This paper reviews the challenges facing the public health workforce in developing countries and the main policy issues that need to be addressed in order to strengthen the public health workforce. The public health workforce is diverse and includes all those whose prime responsibility is the provision of core public health activities, irrespective of their organisational base. Although the public health workforce is central to the performance of health systems, very little is known about the composition, training or performance of the workforce. The key policy question is: Should governments invest more in building and supporting the public health workforce and infrastructure to ensure the more effective functioning of health systems? Other questions concern: the nature of the public health workforce including its size, composition, skills, training needs, current functions and performance; the appropriate roles of the workforce; and how the workforce can be strengthened to support new approaches to priority health problems.
Human Resources
Zimbabwe is experiencing a debilitating flight of professional and skilled people escaping the country's economic crisis, a study funded by the UN Development Programme (UNDP) has found. A large number of Zimbabweans had taken up South African citizenship and there were probably more Zimbabweans in South Africa than in the United Kingdom, the country with the highest official tally of expatriate Zimbabweans.
South Africa is suffering from a ‘brain drain’, or loss of its professionals – but how serious is the problem and what effect is it having on the homeland? This study attempts to assess the number of emigrants and the skills being lost, and asks whether the loss is permanent. Skills loss due to emigration has recently become a high-profile public policy issue in South Africa. A major, unresolved question is the actual scale of the problem and its impact. There has been growing suspicion that South Africa’s official emigration data, SSA, significantly underestimate the number of South Africans leaving the country to settle abroad. This report by the University of Cape Town attempts to assess the true extent of emigration by examining data from the recipient countries.
Human resources are an essential element of a health system's inputs, and yet there is a huge disparity among countries in how human resource policies and strategies are developed and implemented. The analysis of the impacts of services on population health and well-being attracts more interest than analysis of the situation of the workforce in this area. This article presents an international comparison of the health workforce in terms of skill mix, socio demographics and other labour force characteristics, in order to establish an evidence base for monitoring and evaluation of human resources for health.
This paper reviews the challenges facing the public health workforce in developing countries and the main policy issues that need to be addressed in order to strengthen the public health workforce. The public health workforce is diverse and includes all those whose prime responsibility is the provision of core public health activities, irrespective of their organizational base. Although the public health workforce is central to the performance of health systems, very little is known about the composition, training or performance of the workforce. The key policy question is: Should governments invest more in building and supporting the public health workforce and infrastructure to ensure the more effective functioning of health systems?
Despite the undoubted importance of human resources to the functions of health systems, there is little consistency between countries in how human resource strategies are monitored and evaluated. This paper, published in the journal Human Resources for Health, presents an integrated approach for developing an evidence base on human resources for health (HRH) to support decision-making, drawing on a framework for health systems performance assessment. It concludes that evidence-based information is needed to better understand trends in HRH. Although a range of sources exist that can potentially be used for HRH assessment, the information that can be derived from many of these individual sources precludes refined analysis. A variety of data sources and analytical approaches, each with its own strengths and limitations, is required to reflect the complexity of HRH issues.
About 3% of the South African workforce - or about 500 000 people -could have full-blown Aids by 2010, Department of Labour guidelines on HIV/Aids have forecast, reports the Mail and Guardian newspaper. The projected rate of 2,9% in the terminal stage of the illness represents a three-fold increase since 2001, when it stood at 0,93%. Statistics South Africa estimates the current economically active population at 16,5-million, including a million in the informal sector.
One in three countries in Africa and South East Asia has only one medical school for every 10 million people or more, a rate poorer than anywhere in Europe or the Americas, says a new report by researchers from the World Health Organisation. Nine out of 10 countries in the same two regions have fewer than 50 doctors per 100000 inhabitants, and about half of the countries have a similar density of nurses and midwives. The report outlines a series of major new WHO initiatives, which aim to provide better information to allow more meaningful international comparisons. "Despite the undoubted importance of human resources to the functions of health systems, there is little consistency between countries in how human resource strategies are monitored and evaluated," say the authors, from WHO's department of health service provision. "In many countries there is no regular recording of the numbers and activities of all health personnel, and some emphasize only the public sector or can have variable accuracy for rural areas."
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
Despite the undoubted importance of human resources to the functions of health systems, there is little consistency between countries in how human resource strategies are monitored and evaluated. This paper presents an integrated approach for developing an evidence base on human resources for health (HRH) to support decision-making, drawing on a framework for health systems performance assessment. Major variations in the supply of health personnel and training opportunities are found to occur by region. However, certain discrepancies are also observed in measuring the same indicator from different sources, possibly related to the occupational classification or to the sources’ representation.