Progress towards the Millennium Development Goals (MDGs) in sub-Saharan Africa is slow. There is a growing consensus that human resources are a vital part of improving African health systems and making progress towards the MDGs. Reasons for human resource problems in African health systems are complex. Moreover, they vary greatly between and within countries. This means that solutions will be complex and are dependent on the political, economic, historic and social context of each country. Of particular concern are issues such as capacity and training of health workers, migration of skilled workers out of the region, the impact of HIV and AIDS, as well as the need for massive scale-up of ART
(anti-retroviral therapy) services.
Human Resources
Focus on Human Resources for Health in Africa
Human Resources Crisis in the Zambian Health System: A call for urgent action
Partners for Health Reformplus (PHRplus)
This paper, from PHRplus, examines the state of human resources for health in Zambia. Findings show that the Zambian public health sector has reach a point of crisis and is unable to provide basic health services. This is due to: losing health workers because of better prospects elsewhere; the limited capacity of Zambian medical and professional schools to train additional staff; and the impact of HIV and AIDS. Specific findings include: attrition rates of all health staff have increased dramatically compared to historical trends; looking only at national human resources can obscure trends taking place within the country; and facilities will soon experience severe constrains in expanding their HIV and AIDS services.
Must Aid hinder attempts to reach the Millennium Development Goals?
Donor aid creates inflated salary scales and benefits: a driver for a US bilateral agency in Addis Ababa might be paid more than a professor in the medical faculty, and a public-health specialist 4–5 times the government salary on joining an international non-governmental organisation. In certain regions of Ethiopia and Mozambique, the budget of a single large non-governmental organisation may exceed that of the government. The projected budget for vertical programmes in HIV/AIDS for 2006 in Ethiopia is US$100 million, or around a third of the annual health budget for the entire country.
Placing Health workers at the center of health services delivery in Africa
World Health Organisation - Regional Office for Africa
This brochure, published by the WHO Africa Regional Office, aims to raise awareness of human resources for health in Africa. It argues that health workers are central to making the best possible use of other resources and investments in the health sector, yet their importance has not been widely recognised. Declining staff salaries have contributed to a brain drain from the public to the private sector and from developing to more developed countries, and few countries have made systematic efforts to ensure that health professionals return home after training abroad. Training in Africa has tended to mimic developed countries, producing highly trained, expensive, elite and hospital-focused professionals.
Retention of Health Care Workers in Low-Resource Settings: Challenges and Responses
The Capacity Project
The number of health workers employed is an indicator of a country’s ability to meet the health care needs of its people, specially the poorest and most vulnerable. Resource-constrained countries committed to the Millennium Development Goals are facing up to the reality that shortages and uneven distribution of health workers threaten their capacity to tackle the HIV/AIDS pandemic, as well as the resurgence of tuberculosis and malaria. Worker shortages are linked to three factors: 1) decreasing student enrollment in health training institutions, 2) delays or freezes in the hiring of qualified professionals and 3) high turnover among those already employed.
SADC pushes for affirmative action to accelerate gender equality
SARDC
The Southern African Development Community (SADC) is pressing for affirmative action to speed up progress towards substantive equality between women and men at all levels of decision-making. 'To realise full implementation of this decision, member states must endeavour to adopt affirmative action to protect women and enshrine it in national constitutions,' said Mathiba-Madibela at a media briefing prior to the Council of Ministers that takes place in Gaborone this week.
Staff training and ambulatory tuberculosis treatment outcomes: a cluster randomized controlled trial in South Africa
S. Lewin, J.Dick, M. Zwarenstein, C. Lombard, Bulletin of the World Health Organisation 83(4): 250-259
DOTS, the internationally-recommended control strategy for tuberculosis (TB), has been applied in South Africa since 1996. But TB cure rates remain at 65 percent - not high enough to control or reverse the epidemic. Could training clinic staff on patient-centred care, critical reflection on practice and quality enhancement improve treatment success? The rates of successful treatment and bacteriological cure for TB improved marginally in the clinics that received the training, compared with the controls. The differences were not statistically significant. The training was well accepted by staff who became more aware of the need to improve provider-patient relations and made some changes to the organisation of care. These changes in attitudes and practices often did not translate into improved provider-patient relations.
The Health Sector Human Resource crisis in Africa: An issues paper
Support for Analysis and Research in Africa (SARA), USAID
This paper outlines the severity and complexity of the Human Resources (HR) crisis in sub-Saharan Africa and criticises donor neglect of the issues. The document was prepared as a background document for a World Bank/World Health Organization meeting on Building Strategic Partnership in Education in Health in Africa.
Estimating health workforce needs for antiretroviral therapy in resource-limited settings
Efforts to increase access to life-saving treatment, including antiretroviral therapy (ART), for people living with HIV/AIDS in resource-limited settings has been the growing focus of international efforts. One of the greatest challenges to scaling up will be the limited supply of adequately trained human resources for health, including doctors, nurses, pharmacists and other skilled providers. As national treatment programmes are planned, better estimates of human resource needs and improved approaches to assessing the impact of different staffing models are critically needed. However there have been few systematic assessments of staffing patterns in existing programmes or of the estimates being used in planning larger programmes.
Harare Recruits 100 Nurses
The Herald, Harare
Harare City Council has recruited 100 nurses to beef up its depleted nursing staff following the departure of several health personnel for greener pastures within the region and overseas. According to the latest full commission minutes, the nurses filled in all the vacant positions for State Registered Nurses. Harare has been losing nurses on a monthly basis to other more paying institutions outside the country.