One way of improving health globally is promoting mothers’ adoption of healthy home practices for improved nutrition and illness prevention in the first 1000 days of life from conception. The challenge is how to promote learning and behaviour change of mothers more effectively in low-resource settings where access to health information is poor, educational levels are low, and traditional beliefs are strong. In addressing that challenge, a new learning/teaching method called “Sharing Histories” is in development to improve the performance of female community health workers in promoting mothers’ behaviours for maternal, neonatal and child health. This method builds self-confidence and empowerment of community health workers in learning sessions that are built on guided sharing of their own memories of childbearing and child care. Community Health Workers can later share histories with the mother, building her trust and empowerment to change. For professional primary health care staff who are not educators, Sharing Histories is simple to learn and use so that the method can be easily incorporated into government health systems and ongoing community health workers programs. The author presents the Sharing Histories method, describes how it differs from other social and behaviour change methods, and discusses selected literature from psychology, communications, and neuroscience that helps to explain how and why this method works as a transformative tool to engage, teach, transform, and empower Community Health Workers to be more effective change agents with other mothers in their communities.
Human Resources
As the economic burden of HIV/AIDS increases in sub-Saharan Africa, allocation of the burden among levels and sectors of society is changing. The private sector has more scope to avoid the economic burden of AIDS than governments, households, or nongovernmental organisations, and the burden is being systematically shifted away from the private sector. Common practices that transfer the burden to households and government include: Pre-employment screening; Reductions in employee benefits; Restructured employment contracts; Outsourcing of low skilled jobs; Selective retrenchments; and Changes in production technologies. This paper was produced by the Department of International Health at Boston School of Public Health.
About 3% of the South African workforce - or about 500 000 people -could have full-blown Aids by 2010, Department of Labour guidelines on HIV/Aids have forecast, reports the Mail and Guardian newspaper. The projected rate of 2,9% in the terminal stage of the illness represents a three-fold increase since 2001, when it stood at 0,93%. Statistics South Africa estimates the current economically active population at 16,5-million, including a million in the informal sector.
The World Health Organization (WHO) and the Office of the US Global AIDS Coordinator (OGAC) convened representatives from HIV Programmes and Human Resources for Health Departments from Ministries of Health, Professional Associations, Academic Institutions and representatives from workers associations in Geneva for a two day technical consultation about the need for a regulatory framework in support of Task Shifting. The meeting signaled the beginning of a new expert partnership for driving forward the Task Shifting Project in the context of the wider HIV/AIDS and health workforce plan “Treat, Train, Retain”.
This summary of a report by the Portfolio Committee on Health and Child Welfare in Zimbabwe notes that the shortage of doctors in Zimbabwe has reached crisis levels with the country having only 21% of the required medical practitioners. The report by the Portfolio Committee on Health and Child Welfare provided statistics showing that vacancy levels stand at 80% for midwives, 62% for nursing tutors, 63% for medical school lecturers and over 50% for pharmacy, radiology and laboratory personnel. Poor working conditions were cited as among the reasons for the high vacancy rates. The report added that these shortages and disruption of transport and telecommunications have compromised patient transfers, malaria indoor residual spraying, drug distribution and supervision of districts and rural health centres.
The quality and quantity of health care services delivered by the Malawi public health system is severely limited, due to, among other things the shortage of adequate numbers of trained health care workers. In order to suggest policy changes and implement corrective measures, there may be need to describe the perceptions of the legislature on how they perceive as the cause of the problem. Training more health workers, training new but lower cadres of health workers not marketable to the outside world, improving the working conditions and remuneration of health workers are suggested as some of the solutions. Even without the brain drain of health workers to other countries, Malawi's health sector personnel numbers are not adequate to serve the needs of the country. Relying on training more health workers in the numbers normally produced from the prevailing training institutions is unlikely to remove the shortages.
Rich countries are poaching so many African health workers that the practice should be viewed as a crime, a team of international disease experts said. If one of these countries that is being systematically poached were to pursue it as a crime, contributing to unrest they would have some leg to stand on.
In this assessment, researchers aimed to identify critical gaps in the core competencies of the Makerere University College of Health Sciences medicine and nursing, as well as ways to overcome them to achieve the government’s Health Sector Strategic Plan (HSSP) goals. Documents from the Uganda Ministry of Health as well as medicine and nursing curricula were analysed, and 19 key informant interviews) and seven focus group discussions with stakeholders were conducted. The researchers found that the core competencies that medicine and nursing students are expected to achieve by the end of their education were outlined for both programmes. The curricula are in the process of reform towards competency-based education and, on the surface, are well aligned with the strategic needs of the country. But implementation is inadequate, and the researchers argue that learning objectives need to be more applicable to achieving competencies, learning experiences need to be more relevant for competencies and setting in which students will work after graduation (i.e. not just clinical care in a tertiary care facility), and student evaluation needs to be better designed for assessing these competencies.
This article describes how the association between the presence or absence of health personnel and the health status of a population tends to be seen as simplistic, and proceeds to address a range of other factors. The Briefing examines the case for a two-tiered health training system, one for global markets and the other for local markets. It also examines options for outsourcing healthcare to regional centres in poorer countries as a way to assist with retention and return.
This policy brief examines the case for a two-tiered health training system. Within this system, doctors and nurses are trained to international standards, while many others are trained to more basic levels of health care, enabling them to meet the basic needs of the people in rural areas.