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The labour market for human resources for health in low and middle-income countries

SPETZ, Joanne
July 2012

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This paper provides an introduction to the terms and tools of labour market analysis and connects these labour market principles to real-world case studies from LMIC. Three examples are provided of issues: workforce shortage in Thailand; unfilled posts in Kenya; and ghost workers in Rwanda. The labour market for health workers is considered and an integrated framework is provided. The technical structure and dynamics of the health worker market is discussed and applied to the first two examples. Task shifting, health worker performance and health worker productivity are also discussed.

Human Resources for Health Observer, No. 11

The IMF, the global crisis and human resources for health : still constraining policy space

February 2010

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This report "...examines evidence from nine IMF country programmes, chosen based on their HIV prevalence rates, and finds that although the IMF has changed its tune and is talking about greater flexibility, these changes are not enough and are only temporary. "In 2006, the World Health Organisation (WHO) estimated that 57 countries were facing a severe health workforce crisis.... Addressing this shortage, and action alongside it to strengthen health systems around the world, requires substantial, concerted effort from both aid donors and recipient governments. The current global downturn threatens to undermine steps taken in this direction so far and jeopardise progress towards the health-related Millennium Development Goals. "...the IMF has adapted its rhetoric so that it now claims its programmes are more flexible on fiscal and monetary policies, which determine to what extent governments can maintain or increase spending - including of foreign aid - and stimulate economic activity"

World health statistics 2010


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This annual compilation of health-related data for the World Health Organization's 193 member states, includes a summary of the progress made towards achieving the health-related Millennium Development Goals (MDGs) and associated targets

Report on the second expert consultation on increasing access to health workers in remote and rural areas through improved retention


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This report presents a synthesis of the presentations and discussions held in plenary and working groups at the second full expert meeting of a WHO programme to increase access to health workers in remote and rural areas through improved retention. The provisional agenda, list of presentations, and the list of participants are given in thre three Annexes

Seizing the opportunity on AIDS and health systems

OOMMAN, Nandini
August 2008

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This is a comparison of donor interactions with national health systems in Mozambique, Uganda, and Zambia - specifically: the health information systems, the supply chain systems for essential medicines, and human resources for health. It focuses on the US President’s Emergency Plan for AIDS Relief, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the World Bank’s Africa Multi-Country AIDS Program

World health report 2008|Primary health care : now more than ever


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This report considers four sets of reforms that reflect a convergence between the values of primary health care, the expectations of citizens and the common health performance challenges that cut across all contexts. These include: universal coverage reforms, service delivery reforms, public policy reforms, and leadership reforms. "While universally applicable, these reforms do not constitute a blueprint or a manifesto for action. The details required to give them life in each country must be driven by specific conditions and contexts, drawing on the best available evidence"

Does shortening the training on integrated management of childhood illness guidelines reduce effectiveness? results of a systematic review|Final report

ROWE, Alexander K
et al

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This comprehensive report presents the findings of a systematic review of the effectiveness of shortening Integrated Management of Childhood Illness (IMCI) strategy training. The results are useful for NGOs and other national and international bodies working in the field of childhood illness
Health Policy and Planning (in press)

The Kampala declaration and agenda for global action


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This resource contains both the Kampala declaration and an agenda for global action to "guide the initial steps in a coordinated global, regional and national response to the worldwide shortage and mal-distribution of health workers, moving towards universal access to quality health care and improved health outcomes. It is meant to unite and intensify the political will and commitments necessary for significant and effective actions to resolve this crisis, and to align efforts of all stakeholders at all levels around solutions"

Task shifting : rational redistribution of tasks among health workforce teams : global recommendations and guidelines


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These guidelines and 22 recommendations are designed to support for countries that face a high HIV burden and acute shortages within the health workforce. Task shifting involves the rational redistribution of tasks among health workforce teams. Specific tasks are moved, where appropriate, from highly qualified health workers to health workers with shorter training and fewer qualifications in order to make more efficient use of the available human resources for health. The key elements that must be in place if the approach is to prove safe, efficient, effective, equitable and sustainable, cover the need for consultation, situation analysis and national endorsement, and for an enabling regulatory framework. They specify the quality assurance mechanisms, including standardised training, supportive supervision, and certification and assessment, that will be important to ensure quality of care

Guidelines: Incentives for health professionals

WELLER, Bridget

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Staff costs dominate health services expenditure and ongoing shortages in the availability of health professionals present a real and direct threat to the continued delivery and development of health care services. Incentives, both financial and non-financial, provide one tool that governments and other employer bodies can use to develop and sustain a workforce with the skills and experience to deliver the required care. Financial incentives (wages and conditions, performance-linked payments and others) and nonfinancial incentives (career and professional development, workload management, flexible working arrangements, positive working arrangements and access to benefits and supports) are both discussed. The characteristics of an effective incentive scheme and the development of an incentive package are described. 

Working together for health : the world health report 2006


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"The 'World Health Report 2006 - Working together for health' contains both an expert assessment of the current crisis in the global health workforce and an ambitious set of proposals to tackle it over the next ten years, starting immediately"

An action plan to prevent brain drain : building equitable health systems in Africa

June 2004

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The severe shortage of health professionals in Africa is a huge barrier to expanding AIDS treatment and care and other health goals. African countries, donor governments, and international institutions must link their responses to AIDS to a broader initiative to build equitable health systems in Africa, with special attention to strengthening human resources and ensuring the right to health care for all. This report provides an action plan for preventing the 'brain drain' of skilled health workers to developed countries. It addresses issues around building equitable health systems by offering a series of recommendations to meet people's health care needs by paying more attention to human resources. These proposals include improvements in health infrastructure, higher salaries and benefits for health workers, enhanced investment in training institutions, reduced recruitment by wealthy nations and capacity-building for human resources management

Antiretroviral treatment in Zambia : a study of the experiences of treatment users and health care workers

March 2004

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This is a report detailing the main themes that emerged from research in Zambia testing the effect of a package of community education and referral interventions to expand health and ARV literacy, achieve better health-seeking behaviour, improve equity of access, boost ARV adherence and improve prevention for people with HIV. In Zambia, the ARV treatment programme in public health institutions has started scale-up, aiming as a first goal to reach 10,000 people. Zambia's central board of health (CBoH) commissioned an operations research project through the Alliance and Horizons. The research sought to understand how health seeking behaviour, particularly for VCT, adherence to ARV treatment, prevention for people with HIV and equity of access to ART treatment programmes can be improved. Eleven themes emerged from these in-depth interviews and form the main body of the report. Information needs and misinformation about HIV/AIDS and ARVs cross-cut most themes. Key actions to support improvements in policy and advocacy in support of people living with HIV in Zambia are listed at the end

Human resources for health : overcoming the crisis


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This report identifies strategies to strengthen the workforce of health systems. The Joint Learning Initiative was launched because many people believed that the most critical factor driving health system performance, the health worker, was neglected and overlooked

Accountability and health systems : overview, framework and strategies

January 2003

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This paper lays the groundwork for investigating accountability as it relates to health systems reform. It reviews and synthesises the literature on accountability, noting areas of convergence and of ongoing debate, and looks at an analytic framework for accountability and health service delivery systems, the role of health sector actors in accountability, and accountability-strengthening strategies

Corruption and the health sector

VIAN, Taryn
November 2002

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This paper describes important areas of vulnerability to corruption within the health sector and identifies approaches for prevention. Two areas of special focus include the supply of drugs and medical equipment, and informal economic activities of health providers



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