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Selected Topics - Human Resources in Health
 The WWW Virtual Library: Public Health
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Studies on Human Resource in Health at UNSW
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Global policies and related documents
- Global Atlas of the Health Workforce
"There is a growing need for high quality information on human resources in health systems to inform decision making for policies and programmes at the national and international levels. The WHO Department of Human Resources for Health has been collecting and compiling cross-nationally comparable data on health workers in all WHO Member States... Two sets of data are contained in the Global Atlas: a main (aggregated) set and a disaggregated set. The aggregated dataset includes estimates of the stock and density of health workers for up to 9 occupational categories. This includes: (i) physicians; (ii) nursing and midwifery personnel; (iii) dentistry personnel; (iv) pharmaceutical personnel; (v) laboratory health workers; (vi) environmental and public health workers; (vii) community and traditional health workers; (viii) other health service providers; and (ix) health management and support workers, that is, those who do not provide services directly but are critical to the performance of health systems. In the disaggregated dataset, estimates of the stock of health workers are available for some countries for up to 18 occupational categories, reflecting greater distinction of some categories of workers according to assumed differences in skill level and skill specialization."
- Increasing access to health workers in remote and rural areas through improved retention: Global policy recommendations
"Policy-makers in all countries, regardless of their level of economic development, struggle to achieve health equity and to meet the health needs of their populations, especially vulnerable and disadvantaged groups. One of their most complex challenges is ensuring people living in rural and remote locations have access to trained health workers. Skilled and motivated health workers in sufficient numbers at the right place and at the right time are critical to deliver effective health services and improve health outcomes. A shortage of qualified health workers in remote and rural areas impedes access to health-care services for a significant percentage of the population, slows progress towards attaining the Millennium Development Goals and challenges the aspirations of achieving health for all. The World Health Organization (WHO) has produced these recommendations in response to requests from global leaders, civil society and Member States." [World Health Organization WHO - 2010]
- WHO Global Code of Practice on the International Recruitment of Health Personnel
"The objectives of this Code are: (1) to establish and promote voluntary principles and practices for the ethical international recruitment of health personnel, taking into account the rights, obligations and expectations of source countries, destination countries and migrant health personnel; (2) to serve as a reference for Member States in establishing or improving the legal and institutional framework required for the international recruitment of health personnel; (3) to provide guidance that may be used where appropriate in the formulation and implementation of bilateral agreements and other international legal instruments; (4) to facilitate and promote international discussion and advance cooperation on matters related to the ethical international recruitment of health personnel as part of strengthening health systems, with a particular focus on the situation of developing countries." [Sixty-Third World Health Assembly – WHA63.16; Agenda item 11.5 of 21 May 2010]
Reports, guidelines and projects
- Addressing the health workforce crisis: towards a common approach
The challenges in the health workforce are well known and clearly documented. What is not so clearly understood is how to address these issues in a comprehensive and integrated manner that will lead to solutions. This editorial from Human Resources for Health presents – and invites comments on – a technical framework intended to raise awareness among donors and multisector organizations outside ministries of health and to guide planning and strategy development at the country level.
- Australia's Health Workforce: Research Report
This January 2006 paper represents the findings of the Australian Productivity Commission's study to examine issues impacting on the health workforce including the supply of, and demand for, health workforce professionals, and propose solutions to ensure the continued delivery of quality health care over the next 10 years. The study was undertaken in the context of the need for efficient and effective delivery of health services in an environment of demographic change, technological advances and rising health costs.
- Chances for Change: Dutch measures to improve the global distribution of health personnel
"Shortages of health personnel are experienced worldwide. They exist in developing countries as well as in developed countries. When one country’s demand exceeds its supply of health personnel, a ‘pull’ is exerted for migration flows from other countries. This pull is not shaped by the burden of disease in a country, but by unequally distributed financial resources for health systems. Consequently, migration flows are directed towards more affluent countries and regions. This increases the global maldistribution of health personnel and inequities in health." [Wemos Foundation, Amsterdam, The Netherlands; Dutch Alliance for Human Resources for Health, 2011]
- Competency based epidemiologic training in public health practice
"This special Public Health Reports supplement [Volume 123, Issue 7, 2008] presents articles and commentaries on the theme of competency based epidemiologic training in public health practice… The articles in this issue of Public Health Reports underscore the importance of clearly defined competencies for workforce education and training, and the usefulness of competencies for facilitating dialogue between academic and practice communities."
