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


Participatory supervision with provider self-assessment improves doctor-patient communication in rural Mexico

Preliminary research conducted by the Mexican Institute of Social Security/Solidarity (IMSS/S) and the Quality Assurance Project in Michoacan, Mexico, exposed shortcomings in both interpersonal communication and counseling among...

Zambia pilot study of performance-based incentives

The purpose of the Performance-based Incentives Pilot Study was to develop and test a process for motivating staff and increasing performance by offering rewards for position contributions within the healthcare facility. The study was...

Designing and Integrating Quality Family Health Services at the Salt Model Center in Jordan

Quality design is the systematic creation of new services or processes or the redesign of existing ones. It incorporates features that meet the needs of internal and external clients while taking into account the resources available. In...

The quality of supervisor-provider interactions in Zimbabwe

This report presents the results of a formative study that describes and quantifies the quality of supervisor-provider interactions throughout Zimbabwe in 1999. Using a participatory approach, a set of instruments for structured...

Assessing Health Worker Performance of IMCI in Kenya

Quality assessment is the measurement of the quality of healthcare services. A quality assessment measures the difference between expected and actual performance to identify opportunities for improvement. Performance standards can be...

Assessing the functionality of job aids in supporting the performance of IMCI providers in Zambia

In cooperation with the Zambian Central Board of Health, the Quality Assurance Project investigated the way in which job aids could increase compliance with IMCI regulations throughout the country. Zambia was one of the first countries to...