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

 

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.

A call for stronger African leadership in health

Francis Omaswa

Executive Director, African Centre for Global Health and Social Transformation

I am proud to introduce a new book entitled African Health Leaders: Making Change and Claiming the Future.  It was first launched in September 2014 during the UN General Assembly in New York. A number of contributions by the Ashgovnet community have made their way into this book, which was edited by Lord Nigel Crisp and me. There are supporting statements from the Chairperson of the African Union Commission, Her Excellency Dr. Nkosazana Dlamini Zuma and Dr. Tim Evans of the World Bank. It is available for order online on Amazon and the Oxford University Press.

USAID ASSIST Project Annual Performance Monitoring Report FY14

This annual report for the USAID ASSIST Project summarizes the project's accomplishments and results in FY14 supporting the application of modern improvement methods by host country providers and managers in USAID-assisted countries...

Improving Health Care: The Results and Legacy of the USAID Health Care Improvement Project

This final report of the USAID Health Care Improvement Project (HCI) summarizes the key accomplishments and learning of this seven-year global technical assistance project of the USAID Office of Health Systems. Implemented from 2007-2014,...

A Community Health Worker “logic model”: towards a theory of enhanced performance in low- and middle-income countries

This article published in Human Resources for Health (2014; 12:56 doi:10.1186/1478-4491-12-56) describes a generic logic model for community health worker (CHW) performance that posits that optimal CHW performance is a function of high...

Evaluation of Primary Health Care Supervision Services in Mpumalanga Province

In 2013, the Mpumalanga Department of Health proposed to evaluate the implementation of primary health care (PHC) supervision services in order to improve the quality of health care in Mpumalanga Province. In South Africa, PHC services are...

Third Global Symposium on Health Systems Research

Cape Town, South Africa

The theme of the symposium this year was the science and practice of people-centred health systems, chosen to enable participants to address current and critical concerns of relevance across countries in all parts of the world. Researchers, policy-makers, funders, implementers and other stakeholders, from all regions and all socio-economic levels, worked together on the challenge of how to make health systems more responsive to the needs of individuals, families and communities.

See below for the USAID ASSIST Staff involvement at the Symposium. Details and downloads of each presentation are provided below.

USAID ASSIST Project Experience Improving HIV Services

This technical report summarizes the experience of the United States Agency for International Development (USAID) Applying Science to Strengthen and Improve Systems (ASSIST) Project and its predecessor, the USAID Health Care Improvement...

IAMRA 2014: 11th International Conference on Medical Regulation

London, UK
The major international conference on medical regulation is coming to London in September 2014. Hosted by the International Association of Medical Regulatory Authorities (IAMRA), the 11th International Conference on Medical Regulation will bring together leaders in health professional regulation from around the world.  More than 300 participants from over 30 countries are expected to attend.

Why Universal Health Coverage Depends on Human Resources for Health

M. Rashad Massoud

Director, USAID ASSIST Project/URC

This coming September at the Third Global Symposium on Health Systems Research in Cape Town, Frances Day-Stirk, President of the International Confederation of Midwives, and I will be co-chairing a working group on the role of standards, quality improvement, and regulation for improving health worker productivity and performance in the context of universal health coverage (UHC).  We will be part of a satellite session on emerging findings and priorities for human resources for health (HRH) post 2015 and one of seven working groups contributing to this effort.  During the working group we will present a strategic paper and framework that we are developing together with global experts on this topic.  

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