- Developing Public Health Management Training Capacity in Nicaragua - The Cooperative for Assistance and Relief Everywhere (CARE) and Centers for Disease Control and Prevention (CDC) Health Initiative in Nicaragua is distinctive in its focus on developing a cadre of in-country trainers whose aim is to equip frontline public health managers with widely applicable tools and techniques to assist them in identifying and solving implementation problems. Since 1999, 137 trainees — 37% more than originally planned — have demonstrated competence by completing and presenting applied management projects. Nineteen professors from the preventive medicine faculty at the Autonomous University of Nicaragua also have been trained. The country office now has a cadre of seasoned trainers who can meet the ongoing management training needs of CARE staff and their counterparts in the Ministry of Health and in other nongovernmental organizations. [author abstract]
- Distribution and Internal Migration of Canada’s Health Care Workforce
This 2007 report from the Canadian Institute for Health Information states that “…The distribution of health care providers is constantly changing. It is influenced by many factors such as both internal and external migration. Understanding and measuring where exactly these health professionals are located and how they move within the country is critical to the proper planning and management of the health care system. This series of reports uses a combination of Statistics Canada Census of Population and Scott's Medical Database data to examine internal migration - the movement of health care workers within provinces or territories or from one province or territory to another.”
- Educating public health physicians for the future: a current perspective from Aotearoa New Zealand
Persisting, and in some cases widening, inequalities in health within and between countries present significant challenges to the focus and practice of contemporary public health, and by association, to public health education. As public health physicians and academic educators of medically- and non-medically trained public health practitioners, we call for a radical re-think of current approaches to public health medicine education and training in order to address these challenges. The public health physicians of the future, we argue, require not merely technical knowledge and skills but also a set of values that underpin a commitment to ethical principles, social equity, human rights, compassionate action, advocacy and leadership. Furthermore, while they will need to have their action firmly grounded in local realities they should think, if not speak and act, from an informed awareness of global issues. Drawing from our experience in Aotearoa New Zealand, as well as with marginalised communities overseas, we proffer our suggestions for the process and content of public health physician education and training for the future, with the intention of stimulating debate. [author abstract] [Australia and New Zealand Health Policy 2009, 6: 7]
- For Public Service or Money: Understanding Geographical Imbalances in the Health Workforce
Geographical imbalances in the health workforce have been a consistent feature of nearly all health systems, and especially in developing countries. In this paper we investigate the willingness to work in a rural area among final year nursing and medical students in Ethiopia. Analysing data obtained from contingent valuation questions, we find that household consumption and the student’s motivation to help the poor, which is our proxy for intrinsic motivation, are the main determinants of willingness to work in a rural area. We investigate who are willing to help the poor and find that women are significantly more likely to help than men. Other variables, including a rich set of psycho-social characteristics, are not significant. Finally, we carry out some simulations on how much it would cost to make the entire cohort of starting nurses and doctors choose to take up a rural post.
- Global Demographic Change: Dimensions and Economic Significance
This Working Paper by David E Bloom and David Canning is part of the Harvard Initiative for Global Health, Program on the Global Demography of Aging. It examines the potential effects of unusual demographic changes which have occurred in recent decades as the result of baby booms, reduced infant mortality rates and subsequent reductions in fertility in countries throughout the world.
