Health Workforce Development

Health Workforce training with model baby

Crucial for efforts to provide universal health coverage is the strengthening of the existing health workforce – maximizing the talents that are currently available and building mechanisms to ensure that productivity, performance, and engagement will continue to improve as these resources grow and evolve.  In order to obtain desired results, it is necessary to both explore and develop the evidence to enhance our understanding of the factors that influence health worker outputs and clinical outcomes.  This is accomplished through innovative research that is then used to develop practical tools and guidance that is applied to analyze and strengthen health workforce planning, management, and development.  Applying improvement approaches to engage health workers in providing quality care and to empower teams to deliver better services to more users is an integral part of systems strengthening. 

In many countries the performance of health workers is constrained by factors such as regular stock-out of medicines, shortage of supplies, high levels of staff turnover, unclear job expectations, and limited feedback and supervision. Growing evidence suggests that improving the productivity and engagement of health workers and addressing performance factors within the health workforce contribute to improved care outcomes.  Improvement methods can help to:

  • Clarify roles and expectations, assess work distribution and rationalize tasks among team members, and introduce measurement of performance
  • Develop and test incentives, rewards and consequences that reinforce strong performance and discourage poor performance, from verbal recognition to career path and bonus mechanisms
  • Strengthen performance feedback mechanisms among members of the care delivery team, supervisors, and community members
  • Enhance the work environment, including both the physical environment (including safety and the availability of supplies) and the non-physical environment (including management practices that build confidence and security, mechanisms for coordination and communication, and protection from violence or harassment), to enable health workers to perform at their best
  • Build the competencies needed to implement tasks and perform at expected levels

 

Our “Best 9” stories in 2017

Vicky Ramirez

Consultant, USAID ASSIST Project/URC

Looking back, 2017 was a great year for us at ASSIST. In 2017, we were featured in USAID’s Exposure; we collaborated with a number of partners to publish ICHC Blog Series, which was cross-posted on The Huffington Post; and we ran a blog series in honor of Health Worker Week. After our resources page, our blog was the most visited page on our website. In case you missed some of these highlights, we’ve put together our “Best 9” stories. These posts illustrate the stories behind the great work employed by our country teams, partners, and individuals. Let us know which story you loved the most!

A clear guide to improving care of mothers and babies in low-resource settings

By: Tamar Chitashvili, Silvia Holschneider, Jorge Hermida, and Nigel Livesley 

There is growing recognition that clinical training and health infrastructure — while essential—are insufficient for improving and sustaining life-saving maternal and newborn health care services in low-resource settings. Instead, broader systems strengthening and continuous quality improvement efforts at the service delivery level are needed to continuously assess gaps in processes and content of care and to plan, test, implement, regularly monitor, refine and institute changes to deliver services correctly and consistently. To respond to this need and help frontline care providers in their continuous quality improvement journey, “Improving Care for Mothers and Babies: A Guide for Improvement Teams” was recently developed through collaborative efforts of the Survive & Thrive Global Development Alliance (S&T GDA).

Achieving better HIV care with engaged health care workers

Sarah Smith Lunsford

Senior Improvement Advisor, Research & Evaluation, USAID ASSIST/EnCompass LLC

As we work toward ending the global HIV epidemic by the year 2030, optimizing the health workforce has never been more important. PEPFAR 3.0 directs investment to target regions and services to achieve epidemic control. Yet, as countries strive to achieve more with less, what activities and approaches will best support and enable increased utilization of the existing health workforce to deliver and sustain quality HIV/AIDS services? An engaged health workforce is more productive, stays on the job longer, and provides better care.

International Day of the Midwife: Need for midwives is more than ever

Annie Clark

Senior QI Advisor MNCH, USAID ASSIST Project/URC

May 5 is the internationally recognized day for highlighting the work of midwives. The International Confederation of Midwives (ICM) established the idea of the 'International Day of the Midwife' (IDM) following suggestions and discussion among midwives associations in the late 1980s, then launched the initiative formally in 1992. 

Empowering health workers to improve health and nutrition services for males and females in Zambia

Elizabeth Romanoff Silva

USAID ASSIST Project/WI-HER

Last month I had the opportunity to travel to Zambia to provide gender technical assistance to the USAID ASSIST-supported nutrition assessment, counseling and support (NACS) services. Gender inequality is a major factor affecting vulnerability to malnutrition, especially for people living with HIV, so I was especially interested in working with health workers to identify the different issues preventing males and females from accessing services, issues affecting their nutrition status, and to identify the root causes preventing improved nutrition among women, men, girls and boys, and developing changes to test to find solutions.

Bringing experience and knowledge to the Ebola frontline in Liberia: Honoring Dr. Anne Atai

Lani Marquez

Knowledge Management Director, USAID ASSIST Project/URC

It was the tiny pin on her jacket that caught my eye. 

At a tea break during the Safe Male Circumcision Knowledge Handover meeting held last month in Kampala, I found myself standing next to a senior physician from Jinja Referral Hospital.  She was participating in the meeting as part of a team from Jinja’s Safe Male Circumcision program, to learn from other teams in Uganda that had been working on improving the quality of safe male circumcision services.

A health worker's perspective on improving PMTCT services through a community-based system in Mozambique

Percina Paulo Mathe

Maternal and Child Health Nurse, Licilo Health Post/Mozambique

The following blog is written by Percina Paulo Mathe, a health worker in Mozambique,and was originally published in January. ASSIST is highlighting Percina's story as as part of World Health Worker Week (April 6-10). The original Portuguese entry is below the English translation.

My name is Percina Paulo Mathe, I’m a 32-year-old maternal and child health nurse in Licilo in Gaza Province, Mozambique.

After my training on PMTCT, I found it was hard to apply it in my community because there were many barriers to the community approach. For example, often all the information about a patient stayed within the hospital without being passed on to those in their own community or neighborhood who could support the patient. Language was also a barrier; sometimes topics were not explained in the hospital in the same terms as in the community, whereas using a common language would increase what is truly understood by the patient and the community, taking into account the rumors that exist in the community.  For me such incomplete communication was like trying to fight a poisonous tree by just cutting off some branches; leaving the trunk and the roots means that when the rain comes, the tree will just grow back.

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