Human Resources for Health in Maternal, Neonatal and - HRH ...

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Initiative focus Details Context Reference Health and welfare of staff Care and treatment for staff with HIV/AIDS Swazi Wellness Centre for HRH well received Swaziland Malawi (Dlamini 2008) (MoH Malawi 2004) Poor eyesight of Eye testing and provision of glasses improved Ghana (IntraHealth 2002) midwives performance OH&S guidelines for integrating safe disposal of ―sharps‖ PMTC training guide includes notes on cleaning sterilizing & disposing of infectious materials & managing occupational exposure Africa (WHO 2002; ICN 2006; World Bank 2009) (WHO 2004) Training guide that includes consideration of Global (Engender Health Advocacy & lobbying Family friendly work policy Mother & baby friendly policy pregnant health worker & exposure to ensure that occupationally acquired HIV/AIDS is accepted as a work-related disease for which nurses & midwives will be compensated Employers of midwives to provide flexible working conditions and policies so that midwives are enabled to return to work after maternity leave as soon as appropriate without compromising either their relationship with their own infants or optimum breastfeeding 2004) Global (ICN 2006) Global (ICW 2008) PHC teamwork Team work at community level can involve a partnership of CHWs with or as skilled birth attendants working in an enabled environment where quick referral to facility is available. This is regarded an effective way forward for safe motherhood (Graham 2001) and together with mobilised volunteers a route to achieving MDG 5a (Phillips 2006). An example of this team practice is the partnership between community health workers in India where Sahiyyas work who alongside the Anganwadi Worker (AWW) and Auxiliary Nurse Midwifes (ANM) (Government of India 2004). Effective teamwork requires a greater understanding of group processes and team development however this review has noted a paucity of research documenting team work at community level in MNRH in LMIC. In contrast to this there is a great deal of work in developed contexts which can inform strategies for effective team working in primary care (Kroll 1994; While, Shah et al. 2005; Thomas, Sexton et al. 2006; O'Neill 2008). This may have some applicability to resource poor settings however more work is required along with insight into skill mix at PHC level in LMIC with most work relating to North America and Europe (Buchan 2004). Peer support networks have been found to be an important means of providing supervision to staff at community level (IntraHealth 2003) and have contributed to improved performance. Fako reports from a study in Botswana that nurses who relied on peers for information were productive (Fako 2002). A review of the nursing curriculum in Cambodia resulted in a recommendation to establish community support groups for local midwives in rural areas. It is argued that this will particularly help midwives not from the area, to feel a sense of connection with the community and may result in better retention of staff (Sherratt 2006). Laperrier reports upon how community health nurses, in contexts of extreme poverty and conflict in Brazil developed ties of solidarity and belonging. These ties soon developed into P a g e | 101
informal, mutual-help action groups for professional support and health advocacy (Laperriere 2007). A number of tools or instruments have been developed to assess teamwork performance with 15 being designated as ―best measures‖ by Heinemann and Zeiss (2002). However none of these tools has been developed for use in LMIC at community level in MNRH or trialled in this context. Health worker partnerships across sectors While existing government community based health workers (CHW) will have a role in the community-based efforts, they are unlikely to be adequate. A well designed program also needs to involve the targeted use of CHWs recruited by NGOs, and informal private sector providers.(NIPORT/ Mitra and Associates/Macro International 2009). Intersectorial collaboration is therefore necessary to quality care and performance (WHO 1989). Intersectorial collaboration requires health personnel from multiple organisations to work together. Gordon et al reports on some lessons learned from experience in this area which may have some applicability for HRH in MNRH at community level (Gordon, Kavanagh et al. 1998). These lessons include the consideration of the need to effectively integrate multi-organizational perspectives and resources; communicate effectively to a range of audiences; work with different styles of leadership and approaches to problem solving, and decision making align the missions of various partners to deliver a more appropriate mix of resources to communities These challenges are no where better illustrated in the context of bilateral donor programmes such as the provision of Cuban health workers to countries such as Timor Leste (Anderson 2008). Partnerships with professionals outside the traditional health sector such as in education are important in order to provide access to accurate information on health and linkages for referral. Teachers are key to providing reproductive health education in primary and secondary schools. However little is known about how teachers and health workers actually work together to support the delivery of sex education in schools. Some insight is provided from a study of teacher and health workers perceptions of a large scale programme in Egypt (Arab Int. Centre for fighting against AIDS 2002) which found that this approach to health education is acceptable to both professionals. Training for school teachers in HIV/AIDS life P a g e | 102
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Human Resources for Health in Mater
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What human resource practices in ma
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Collaboration with traditional and
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Acronyms AAAH Asia and Pacific Acti
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TBA T & L UNFPA UNICEF UOG UPNG USA
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Figure 34 Potential gain in percent
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Executive Summary Addressing the ba
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Introduction What human resource pr
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Review Questions 1. What HR approac
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Effective HRH practice and quality
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is no single prescribed set of ways
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Table 3 Classification of health ce
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Figure 5 Millennium Development Goa
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(UNICEF 2007) However, the road to
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A number of steps are purported to
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Figure 10 Overview of HRH at commun
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functions, the latter involving mob