- Global health diplomacy: training across disciplines
"The interface between trade and health is on the cutting edge of global health diplomacy, write Ilona Kickbusch et al. in a perspective. Foreign policy is now being driven substantially by health to protect national security, free trade and economic advancement, they say. But this exciting new field of study requires conceptual development and practical training programmes….Some governments have taken purposeful strides to incorporate health as a foreign policy tool. Perhaps, however, it is the other way around: foreign policy is now being driven substantially by health to protect national security, free trade and economic advancement. We offer a few examples of this changing field of health and foreign policy as background to our academic response: The United Kingdom is attempting to establish policy coherence with the development of a central governmental global health strategy based on health as a human right and global public good. Rooted in the recognition of globalization and its effects on health, this new effort will bring together the United Kingdom’s foreign relations, international development, trade and investment policies that can affect global health." (author)
- Health Care Workforce in Europe: Learning from Experience
"A trained and motivated workforce, with appropriate skills, a commitment to life-long learning and receiving adequate rewards is an essential prerequisite for high-performing health systems. Yet, for many countries the challenge of getting this right too often proves elusive. ...This volume is one of a series of books produced by the European Observatory on Health Systems and Policies attempting to address this issue."
- Health service providers in Somalia: their readiness to provide malaria case-management
Background: Studies have highlighted the inadequacies of the public health sector in sub-Saharan African countries in providing appropriate malaria case management. The readiness of the public health sector to provide malaria case-management in Somalia, a country where there has been no functioning central government for almost two decades, was investigated. Methods: Three districts were purposively sampled in each of the two self-declared states of Puntland and Somaliland and the south-central region of Somalia, in April-November 2007. A survey and mapping of all public and private health service providers was undertaken. Information was recorded on services provided, types of anti-malarial drugs used and stock, numbers and qualifications of staff, sources of financial support and presence of malaria diagnostic services, new treatment guidelines and job aides for malaria case-management. All settlements were mapped and a semi-quantitative approach was used to estimate their population size. Distances from settlements to public health services were computed. Results: There were 45 public health facilities, 227 public health professionals, and 194 private pharmacies for approximately 0.6 million people in the three districts. The median distance to public health facilities was 6 km. 62.3% of public health facilities prescribed the nationally recommended anti-malarial drug and 37.7% prescribed chloroquine as first-line therapy. 66.7% of public facilities did not have in stock the recommended first-line malaria therapy. Diagnosis of malaria using rapid diagnostic tests (RDT) or microscopy was performed routinely in over 90% of the recommended public facilities but only 50% of these had RDT in stock at the time of survey. National treatment guidelines were available in 31.3% of public health facilities recommended by the national strategy. Only 8.8% of the private pharmacies prescribed artesunate plus sulphadoxine/pyrimethamine, while 53.1% prescribed chloroquine as first-line therapy. 31.4% of private pharmacies also provided malaria diagnosis using RDT or microscopy. Conclusion: Geographic access to public health sector is relatively low and there were major shortages of appropriate guidelines, anti-malarials and diagnostic tests required for appropriate malaria case management. Efforts to strengthen the readiness of the health sector in Somalia to provide malaria case management should improve availability of drugs and diagnostic kits; provide appropriate information and training; and engage and regulate the private sector to scale up malaria control. [author abstract] [Malaria Journal 2009, 8:100 doi:10.1186/1475-2875-8-100]
- Health Workforce and International Migration: Can New Zealand Compete?
"This paper examines health workforce and migration policies in New Zealand, with a special focus on the international recruitment of doctors and nurses. The health workforce in New Zealand, as in all OECD countries, plays a central role in the health system. Nonetheless, maybe more than for any other OECD country, the health workforce in New Zealand cannot be considered without taking into account its international dimension. New Zealand has the highest proportion of migrant doctors among OECD countries, and one of the highest for nurses. There is no specific immigration policy for health professionals, although the permanent and temporary routes make it relatively easy for doctors and nurses who can get their qualification recognised to immigrate in New Zealand. At the same time, New Zealand also has high emigration rates of health workers, mainly to other OECD countries. International migration is thus at the same time an opportunity and a challenge for the management of the human resources for health (HRH) in New Zealand. Increasing international competition for highly skilled workers raises important issues such as sustainability and ability to compete in a global market. In this context, new approaches to improve the international recruitment of health workers, as well as developing alternative policies, may need to be considered. As for international recruitment, better coordination and stronger collaboration between main stakeholders could contribute to more effective and pertinent international recruitment."
