In common with other developing countries, South Africa's public health system is characterised by human resource shortfalls. These are likely to be exacerbated by the escalating demand for HIV care and a large-scale antiretroviral therapy (ART) programme. Focusing on professional nurses, the main front-line providers of primary health care in South Africa, this study examines patterns of planning, recruitment, training and task allocation associated with an expanding ART programme in the districts of one province, the Free State. The researchers found that introduction of the ART programme has revealed both strengths and weaknesses of human resource development in one province of South Africa. Without concerted efforts to increase the supply of key health professionals, accompanied by changes in the deployment of health workers, the core goals of the ART programme - i.e. providing universal access to ART and strengthening the health system - will not be achieved.
Human Resources
This study was conducted to determine how 20 low- and middle-income countries are operationalising health governance to improve health workforce performance. The 20 countries assessed showed mixed progress in implementing the eight governance principles. Strengths highlighted include increasing the transparency of financial flows from sources to providers by implementing and institutionalising the National Health Accounts methodology; increasing responsiveness to population health needs by training new cadres of health workers to address shortages and deliver care to remote and rural populations; having structures in place to register and provide licensure to medical professionals upon entry into the public sector; and implementing pilot programs that apply financial and non-financial incentives as a means to increase efficiency. Common weaknesses included difficulties with developing, implementing and evaluating health workforce policies that outline a strategic vision for the health workforce; implementing continuous licensure and regulation systems to hold health workers accountable after they enter the workforce; and making use of health information systems to acquire data from providers and deliver it to policymakers. Further research is warranted into the effectiveness of specific interventions that enhance the links between the health workforce and governance to determine approaches to strengthening the health system.
This article describes the human resource challenges that managers around the world report and analyses why solutions often fail to be implemented. Despite rising attention to the acute shortage of health care workers, solutions to the human resource (HR) crisis are difficult to achieve, especially in the poorest countries. Although HR strategies have been developed around the issues, the problem is that some old systems of leading and managing human resources for health do not work in today's context. The Leadership Development Program (LDP) is grounded on the belief that good leadership and management can be learned and practiced at all levels. Case studies were chosen to illustrate results from using the LDP at different levels of the health sector. The LDP makes a profound difference in health managers' attitudes towards their work. Rather than feeling defeated by a workplace climate that lacks motivation, hope, and commitment to change, people report that they are mobilized to take action to change the status quo. The lesson is that without this capacity at all levels, global policy and national HR strategies will fail to make a difference.
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.
"Health care agencies report that the major limiting factor for implementing effective health policies and reforms worldwide is a lack of qualified human resources. Although many agencies have adopted policy development and clinical practice guidelines, the human resources necessary to carry out these policies towards actual reform are not yet in place. The goal of this article is to evaluate the current status of human resources quality, availability and distribution in Northern Tanzania in order to provide emergency obstetric care services to specific districts in this area. The article also discusses the usefulness of distribution indicators for describing equity in the decision-making process."
This dossier offers practical up to date information about how to address human resource problems and issues, drawing upon evidence about what works, and identifying innovations in approaches, policy and practice. Developing countries have committed to achieving the Millennium Development Goals (MDGs). They will need to make the most effective use of all available resources to achieve the MDGs - this includes human resources. Many countries are improving their short and medium term financial planning and budgetary processes but in the past, few, if any, have given human resource management a similar focus. Now, however, human resources are being seen to be as crucial as money in improving services for poor people. Sections include: planning for human resources; strengthening capacity; migration; management issues; international initiatives; and a section focusing on Africa.
This paper responds to some central assertions in the paper Country Action Alliances to drive the HRH agenda (circulated as background reading for the Oslo consultation on Human Resources for Health, 24-25 February 2005), which describes the diverse nature of partnerships required to enhance global and country level commitments to expanding human resources for health. In response, this paper describes three examples of human resource development in community-driven HIV/AIDS programmes. The basic proposition is that acknowledgement, inclusion of and support for community based health initiatives is necessary to understand fully where health action is occurring and where potential for expansion lies.
African countries have a very low density health workforce, compounded by poor skill mix and inadequate investment. Yet trained healthcare staff continue to migrate from Africa to more developed countries. The World Health Organization has estimated that, to meet the ambitious targets of the millennium development goals, African health services will need to train and retain an extra one million health workers by 2010.
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 of HRH in relation to supply, utilisation and management systems. 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.
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.