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.
Human Resources
The state of nursing practice in SSA appears to have been impacted negatively by migration. Available (though inadequate) quantitative data on stocks and flows, qualitative information on migration issues and trends, and on the main strategies being employed in both source and recipient countries indicate that the problem is likely to grow over the next 5–10 years. the paper reports that multiple actions are needed at various policy levels in both source and receiving countries to moderate negative effects of nurse emigration in developing countries in Africa; however, critically, source countries must establish more effective policies and strategies.
The loss of human resource capacity has had a severe impact on the health system in South Africa. This study investigates the causes of migration focussing on the role of salaries and benefits. Health professionals from public, private and non-governmental (NGO) health facilities located in selected peri–urban and urban areas in KwaZulu-Natal, South Africa were surveyed about their current positions and attitudes toward migration. The study uses cross-sectional data collected in 2009. A total of 694 health professionals (430 in the public sector, 133 in the NGO sector and 131 in the private sector) were surveyed. An additional 11 health professionals were purposively selected for in-depth interviews. Odds ratios with 95% confidence intervals were calculated to determine whether salaries influenced HWs decisions to migrate. HWs decision to move was not positively associated with lower salaries. It was found, instead, that the consideration to move was determined by other factors including age, levels of stress experienced and the extent to which they were satisfied at their current place of work. The OSD appears to have lowered the risk of HWs migrating due to low salaries. However, the results also indicate that the South African Department of Health needs to improve working conditions for HWs within the public health sector to assist in retention.
African Ministers of Health currently attending the World Health Assembly (WHA), have all joined South African health minister Dr Manto Tshabalala-Msimang in expressing their concerns about the continued migration and recruitment of health personnel from developing to developed countries. The resolution also calls upon the Director General of the World Health Organisation (WHO) to ensure that the previous decision of the WHA aimed at addressing this matter is fully implemented. This includes strengthening of the Human Resources for Health division in the WHO by allocating adequate financial and resources to enable the division to effectively execute the necessary actions aimed at addressing this matter.
This study presents an innovative approach to healthcare worker (HCW) training using mobile phones as a personal learning environment. Twenty physicians used individual Smartphones, each equipped with a portable solar charger. A set of 3D learning scenarios simulating interactive clinical cases was developed and adapted to the Smartphones for a continuing medical education programme lasting three months. A mobile educational platform supporting learning events tracked participant learning progress. Learning outcomes were verified through mobile quizzes using multiple choice questions at the end of each module. Training, supervision and clinical mentoring of health workers are the cornerstone of the scaling up process of HIV and AIDS care in resource-limited settings. Educational modules on mobile phones can give flexibility to HCWs for accessing learning content anywhere. However lack of software interoperability and the high investment cost for the Smartphones' purchase could represent a limitation to the wide spread use of such learning programmes.
Mobile phone companies have announced a US$10 million initiative to help health workers in Africa deliver quality services to HIV and AIDS patients. The Phones for Health project will equip workers in remote areas of Rwanda with mobile phones and software for exchanging information on patients. Paul Meyer, chairman of US-based Voxiva who designed the software, said workers would also be able to order medicines, receive news alerts and download treatment guidelines and training materials. According to the National Institute of Statistics of Rwanda (NISR), health workers in remote areas of the country rely on paper records – often out of date – to track diseases' spread and have no transport for gathering field data or collecting medicines. The project aims to make things easier. Workers in the field can use phones to record patient information and send it to a central database via a high-speed network or text message. The information is then made available to health officials via the internet and can be sent to field staff by text message. The initiative is a partnership between the Global System for Mobile Communications Association (GSMA), the US President's Emergency Plan for AIDS Relief, the Accenture Development Partnership, and mobile phone operators. If it is successful it will be extended to other countries in Africa.
G. Goldstein, R. Helmer, M. Fingerhut
WHO, African Newsletter on Occupational Health and Safety, Volume 11, December 2001.
Conditions at work, and especially occupational health and safety have improved substantially during the past few decades in many parts of the world. But the overall global situation remains poor. Working conditions for the majority of workers do not meet the minimum standards and guidelines set by the International Labour Organisation (ILO) and the World Health Organization for occupational health, safety and social protection. As an example the majority of the world’s workforce is still not served by competent occupational health services. As a result the global burden of occupational disease and injury remains unacceptably high, on a par with the burden from malaria. Yet occupational health programmes receive only a tiny fraction of the resources devoted to combating malaria.
The East, central and Southern African Health Community College of Nursing (ECSACON) has released a report documenting how health professionals can take the initiative to come together to address regional issues of concern. Documenting the process of developing the ECSACON model also demonstrates how acting together in synergy and partnership can expand the impact of similar networks.
Despite the undoubted importance of human resources to the functions of health systems, there is little consistency between countries in how human resource strategies are monitored and evaluated. This paper presents an integrated approach for developing an evidence base on human resources for health (HRH) to support decision-making, drawing on a framework for health systems performance assessment. Major variations in the supply of health personnel and training opportunities are found to occur by region. However, certain discrepancies are also observed in measuring the same indicator from different sources, possibly related to the occupational classification or to the sources’ representation.
Despite the undoubted importance of human resources to the functions of health systems, there is little consistency between countries in how human resource strategies are monitored and evaluated. This paper, published in the journal Human Resources for Health, presents an integrated approach for developing an evidence base on human resources for health (HRH) to support decision-making, drawing on a framework for health systems performance assessment. It concludes that evidence-based information is needed to better understand trends in HRH. Although a range of sources exist that can potentially be used for HRH assessment, the information that can be derived from many of these individual sources precludes refined analysis. A variety of data sources and analytical approaches, each with its own strengths and limitations, is required to reflect the complexity of HRH issues.