In the health sector, HIV/AIDS increases the demand for care, the level and complexity of work and the risk of infection, whilst also placing a strain on resources. These burdens exacerbate problems of sickness, absenteeism and workload, increasing losses of health workers. The stress and fear lowers health worker morale and adds to factors pushing them out of low-income countries and into the international labour market. This paper, produced by EQUINET, discusses the implications for health personnel of the HIV epidemic, and health sector responses to it, in southern Africa, using Malawi as a case study. The paper first covers the context of health sector organisations in southern Africa, and then in Malawi.
Human Resources
HIV/AIDS, Equity and health sector personnel in southern Africa
Impact of HIV on the health workforce
The devastating impact of HIV/AIDS on the general population in Africa is now well recognised but the extent to which it affects the health workforce is less understood and appreciated. Recently two researchers from the Support for Analysis and Research in Africa (SARA) project, under the oversight of the Academy for Educational Development (AED), looked at the dual impact of HIV/AIDS on the health workforce and on health care systems. The result is a streaming video, produced by the World Bank, which records a discussion of the findings of this research with the SARA researchers, Dr. Stephen Kinoti, a former professor of paediatrics at the University of Nairobi, and Oscar Picazo, a senior health economist on leave from the World Bank's Africa region. The video includes a discussion of the real and perceived risks health care workers face with the pandemic and human resource factors that influence the supply of services, costs and data.
Monitoring geographical imbalance in the health workforce: snapshots from three developing countries
The problem of geographical imbalance among human resources for health (HRH) across countries in the developing world holds important implications at the local, national and international levels, in terms of constraints for the effective deployment, management and retention of HRH, and ultimately for the equitable delivery of health services. This is according to a study that investigated the uses of demographic census data for monitoring geographical imbalance in the health workforce for three developing countries, as a basis for formulation of evidence-based health policy options.
Nursing and midwifery the champions in HIV/AIDS care in Southern Africa
Commissioned by the SADC (Southern African Development Community) AIDS Network of Nurses and Midwives (SANNAM) in collaboration with UNAIDS, this report summarises the results of a month of field research in five countries in Southern Africa – Botswana, Lesotho, Namibia, South Africa and Zambia. It highlights the fact that, among health professionals, nurses and midwives shoulder most of the care, treatment and support responsibilities for people living with HIV/AIDS (PLWHA) in Southern Africa. It also stresses the limited resources and constraints under which they deliver care.
Towards a global health workforce strategy
A new book on human resources for health issues
The papers presented in the book cover the main dimensions of HRD in health: planning and managing the workforce, education and training, incentives and working conditions, managing the performance of personnel and policies needed to ensure that investments in human resources produce the benefits to which the investing populations are entitled. Authors write from diverse professional, regional and cultural perspectives, and yet there is a high degree of consistency in their diagnosis of problems and proposals for strategies to address them. They all agree on the multidimensionality of problems and on the need for solutions that take into account all dimensions. They also agree that if problems tend to be similar in nature, they take forms that are time and context-determined.
Risks to healthcare workers in developing countries
Health care workers are a crucial resource in the health care systems of developing nations. In many countries, including those in sub-Saharan Africa, workers are at high risk for preventable, life-threatening occupational infections. Yet the protection of health care workers in these countries is largely neglected in national priorities for health care and by the international organisations that fund health care initiatives.
The great brain drain discussion
Some possible solutions to the brain drain include a greater investment in more research and policy study about the causes of the drain, educating policy makers about the causes, and a rethink of the nursing profession in relation to compensation. This is according to notes that summarize a 41-message discussion on the brain drain of health professionals from developing to developed countries. The discussion took place on the listserv HIF-net at WHO.
Further details: /newsletter/id/30119
Developing evidence-based ethical policies on the migration of health workers
Human Resources for Health 2003
It is estimated that in 2000 almost 175 million people, or 2.9% of the world's population, were living outside their country of birth, compared to 100 million, or 1.8% of the total population, in 1995. As the global labour market strengthens, it is increasingly highly skilled professionals who are migrating. Medical practitioners and nurses represent a small proportion of highly skilled workers who migrate, but the loss of health human resources for developing countries can mean that the capacity of the health system to deliver health care equitably is compromised.
The interface between health sector reform and human resources in health
Human Resources for Health 2003
The relationship between health sector reform and the human resources issues raised in that process has been highlighted in several studies. These studies have focused on how the new processes have modified the ways in which health workers interact with their workplace, but few of them have paid enough attention to the ways in which the workers have influenced the reforms. The impact of health sector reform has modified critical aspects of the health workforce, including labour conditions, degree of decentralization of management, required skills and the entire system of wages and incentives.
Chemists leaving SA by the hundreds as US group dispenses big bucks
Having difficulty getting an airline booking to the US? The problem may well be that you're standing in line with a small army of pharmacists and their families due to leave SA over the next few weeks. Behind this exodus is Albertson's, a $28bn/year turnover US retail pharmacy group with a staff of 200 000. One of their recruits, Cape Town pharmacist Keith Hughes, will be leaving behind a 20-year career to begin afresh in Delaware. As an "intern" Hughes can expect an immediate $2 000/month income boost.