- How to create an attractive and supportive working environment for health professionals
"As a working definition, an attractive and supportive workplace can be described as an environment that attracts individuals into the health professions, encourages them to remain in the health workforce and enables them to perform effectively. In order to develop coherent policies to ensure a work environment that attracts and retains health professionals, policy responses have to be considered at four levels: international/regional level; national level; sectoral level; and local/organizational level. Improvement of the work environment will require the use of measures that are relevant to (and applicable in) the specific context of a given health system. These measures should also observe international standards and take account of regional harmonization efforts. Effective solutions are context-related and therefore priority has to be given to the local and organizational level; the other levels provide the legislative and regulatory framework, guidance and support for the development of workplace policies." [WHO Regional Office for Europe and European Observatory on Health Systems and Policies, 2010]
- Human resources for health: a gender analysis
This 2007 paper by Asha George “[examines] gender dynamics in medicine, nursing, community health workers and home careers. It also explores from a gender perspective issues concerning delegation, migration and violence, which cut across these categories of health workers. These occupational categories and themes reflect priorities identified by the terms of reference for this review paper and also the themes that emerged from the accessed literature. This paper is based on a desk review of literature accessed through the internet, search engines, correspondence with other experts and reviewing bibliographies of existing material. These efforts resulted in a list of 534 articles, chapters, books and reports. Although most of the literature reviewed was in English, some of it was also in Spanish and Portuguese.”
- Human Resources for Health in Europe
"This book analyses how the current regulatory processes and practices related to key aspects of the management of the health professions may facilitate or inhibit the development of effective responses to challenges facing health care systems in Europe. The authors document how health care systems in Europe are confronting existing challenges in relation to the health workforce and identify strategies to optimize the management of health professionals in the future."
- Impact of Migration on Health
Human Resources in Health is [sic] becoming important in these days. The Human Resources is an important area to be addressed for better healthcare delivery. Health is a sector which depends much on the human resources compared to other sectors. The human resources is [sic] the base for carrying out the services in health. The human resources in health includes [sic] professionals, technicians and auxiliaries. The workforce engaged in promotion and protection of health of members of the community. As per the available figures, in India 17.5 % Doctors posts were vacant in 2006. There are also shortfall in Nursing positions, and other health worker positions. About 50% of All India Institute of Medical Sciences (An institute of national importance in Medicine in India) students have migrated either to overseas or to private sectors. This is a problem faced by all developing countries. It is also important to note that all those who have migrated belong to the economically actuve [sic] age group. Majority of them are physicians, nurses, dentists and pharmacists. The present study is a meta analysis based on detailed review of different studies in the area of migration in health. The objective of the study is to find the impact of migration of health workers on health. [author abstract] [MPRA (Munich Personal RePEc Archive) Paper No. 13888, 2008]
- International collaboration to protect health workers from infectious diseases in Ecuador
The Healthy Hospital Project, an international collaboration, aimed to strengthen Ecuador’s capacity to promote healthier and safer hospitals by reducing occupational transmission of infectious diseases. Team members conducted a needs assessment to identify workplace hazards and health risks in three hospitals. A survey of health care workers’ knowledge and practices of occupational health (OH) and infection control (IC) revealed positive practices such as a medical waste disposal program and widespread dissemination of health information. Challenges identified included a high frequency of recapping needles and limited resources for workers to apply consistent IC measures. The survey revealed underreporting of needlestick injuries and limited OH and safety (OHS) training. Therefore, project collaborators organized a training workshop for health care workers that aimed to overcome the identified obstacles by integrating interdisciplinary local, national, and international stakeholders to build capacity and institutionalize work-related infection prevention and control measures. The knowledge transferred and experience gained led to useful hospital-based projects and serves as a basis for implementation of other OHS projects nationwide. International interdisciplinary, interinstitutional collaboration in OHS and IC can build capacity to address OHS concerns in health care. [publication synopsis] [Rev Panam Salud Publica. 2010; 27(5): 396–402]
- International Mobility of Health Professionals: Brain Drain or Brain Exchange?
