Malawi’s health service is struggling under the burden of HIV and AIDS and tuberculosis (TB). Its health workforce has only limited capacity to cope due to severe staff shortages, poor salaries and working conditions, high levels of HIV and AIDS-related deaths and chronic absenteeism due to illness among staff. Without a strong health workforce, community members may have an important role to play in providing HIV and TB care. Médecins Sans Frontières describes an example of community involvement in district level HIV and TB care. The study focuses on Thyolo district, a rural region of southern Malawi with 458,976 inhabitants, of which an estimated 41,000 are living with HIV. It covers a two-year period from January 2003 to December 2004.
Human Resources
Communities provide HIV and tuberculosis care in Malawi
Zachariah R, Teck R, Buhendwa L: id21 Infectious Diseases, 16 June 2006
Holding second jobs: Regulation in the public health sector
Jan S, Bian Y, Jumpa M, et al: id21 Health, 9 May 2006
Medical professionals working in the public sector often supplement their salaries through second jobs in the private sector. Their dual job activities have both positive and negative implications for the public health sector. What policy options exist for regulating dual job holding and what is their likely effect?
Internationally recruited nurses in London: A survey of career paths and plans
Buchan J, Jobanputra R, Gough P, Hutt R: Human Resources for Health 4:14, 26 June 2006
The paper reports on a survey of recently arrived international nurses working in London, to assess their demographic profile, motivations, experiences and career plans. The Philippines, Nigeria and South Africa were the three most commonly reported countries of training (in total, more than 30 countries of training were reported). Sixty per cent of the nurses from sub-Saharan Africa and more than 40% from South Africa and India/Pakistan/Mauritius were aged 40 or older; the youngest age profile was reported by the Australia/New Zealand/USA nurses.
Public sector nurses in Swaziland: Can the downturn be reversed?
Kober K, Van Damme W: Human Resources for Health 4:13, 31 May 2006
The lack of Human Resources for Health (HRH) is increasingly being recognised as a major bottleneck for scaling-up anti-retroviral treatment (ART), particularly in sub-Saharan Africa whose societies and health systems are hardest hit by HIV/AIDS. This country case study of Swaziland describes the current HRH situation in the public sector and identifies major factors that contribute to the crisis, describe policy initiatives to tackle it and base on these a number of projections for the future. It also suggests some areas for further research that may contribute to tackling the HRH crisis in Swaziland.
Skilled migration: Healthcare policy options
Gent S, Skeldon R: Development Research Centre on Migration, Globalisation and Poverty Policy Briefing 6, March 2006
This article describes how the association between the presence or absence of health personnel and the health status of a population tends to be seen as simplistic, and proceeds to address a range of other factors. The Briefing examines the case for a two-tiered health training system, one for global markets and the other for local markets. It also examines options for outsourcing healthcare to regional centres in poorer countries as a way to assist with retention and return.
WHO alliance aims to tackle the world's lack of health workers
Rehwagen C: British Medical Journal 332:1294, 3 June 2006
A new global partnership that aims to improve the world's shortage of doctors, nurses, midwives, and other health workers was launched at last week's World Health Assembly in Geneva. The announcement came six weeks after the World Health Organization made the issue a priority in its annual report, in which it called for a global action plan to tackle the shortage of an estimated 4.2 million health workers.
Further details: /newsletter/id/31583
Holding second jobs: Regulation in the public health sector
id21 Health, 9 May 2006: Jan S, Bian Y, Jumpa M
Medical professionals working in the public sector often supplement their salaries through second jobs in the private sector. Their dual job activities have both positive and negative implications for the public health sector. What policy options exist for regulating dual job holding and what is their likely effect?
New global alliance seeks to address worldwide shortage of doctors, nurses and other health workers
World Health Organisation, 25 May 2006
A new global partnership that will strive to address the worldwide shortage of nurses, doctors, midwives and other health workers was launched today. The Global Health Workforce Alliance will draw together and mobilize key stakeholders engaged in global health to help countries improve the way they plan for, educate and employ health workers. The Alliance will seek practical approaches to urgent problems, and will also serve as an international information hub and monitoring body.
Not enough there, too many here: understanding geographical imbalances in the distribution of the health workforce
Human Resources for Health 4(12), 26 May 2006
Access to good-quality health services is crucial for the improvement of many health outcomes, such as those targeted by the Millennium Development Goals (MDGs) adopted by the international community in 2000. The health-related MDGs cannot be achieved if vulnerable populations do not have access to skilled personnel and to other necessary inputs. This paper focuses on the geographical dimension of access and on one of its critical determinants: the availability of qualified personnel.
Skilled migration: healthcare policy options
Development Research Centre on Migration, Globalisation and Poverty, University of Sussex: Gent S, Skeldon, R
This policy brief examines the case for a two-tiered health training system. Within this system, doctors and nurses are trained to international standards, while many others are trained to more basic levels of health care, enabling them to meet the basic needs of the people in rural areas.