little knowledge about the nonfinancial factors that influence HWs choice of employer (public, private or nongovernmental organization) or their choice of work location (urban, rural or overseas). This paper aims to fill these gaps in the literature. The study utilized cross-sectional survey data gathered in 2009 in the province of KwaZulu-Natal from three public hospitals, two private hospitals and one nongovernmental organization hospital in urban areas, from professional nurses, staff nurses and nursing assistants. HWs in the public sector reported the poorest working conditions, as indicated by participants’ self-reports on stress, workloads, levels of remuneration, standard of work premises, level of human resources and frequency of in-service training. Health workers in the non state sector expressed a greater desire than those in the public and private sectors to leave their current employer. Innovative efforts are required to address the causes of HWs dissatisfaction and to further identify the nonfinancial factors that influence work choices of HWs. The results highlight the importance of considering a broad range of nonfinancial incentives that encourage HWs to remain in the already overburdened public sector.

Understanding the factors influencing health-worker employment decisions in South Africa
George G, Gow J and Bachoo S: Human Resources for Health 11(15), 23 April 2013

Little is known about the nonfinancial factors that influence South African health workers’ (HWs) choice of employer (public, private or nongovernmental organisation) or their choice of work location (urban, rural or overseas). To fill these gaps in the literature, researchers used a cross-sectional survey to gather data in 2009 in the province of KwaZulu-Natal. HWs in the public sector reported the poorest working conditions, as indicated by participants’ self-reports on stress, workloads, levels of remuneration, standard of work premises, level of human resources and frequency of in-service training. However, HWs in the NGO sector expressed a greater desire than those in the public and private sectors to leave their current employer. The authors call for innovative efforts to address the causes of HWs dissatisfaction and to further identify the nonfinancial factors that influence work choices of HWs. Policymakers must consider a broad range of nonfinancial incentives that encourage HWs to remain in the already overburdened public sector.

Universal antiretroviral treatment: The challenge of human resources
Bärnighausen T, Blooma DE and Humair S: Bulletin of the World health Organization 88(12): 943-948, December 2010

Despite scale up of anti-retroviral therapy (ART) in Africa, this study draws attention to the shortage of quality data to assess the impact of task-shifting and the loss of doctors from other parts of the health system to HIV and AIDS programmes. It calls for greater documentation and further studies how past increases in ART coverage have been achieved, for instance, by assessing health worker performance using surveys of ART facilities. However, the paper argues that such research alone is not enough. Some of the most important factors determining the long-term progress towards universal coverage – such as ‘victim of our own success’ mechanisms – may only become apparent with time and as ART coverage increases. The challenge of predicting future need through the study of past outcomes is exacerbated by uncertainties around the definition of ART need (such as increases in the CD4 count threshold for treatment eligibility) and ART-related health problems (such as widespread viral resistance). Health policy-makers need to anticipate these factors with the aid of models, allow for significant uncertainty in their ART strategies, and set realistic expectations for the magnitude of resources required for universal ART coverage.

University partnership to address the shortage of healthcare professionals in Africa
Taché S, Kaaya E, Omer S, Mkony CA, Lyamuya E, Pallangyo K, Debas HT, MacFarlane SB: Global Public Health 3(2): 137 - 148, April 2008

The shortage of qualified health professionals is a major obstacle to achieving better health outcomes in many parts of the world, particularly in Africa. The role of health science universities in addressing this shortage is to provide quality education and continuing professional development opportunities for the healthcare workforce. Academic institutions in Africa, however, are also short of faculty and especially under-resourced. We describe the initial phase of an institutional partnership between the Muhimbili University of Health and Allied Sciences (MUHAS) and the University of California San Francisco (UCSF) centred on promoting medical education at MUHAS. The challenges facing the development of the partnership include the need: (1) for new funding mechanisms to provide long-term support for institutional partnerships, and (2) for institutional change at UCSF and MUHAS to recognize and support faculty activities that are important to the partnership. The growing interest in global health worldwide offers opportunities to explore new academic partnerships. It is important that their development and implementation be documented and evaluated as well as for lessons to be shared.

Unpaid Care Work Programme: Uganda Country Progress Report (2012–2014)
Nesbitt-Ahmed Z; Malinga Apila H: Institute of Development Studies Evidence Report 126, IDS Sussex, 2015

The Institute of Development Studies (IDS) partnered with ActionAid International (AAI) in Uganda to develop and implement an advocacy strategy to make unpaid care work more visible in public policy, as well as to integrate unpaid care issues into each country’s programming. It used an action learning methodology to look at what works and does not work in making the care economy more visible. It aimed to track and capture changes in policy and practice in order to improve understanding around the uptake of evidence. This report covers the progress of the programme in Uganda over the first two and a half years of the four-year programme. The work identified that making unpaid care work more visible calls for a collective voice amongst those involved and engaging and working effectively with the media with clear messaging.

Urgent need to get health workers back at their posts to tackle Zimbabwe cholera crisis
Zimbabwe Health Cluster Bulletin 1, 5 December 2008

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.

US agencies plan to invest US$130 million in African medical education
National Institutes of Health News: 7 October 2010

The United States (US) Department of Health and Human Services is partnering with the US President’s Emergency Plan for AIDS Relief (PEPFAR) with a plan to invest US$130 million over five years in African medical education to increase the number of health care workers. Through the Medical Education Partnership Initiative (MEPI), grants are being awarded directly to African institutions in a dozen countries, working in partnership with US medical schools and universities. The initiative will form a network including about 30 regional partners, country health and education ministries, and more than 20 US collaborators.

US plan to lure nurses may hurt poor nations
The New York Times, 24 May 2006: Dugger CW

As the United States runs short of nurses, senators are looking abroad. A little-noticed provision in their immigration bill would throw open the gate to nurses and, some fear, drain them from the world's developing countries.

Use of task-shifting to rapidly scale-up HIV treatment services: Experiences from Lusaka, Zambia
Morris MB, Chapula BT, Chi BH, Mwango A, Chi HF, Mwanza J, Manda H, Bolton C, Pankratz DS, Stringer JS and Reid SE: BMC Health Services Research, January 2009

As part of ART services expansion in Lusaka, Zambia, this study implemented a comprehensive task-shifting programme among existing health providers and community-based workers. It provides on-going quality assessment using key indicators of clinical care quality at each site. Programme performance is reviewed with clinic-based staff quarterly. When problems are identified, clinic staff members design and implement specific interventions to address targeted areas. Ongoing quality assessment demonstrated improvement across clinical care quality indicators, despite rapidly growing patient volumes. The task-shifting strategy was designed to address current health care worker needs and to sustain ART scale-up activities. While this approach has been successful so far, long-term solutions to the human resource crisis are urgently needed.

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