"The consequences of health professional mobility have become a prominent public policy concern. This paper considers trends in mobility amongst doctors and nurses and the consequences for health systems. Policy responses are shifting from a reactive agenda that focuses on stemming migration towards a more active agenda of managed migration that benefits source and destination countries."
- Link between Clinical Pharmacy Services, Pharmacy Staffing and Hospital Mortality Rates
Discusses research demonstrating the link between the number of pharmacy administrators and reduced mortality rates in the US, UK and Australia. [Journal of Pharmacy Practice and Research Volume 37, No. 4, p.256, 2007]
- Migration of health workers
"Health workers, like workers in all sectors, tend to go where the working conditions are best. Income is an important motivation for migration, but not the only one. Other reasons include: greater job satisfaction; career opportunities; the quality of management and governance; and moving away from political instability, war, and the threat of violence in the workplace." [WHO Fact sheet N° 301, Updated July 2010]
- Mobbing, Stress, and Work Ability Index among Physicians in Bosnia and Herzegovina: Survey Study
Aim: To assess the frequency of reported mobbing and the association among mobbing, working environment factors, stress, health outcome, personality type, and work ability index in a sample of physicians in Bosnia and Herzegovina. Method: We conducted a questionnaire survey using a validated self-reported questionnaire among 511 physicians in national health sector of Bosnia and Herzegovina. The questions covered five major categories of mobbing behavior. Characteristics of the work, perceived work environment and its effects, stress, health, and satisfaction with work and life were assessed by the standardized abridged form of Occupational Stress Questionnaire (OSQ). A standardized questionnaire Work Ability Index (WAI) was used to determine the relation between mobbing and work ability. Results: Of 511 surveyed physicians, 387 (76%) physicians self-reported mobbing behavior in the working environment and 136 (26%) was exposed to persistent mobbing. More than a half of the physicians experienced threats to their professional status and almost a half felt isolated. Logistic regression analysis showed that lack of motivation, loss of self-esteem, loss of confidence, fatigue, and depressiveness were significantly associated with lack of support from colleagues. Intention to leave work was associated with lack of support from colleagues (OR 2.3, 95% CI, 1.065-3.535; t = 4.296, P = 0.003) and lack of support from superiors (OR 1.526, 95% CI, 0.976-2.076; t = 5.753; P = 0.001). Isolation or exclusion and threats to professional status were predictors for mental health symptoms. Persistent mobbing experience was a significant predictor for sick leave. Conclusion: Exposure to persistent threat to professional status and isolation or exclusion as forms of mobbing are associated with mental health disturbances and lack of self-esteem and confidence. Setting up a system of support for physicians exposed to mobbing may have important benefits. [author abstract] [Croat Med J. 2006; 47: 750-758]
- Not enough there, too many here: understanding geographic imbalances in the distribution of the health workforce
"The objective of this paper is to offer a better understanding of the determinants of geographical imbalances in the distribution of health personnel, and to identify and assess the strategies developed to correct them. It reviews the recent literature on determinants, barriers and the effects of strategies that attempted to correct geographical imbalances, with a focus on empirical studies from developing and developed countries. An analysis of determinants of success and failures of strategies implemented, and a summary of lessons learnt, is included." [Human Resources and Health Vol.4, 2006]
- Nursing and public health in Europe – a new continuous education programme
The aim of this paper is to describe the development of a new education programme in public health for nurses in the European Union (EU). The project, ‘Development of a Continuous Professional Education Programme for Nurses in Public Health’, is described together with its background and aim, which is to contribute to the development of new competencies of nurses in nursing and public health. For the development of these competencies, the framework for the programme’s guidelines is organized around core modules common for all EU countries and elective modules, based on national health needs and policies proposed by each country. An example of the implementation of the programme from Sweden, where the programme has already been offered, is also presented. In addition to the educational programme itself, the opportunities for networking for nurses and teachers from different countries resulting from this effort are discussed. Finally, the evolving nature of public health in nursing is presented in relation to the roles that nurses/midwives already perform in various countries and situations, in order to point out the potential of this programme’s contribution to the promotion of health of all European citizens. [author abstract] [International Nursing Review, 52, 32–38 (2005)]
