Human Resources

Women on the move: migration, care work and health
World Health Organisation: WHO, Geneva, 2017

Care workers - who are largely migrant women, often working in informal home settings - make a considerable contribution to public health in many countries but are themselves exposed to health risks, face barriers to accessing care, and enjoy few labour and social protections. This WHO report, and its reflection on potential next steps, aims to foster debate about approaches to ensure that the global community meets its obligations in relation to these care workers. The report focuses on paid home-based care workers who attend to the varied needs of children, older people, people with disabilities and the disabled and ill people.It notes that a significant knowledge gap exists when it comes to how migrant care workers’ health is influenced – both positively and negatively – by the labour they perform and the contexts in which they undertake this work. The report highlights three key steps for all countries and regions to consider to improve the health and well-being of migrant care workers and their families:1. To generate evidence on the nature of migrant care work, the contributions to global health care and the terms and conditions of their employment. 2. To improve access to health services through specific measures to address non-discrimination, promote inclusion and participation of migrant care workers. 3. Promote and recognize care as a global public good that contributes to global health and well-being. The authors advocate for holistic, universal and person-centred health and social care systems.

Workers Without Health Insurance:
Who Are They and How Can Policy Reach Them?

Urban Institute - August, 2001, Washington, D.C., USA.
A new Urban Institute report on workers without health insurance suggests that the most efficient way to increase coverage is to target subsidies toward low-income workers. The report offers the most detailed picture yet of the uninsured working population—now numbering more than 16 million—and compares the relative merits of two key vehicles for expanding coverage: tax credits or public programs. Researchers Bowen Garrett, Len Nichols and Emily Greenman, characterizes today’s uninsured and examines the policy implications. The report, based on analyses of 1999 Current Population Survey data and a survey of the literature on the working uninsured, was developed for the W.K. Kellogg Foundation as part of its Community Voices: HealthCare for the Underserved initiative series.

Working with community health workers to improve maternal and newborn health outcomes: implementation and scale-up lessons from eastern Uganda
Namazzi G; Okuga M; Tetui M; et al.: Global Health Action 10(S4)72-81, 2017

This paper explores knowledge levels of community health workers (CHWs), describes the coverage of home visits, and shares lessons learnt from setting up and implementing the CHW strategy in eastern Uganda. The CHWs were trained to conduct four home visits: two during pregnancy and two after delivery. The visits aimed to promote birth preparedness and utilization of maternal and newborn health (MNH) services. CHWs’ knowledge of MNH improved after training. However, knowledge of new born danger signs declined after a year. The level of coverage of at least one CHW visit to pregnant and newly delivered mothers was 57% and CHW reports complemented the facility-based health information. CHWs formed associations, which improved teamwork, reporting, and general performance, and maintained low dropout rates at 3.6%. Their challenges included dissatisfaction with the quarterly transport refund of 6 USD and lack of a means of transport, such as bicycles.

Workload indicators of staffing need method in determining optimal staffing levels at Moi Teaching and Referral Hospital
Musua P, Nyongesa P, Shikhule A, Birech E, Kirui D, Njenga M, Mbiti D, Bett A, Lagat L, Kiilu K: East African Medical Journal 85(5):232-239, 2008

This study aimed to highlight the experience and findings of an attempt at establishing the optimal staffing levels for a tertiary health institution using the Workload Indicators of Staffing Need (WISN) method popularised by the World Health Organisation (WHO), Geneva, Switzerland. The descriptive study captures the activities of a taskforce appointed to establish optimal staffing levels. The cadres of workers, working schedules, main activities, time taken to accomplish the activities, available working hours, category and individual allowances, annual workloads from the previous year's statistics and optimal departmental establishment of workers were examined. There was initial resentment to the exercise because of the notion that it was aimed at retrenching workers. The team was given autonomy by the hospital management to objectively establish the optimal staffing levels. Very few departments were optimally established with most either understaffed or overstaffed. There were intradepartmental discrepancies in optimal levels of cadres even though many of them had the right number of total workforce. The WISN method is a very objective way of establishing staffing levels but requires a dedicated team with adequate expertise to make the raw data meaningful for calculations.

Workplace violence and gender discrimination in Rwanda's health workforce: increasing safety and gender equality
Newman CJ, de Vries DH, Kanakuze J and Ngendahimana G: Human Resources for Health 9(19), 19 July 2011

The authors of this article examined the influence of gender on workplace violence, and synthesised their findings with other research from Rwanda, before they examined the subsequent impact of the study on Rwanda's policy environment. Fifteen out of 30 districts were selected at random. Forty-four facilities at all levels were randomly selected in these districts. From these facilities, 297 health workers were selected at random, of whom 205 were women and 92 were men. Researchers administered health worker survey, facility audits, key informant and health facility manager interviews and focus groups to collect data in 2007. They found that 39% of health workers had experienced some form of workplace violence in year prior to the study. The study identified gender-related patterns of perpetration, victimisation and reactions to violence. Negative stereotypes of women, discrimination based on pregnancy, maternity and family responsibilities and the 'glass ceiling' affected female health workers' experiences and career paths and contributed to a context of violence. Addressing gender discrimination and violence simultaneously should be a priority for workplace and violence research, workforce policies, strategies, laws and human resources management training, the authors conclude.

World AIDS Day: Medical professionals speak out for their colleagues in Africa
Physicians for Human Rights

On World AIDS Day, Physicians for Human Rights sent a letter to President Bush urging the US government to address the massive health worker shortage in Africa. An estimated one million additional health workers are needed in sub-Saharan Africa alone to fight AIDS and other diseases. The letter was signed by over 100 prominent US health professionals, including 33 deans of medical, nursing, and public health schools, representing some of the country's most influential health leaders. Many of these health experts have seen first-hand the devastation caused by the lack of health workers, medicines, and supplies in many African countries struggling with the AIDS pandemic.

World Health Day: Chronic deficit of health workers
Inter Press Service News Agency: Capdevila G

There is a critical shortage of health workers - doctors, nurses and lab technicians - in poor countries, which most desperately need them. This was the warning given by the World Health Organisation warned in its annual report on global health problems.

World Health Day: Kenyan medics deplore low pay, scarce incentives
IPS News Agency: Mulama J

As the international community prepared to commemorate this year’s World Health Day on April 7, the issue of poor remuneration for health workers in Kenya were being debated. The pay for doctors and other health care givers in the public service is so low that many of these people could not devote their full time to public service. This forms the basis of the argument for improving remuneration packages for Kenyan doctors.

World Health Day: Mozambican nurses to the fore with ARV distribution
Inter Press Service News Agency: Ayisi RA. 3 April 2006

As World Health Day (Apr. 7) was rapidly approaching, public attention that week was being directed to the widespread shortage of health workers. The theme for World Health Day 2006, 'Working together for health', was chosen to add momentum to efforts at resolving the crisis -- something that is nowhere more evident than in Mozambique.

World Health Report 2005 policy brief two: rehabilitating the workforce
World Health Organization (WHO), 2005

This policy brief from the World Health Report argues that it will not be possible to effectively scale up Maternal, Newborn and Child Health (MNCH) care without confronting the global health workforce crisis. It argues that the low number of health professionals is one of the main factors in the exclusion from care and high mortality rates for mothers and newborns. It highlights how lack of managerial autonomy, gender discrimination and violence in the workplace, dwindling salaries, poor working conditions and some donor interventions have all contributed to a lack of productivity, as well as the rural to urban, public to private and poor to rich country brain drain and migration.