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settings‖(ICN 2009). They may be
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Table 7 What Skilled attendants can
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Traditional healers may also be inv
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Methodology What human resource pra
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Table 9 Search terms used for the s
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findings. Differences and similarit
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Barriers and constraints to HRH pra
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PHEs. In the Pacific the density of
Page 51 and 52: partum services as being from 1:60
Page 53 and 54: husbands who oppose family planning
Page 55 and 56: Remuneration for CHWs, nurse and mi
Page 57 and 58: Supportive HRH strategies and appro
Page 59 and 60: Strengthening HRH policy legislatio
Page 61 and 62: Strategies to improve Human resourc
Page 63 and 64: there are interrelationships betwee
Page 65 and 66: Table 11 Tools for managing HR in M
Page 67 and 68: Performance management Effective ma
Page 69 and 70: The Health and Family Planning Mana
Page 71 and 72: as a guide to mentoring, delegation
Page 73 and 74: eceived from outside the routine pu
Page 75 and 76: The isolated nature of much communi
Page 77 and 78: progress over time. This tool and t
Page 79 and 80: At national level, countries may ha
Page 81 and 82: evaluating and adjusting the size a
Page 83 and 84: There are a number of difficulties
Page 85 and 86: Figure 23 The Task Shifting Process
Page 87 and 88: Substitution Substitution is differ
Page 89 and 90: which was developed in 2002. This w
Page 91 and 92: al. 2008). Dual practice is another
Page 93 and 94: Figure 24 Motivational determinants
Page 95 and 96: Many of the incentives to health wo
Page 97 and 98: files suggests that more careful at
Page 99 and 100: Management autonomy at community le
Page 101: Initiative focus Details Context Re
Page 105 and 106: Building relationships with cultura
Page 107 and 108: groups; encouraging recruitment thr
Page 109 and 110: Summary This section has identified
Page 111 and 112: encouraging midwives to proactively
Page 113 and 114: Facilitation & attendance at MOH/ N
Page 115 and 116: of community leaders improved the c
Page 117 and 118: Table 19 Examples of initiatives in
Page 119 and 120: information and advice from peers (
Page 121 and 122: esources to provide clinical and ma
Page 123 and 124: Strengthening Education and compete
Page 125 and 126: Table 20 Examples of Partnership ap
Page 127 and 128: Table 21 Learner needs analysis and
Page 129 and 130: Table 22 Some approaches to the des
Page 131 and 132: Participants/ Method / document typ
Page 133 and 134: strengthening and establishing accr
Page 135 and 136: Participants / context LMICs method
Page 137 and 138: alongside health service improvemen
Page 139 and 140: Country / cadre Niger: Birth attend
Page 141 and 142: Country / cadre Indonesia Surabaya
Page 143 and 144: Lessons learned from countries that
Page 145 and 146: Malaysia The sharp decline in mater
Page 147 and 148: although supplemented with epidemio
Page 149 and 150: A technical meeting in Bangkok in 2
Page 151 and 152: Development approach is an example
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flexibility in order to overcome ge
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up skilled birth attendance‖. The
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Scaling up of the Navrongo service
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conditions (Walt, Perera et al. 198
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Figure 37 Critical success factors
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Health system standards are explici
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prevalence rate, however in order t
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(Dieleman 2006) Selected key indica
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In order to determine the answers t
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Summary of findings This narrative
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Health worker performance is theref
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Discussion and Recommendations What
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outlines how the HRH information ba
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communities. A collaborative approa
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Table 29 Examples of HRH performanc
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Appendices Appendix 1. MDG5 Country
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World Health Statistics http://www.
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Appendix 3. Sources of all material
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Data source Keywords used in search
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Appendix 4: Barriers and Constraint
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Area Barriers & constraints in MNRH
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Area Barriers & constraints in MNRH
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Appendix 5 Literature that document
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P a g e | 206
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IMNCI PMTCT Perinatal Period Postna
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Ambegaokar, M., Lush, L. (2004). "F
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Barrett, B., J. Ladinsky, et al. (2
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University South Africa with the Re
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Cruse, D. (1997). Community Health
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Elson, D., Evers, B. (1998). Sector
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Flanagan, D., Williams, C., Mahler,
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Greenwood, A. M., Bradley, A.K., By
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Howard, G., Bogh, C., Goldstein, G.
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Jhpeigo (1998). Participatory techn
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Kroll, D., Dwyer, D. (1994). "Postn
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Manandhar, D. S., D. Osrin, et al.
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Morisky, D. E. (1985-86). "Evaluati
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O‘Brien-Pallas, L., Irvine, D., P
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Pfeiffer, J. and J. Pfeiffer (2003)
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Replogle, J. (2007). "Training Trad
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Shankar, A., S. Sebayang, et al. (2
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Teela, K. C., L. C. Mullany, et al.
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van Damm, W., et. al (2008). "Scali
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WHO (2008). Global Standards for In
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