- Public Health Training in the Democratic Republic of Congo: A Case Study of the Kinshasa School of Public Health
"The Democratic Republic of Congo (DRC), formerly Zaire, presents one of the most challenging environments for health development in Sub-Saharan Africa (SSA). Within SSA it is the second largest country in land area, has the third largest population, is challenged by high levels and a wide spectrum of infectious diseases, and relies upon a physical and human health infrastructure that has suffered more than four decades of neglect, a recent decade of conflict and the economic collapse of the country. Consequently, infant mortality rates in DRC are among the highest in Africa. Previously controlled diseases such as African Trypanosomiasis have reappeared, and many areas of the country remain inaccessible due to poor infrastructure or security threats. On the other hand, DRC has a legacy of a well-organized and functioning ‘district’ health primary care and referral system. While the central Ministry of Health (MoH) has not been influential until recent times, DRC has articulated Health Zones (HZ) over the years with clearly identified organizations, norms and functions. Since colonial times religious missions have acted as major implementing agencies in the health and education sectors, and the DRC now also has a thriving non-profit indigenous network of health care providers who are major partners in the management of the HZ system." [Johns Hopkins Bloomberg School of Public Health, May 2006]
- Public Health Workforce in Latin America and the Caribbean: assessment of education and labor in 17 countries
"Health systems in Latin America and the Caribbean have experienced a series of reforms since the 1990s as a result of the identification of problems with populations accessing services, scarce resources available to finance health, inequality in access to available resources, and issues concerning efficiency and quality of services. The reforms led to a redefining of the model of care from one that had focused resources on the production of personal services in the clinical environment to those that facilitate health promotion and risk prevention. These reforms have opened the door to a greater utilization of new public health models that address the challenges created by the epidemiological transition, the aging of the population, and the increase in service production costs... Their implementation requires, among other factors, a great deal of political commitment by key actors (including health ministries, social security institutions and professional associations), technically capable institutional leadership, and a well-informed civil society. Health personnel is fundamental to this process. Human resources in the sector play an active change role, as their functions as educators, trainers, and counselors are determining factors for the successful development of such models. In various countries, the transformations generated in the public health field have directly determined the need for highly qualified human resources to promote the implementation of models based on public health principles. It has therefore been necessary not only to revise the curricula currently in place at academic institutions but also to seek educational formats that enable the training of public health human capital to be broadened to better respond to the growing demand for these resources. In addition, once human resources are trained, it is important to guarantee their integration into the workforce, since it is in this environment that the knowledge and skills acquired in training become actions. Public health personnel, therefore, must not only carry out technical tasks but also possess the ability to lead processes." [Salud Pública de México, vol. 51, no. 1, pp.62-75, Jan-Feb 2009]
- Satisfied Workers, Retained Workers: Effects of Work and Work Environment on Homecare Workers' Job Satisfaction, Stress, Physical Health and Retention
The goal of this project, undertaken by the Canadian Health Services Research Foundation was to assist health system managers and policy makers develop policies and strategies to recruit and retain human resources in the homecare sector and have a satisfied, healthy workforce. Researchers worked in partnership with the agencies and the unions representing workers in the agencies to examine the effects of work and work environments on homecare workers’ emotional, mental, and physical health and intention to leave their workplaces.
