Researchers conducted a cost-benefit analysis of a health care education scholarship that is conditional on the recipient committing to work for several years after graduation delivering ART in sub-Saharan Africa. Such a scholarship could address two of the main reasons for the low numbers of health workers in sub-Saharan Africa: low education rates and high emigration rates. Conditional scholarships for a HAHW team sufficient to provide ART for 500 patients have an expected net present value (eNPV) of US$1.24 million per year. The eNPV of the education effect of the scholarships is larger than eNPV of the migration effect. Policy makers should consider implementing ‘conditional scholarships’ for HAHW, especially in countries where health worker education capacity is currently underutilised or needs to be rapidly expanded.
Human Resources
This study examined the relationship between doctor and nurse concentrations and utilisation rates of six essential health services in developing countries: antenatal care, attended delivery, caesarean section, measles immunisation, tuberculosis case diagnosis and care for acute respiratory infection. It found that nurses were associated with high levels of utilisation of skilled birth attendants and doctors were associated with high measles immunisation rates, but neither were associated with the remaining four services. It is plausible that other health workers, such as clinical officers and community health workers, may be providing a substantial proportion of these health services, which means that the human resources for health research agenda must be expanded to include these other workers.
Through distance education, the School of Public Health of the University of the Western Cape, South Africa has provided access to master's level public health education for health professionals from more than 20 African countries while they remain in post. Since 2000, interest has increased overwhelmingly to a point where four times more applications are received than can be accommodated. This brief paper describes the innovative aspects of the programme, offering some evaluative indications of its impact, and reviews how the delivery of text-led distance learning has helped realise the objectives of public health training. Strategies are proposed for scaling up such a programme to meet the growing need for health professional development in Africa.
This article investigates whether present community health worker programmes for antiretroviral treatment are taking into account the lessons learnt from past experiences with community health worker programmes in primary health care and to what extent they are seizing the new antiretroviral treatment-specific opportunities. It is based on a desk review of multi-purpose community health worker programmes for primary health care and of recent experiences with antiretroviral treatment-related community health workers. The renewed attention to community health workers is very welcome, but the scale-up of community health worker programmes runs a high risk of neglecting the necessary quality criteria if it is not aligned with broader health systems strengthening. To achieve universal access to antiretroviral treatment, this is of paramount importance and should receive urgent attention.
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.
On the occasion of World Health Day 2009, the Global Health Workforce Alliance has underlined the important and critical role played by health workers at times of disaster and emergency. At the heart of making hospitals safer are the people responsible for saving lives - the health workers. And when an emergency strikes - health workers are on the frontline. Often 'first on scene', health workers are tragically also often the first casualties themselves - there are many examples around the work where health workers have been killed in large numbers in the early instances of disaster. Added to this, health workers - like all members of populations in crisis zones - lose family members, friends, colleagues and others close to them.
This paper reports on the first international attempt to investigate the migration intentions of pharmacy students and identify migration factors and their relationships. Nine countries were surveyed, including Zimbabwe. Results showed a significant difference in attitudes towards the professional and sociopolitical environment of the home country and perceptions of opportunities abroad between those who have no intention of migrating and those who intend to migrate on a long-term basis. Given the influence of the country context and environment on migration intentions, research and policy should frame the issue of migration in the context of the wider human resource agenda, thus viewing migration as one form of attrition and a symptom of other root causes. Policy development must take into account both remuneration and professional development to encourage retention.
This is a series of facility-based surveys using a common approach in six countries, including Mozambique and Zimbabwe. The objectives were twofold: to inform the development and monitoring of human resources for health (HRH) policy within the countries; and to test and validate the use of standardised facility-based human resources assessment tools across different contexts. The findings revealed that, with increasing experience in health facility assessments for HRH monitoring comes greater need to establish and promote best practices regarding methods and tools for their implementation, as well as dissemination and use of the results for evidence-informed decision-making. The overall findings of multi-country facility-based survey should help countries and partners develop greater capacity to identify and measure indicators of HRH performance via this approach, and eventually contribute to better understanding of health workforce dynamics at the national and international levels.
Heads and implementing workers of fifty HIV and AIDS programs and institutions accredited to offer antiretroviral services in Uganda, Kenya, Tanzania and Rwanda were key informants in face-to- face interviews guided by structured questionnaires. Inadequate human resource capacity including, inability to select, quantify and distribute ARVs and related commodities, and irrational prescribing and dispensing were some of the problems identified. A competence gap existed in all the four countries with a variety of healthcare professionals involved in the supply and distribution of ARVs. There is inadequate capacity for managing medicines and related commodities in East Africa. There is an urgent need for training in aspects of pharmaceutical management to different categories of health workers. Skills building activities that do not take healthcare workers from their places of work are preferred.
Human resources for health (HRH) is a critical component of health systems Many governments of our member states have expressed the need to determine the status HRH in relation to supply, utilization and management systems. The DJCC meeting of July 2003 recommended the establishment of the Human Resources for Health Technical Advisory Group to oversee the implementation ofthe many recommendations and the resolutions of health ministers at their 38thRegional Health Minister’s Conference of November 2003, all aimed at addressing the HRH Crisis in ECSA. To address this resolution, ECSA Health Community has conducted a series ofrelated studies addressing the issue of HRH in the region. Three studies have been on the impact of HIV/AIDS on the health workforce and this study focused on establishing the situation of HRH in the region. The findings of this study will assist not only in identifying further areas of research in relation to HRH but aid in developing both regional and national level strategies on training, deployment and retention.