- Strengthening Midwifery Toolkit
There have been serious efforts over the past several decades to review effective interventions for improving pregnancy and childbirth outcomes. A clear consensus has emerged from these analyse that providing skilled care at every birth is an essential component of interventions to reduce maternal and perinatal morbidity and mortality. Without availability of a health provider with specific midwifery skills and competencies, particularly lifesaving skills, international goals for maternal and newborn health cannot be reached. This toolkit focuses specifically on strengthening the central role and function of the professional midwife in the provision of quality care during pregnancy and childbirth and in other reproductive and sexual health services. It includes 9 modules: Module 1 - A background paper; Module 2 - Legislation and regulation of midwifery - making safe motherhood possible; Module 3 - Developing standards to improve midwifery practice; Module 4 - Competencies for midwifery practice; Module 5 - Developing a midwifery curriculum for safe motherhood: Guidelines for midwifery education programmes; Module 6 - Developing effective programs for preparing midwife teachers; Module 7 - Developing standards to improve midwifery practice; Module 8 - Monitoring and assessment of continued competency for midwifery practice; Module 9 - Developing midwifery capacity for the promotion of maternal and newborn health; and Annex 1 - A model curriculum for midwifery education and practice. [WHO, 2011]
- The Capacity Project in Mali
"Since March 2006, the Capacity Project has been working to enhance the availability and quality of health care service provision to communities in currently underserved areas of Mali. Toward this aim, the Project is collaborating with Malian colleagues to address a number of needs, including the lack of a consistent supply of well-trained health workers committed to providing health services to rural communities. In particular, there is a shortage of health workers in the three underserved northern regions of Mali and a chronic shortage of well-trained midwives available to serve in rural areas throughout the country—about 75% of nurses/midwives in Mali are based in the capital city of Bamako." [Capacity Project: knowledge sharing – Country Brief 6, November 2008]
- The development of postgraduate surgical training in Guyana
Background: Like many developing countries, Guyana has a severe shortage of surgeons. Rather than rely on overseas training, Guyana developed its own Diploma in Surgery and asked for assistance from the Canadian Association of General Surgeons (CAGS). This paper reviews the initial results of Guyana’s first postgraduate training program. Methods: We assisted with program prerequisites, including needs assessment, proposed curriculum, University of Guyana and Ministry of Health approval, external partnership and funding. We determined the outputs and outcomes of the program after 2 years, and we evaluated the impact of the program through a quantitative/ qualitative questionnaire administered to all program participants. Results: Five residents successfully completed the 2-year program and are working in regional hospitals. Another 9 residents are in the training program. Twenty-four modules or short courses have been facilitated, alternating Guyanese with visiting Canadian surgical faculty members coordinated through CAGS. A postgraduate structure, including an Institute for Health Sciences Education and Surgical Postgraduate Education Committee, has been developed at the Georgetown Public Hospital Corporation (GPHC). An examination structure similar to Canada’s has been established. Hospital staff morale is greater, surgical care is more standardized and academic opportunities have been enhanced at GPHC. Four regional hospitals have welcomed the new graduates, and surgical services have already improved. Canadian surgeons have a greater understanding of and commitment to surgical development in low-income countries. Conclusion: Guyana has proven that, with visiting faculty assistance, it can mount its own postgraduate training suitable to national needs and will provide a career path to encourage its own doctors to remain and serve their country. [author abstract] [Canadian Journal of Surgery, Vol. 53, No. 1, February 2010, pp.11-16]
- The harmonization of the medical speciality in Public Health in the EU countries—a challenge for the profession
"Facing the challenges for Public Health in Europe it is of importance to outline a common strategy for a European training programme in Public Health. At present the medical speciality of Public Health is strengthening its position in the EU medical specialist system. According to the present EU decision the speciality Public Health Medicine will be automatically recognized in all EU countries, i.e. a specialist trained in one EU country will be recognized as a specialist in all EU countries. As a consequence, Public Health today is one of the established specialities in EU. Thus, the need for harmonization of the specialist training is further emphasized. The objective of this paper is to discuss the process of harmonization of the speciality in Public Health in the EU countries." [The European Journal of Public Health – Advance Access, published online on 15 April 2009]
- The looming crisis of the health workforce: How can OECD countries respond?
"OECD countries face a challenge in responding to the growing demand for doctors and nurses over the next 20 years. This challenge arises in a world which is already characterised by significant international migration of health workers, both across OECD countries and between some developing countries and the OECD area. What combination of human-resource management policies and migration policies is adopted by OECD countries? How do migration and other health workforce policies interact with each other? How can destination countries build a sustainable health workforce? What are the consequences of emigration of doctors and nurses for origin countries? Drawing from selected OECD countries' experience, the study also provides for selected countries (Canada, France, Italy, New Zealand, United Kingdom and United States) an overview of health workforce policies implemented to build adequate human resources for the provision of health care."
- The Voluntary Code of Ethical Conduct for the Recruitment of Foreign-Educated Nurses to the United States
"The Voluntary Code of Ethical Conduct for the Recruitment of Foreign-Educated Nurses to the United States (the Code) reflects the mutual recognition of stakeholder interests relevant to the recruitment of foreign educated nurses (FENs) to the United States. It is based on an acknowledgement of the rights of individuals to migrate, as well as an understanding that the legitimate interests and responsibilities of nurses, source countries, and employers in the destination country may conflict. It affirms that a careful balancing of those individual and collective interests offers the best course for maximizing the benefits and reducing the potential harm to all parties. While the Code acknowledges the interests of these three primary stakeholder groups, its subscribers are the organizations that recruit and employ foreign educated nurses, e.g., third party recruiting firms, staffing agencies, hospitals, long-term care organizations and health systems."
- Violence against health personnel in some health care units in Maputo City
"This report results from a research project on violence against health care providers in selected health care units in Maputo city… The research was carried out in the following health units in Maputo: Maputo Central Hospital; José Macamo General Hospital (including the health centre linked to the hospital), Mavalane General Hospital, Maputo Military Hospital and Bagamoyo Health Centre… The questionnaire was applied to health care providers and other health personnel (physicians, nurses, orderlies, technicians - health, pharmacy, laboratory -, administrative personnel) working in the health units selected for the study… The main objective of this work was to analyse the level of violence which existed in the hospitals of Maputo city, identifying the factors and forms of struggle or prevention of these events. The specific objectives defined were the following: Obtain information about the level of violence in Maputo health units; Gather knowledge about the mechanisms and procedure adopted by health personnel regarding violence problems; Evaluate the positive and negative impacts of the adopted mechanisms and study forms to reduce negative impacts; Understand the aspirations of the health care personnel and their coping strategies regarding the problems they have to face in their daily work; and Help the health care personnel in the struggle against violence." [International Labour Office (ILO), International Council of Nurses (ICN), World Health Organisation (WHO) and Public Services International (PSI): Joint Programme on Workplace Violence in the Health Sector, Geneva, 2003]
- World Health Report 2006
"The World Health Report 2006 - Working together for health contains an expert assessment of the current crisis in the global health workforce and ambitious proposals to tackle it over the next ten years, starting immediately. Focusing on all stages of the health workers' career lifespan from entry to health training, to job recruitment through to retirement, the report lays out a ten-year action plan in which countries can build their health workforces, with the support of global partners."
Educational resources
- Guidelines on incentives for health professionals
"The world's leading health and hospital professional associations have joined to produce the first-ever joint guidelines on incentives for the retention and recruitment of health professionals. Commissioned by GHWA as part of its work to identify and implement solutions to the health workforce crisis, the Guidelines on Incentives for Health Professionals is the combined result of collaboration. …The report underlines how incentives are important levers that organizations can use to attract, retain, motivate and improve the performance of their staff in all professions and walks of life, This is especially and urgently needed in the health care sector, it states, where the growing gap between the supply of health care professionals and the demand for their services is reaching crisis levels in many countries. The 'Incentives' guidelines offer practical solutions that can make a difference. Professional associations will implement the guidelines by using the research to support claims and raise awareness of all stakeholders including patients. The serious shortage of health workers across the world has been identified as one of the most critical constraints to the achievement of health and development goals. The 2006 World Health Report estimated a global shortage of 4.3 million health workers, including 2.4 million physicians, nurses and midwives. Translated into access to care, the shortage means that over a billion people have no access to heath care professionals." Available in English, French and Spanish.
- The Observatory of Human Resources in Health Sector Reforms
The Observatory of Human Resources is a cooperative initiative among the countries of the Latin American Region and the Caribbean to produce information and knowledge necessary for improving human resources in health policy decisions, and to share the knowledge obtained from the experiences in order to improve the management of human resource development in the health services sector.
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Original website founded Lucien E. Schlosser and Eberhard Wenzel, 1997.
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