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

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Integrated training activities Partnerships facilitate the integration of training activities which can be more cost effective than running stand alone training activities. In India, the MOH adopted an integrated approach to train 200,000 health workers on emergency contraception pills (ECPs) to lower the cost. ECP training was integrated into the Reproductive and Child Health training program under which paramedics undergo three days of training. All paramedics were then reoriented in the new service, through a two-hour session on ECPs. ECPs have now been included in the MOH Contraceptive Technology Update (CTU) manual (Hossain 2009). Curriculum review and development There are a number of documents that outline changes that have been made or need to be made to HRH curriculum for cadres working at community level in MNRH. These revisions and additions are necessary in order to ensure that the courses are responsive to community needs and are technically current. Learner needs analysis and curriculum reviews necessary part of on-going improvement of education and training and health worker performance. Specific priority areas have been identified at the community level including: training in recognition of complications among women, families, and TBAs to promote timely referrals (Sibley and Armbruster 1997) and training for integrating HIV prevention and care into maternal and child health care settings(Rutenberg 2002). Others have highlighted communication training (QAP 2000), advocacy and negotiation (FIGO 2009), management (Howard 2002) and the need for business skills for private midwifes (Segall 2006). The ICM has defined core competencies that are of value to those developing pre-service and continuing education for community healthy personnel however the competencies required depend on models of care that is adopted (Koblinsky, Campbell et al. 1999). There is little discussion in the literature regarding the competencies needed for international health workers in MNRH at community level. An article on the competencies for Australian health professionals working in international health (Akbar 2005) does not examine the specific graduate requirements for work in this context but provides a list of 9 core competencies derived from key informant interviews and an analysis of job descriptions. The table below provides some examples of studies undertaken to establish the curriculum required to prepare health workers to practice in MNRH at community level in LMICs. P a g e | 125
Table 21 Learner needs analysis and curriculum reviews Participants/ curricula CHWs, VHV and TBAs Asia and near East Method Findings / Description Reference Survey Need for training and refresher training for community based newborn & PPC & FP (ESD Project 2008) Indonesia 332 midwives in 3 provinces, hospital & community range of grades East African Nurses Including CHNs Kenya nurse midwives Botswana: Nurse & midwifes Curriculum reviews Auxiliary nurse midwife: India East Timor: nurse and village health worker Cambodia: nurse midwife Cambodia: nurse midwife India: Aux nurse midwife psychometrically valid training-needs instrument Baseline needs assessment- survey Multivariate analyses of performance Curriculum review needs analysis Curriculum review Curriculum review Curriculum review including workshops & consultation The most-educated midwives recorded training needs for 24 tasks, while the lesseducated had training requirements for all tasks, which suggests that new training programmes are effective. Few differences in training needs were revealed between hospital and community midwives Questionnaire for Educational Needs Assessment for East, Central and Southern Africa College of Nursing in Member Countries Ninety-six percent of the facility incharges reported an interest in training & other support to enable them to meet the demand for PAC. The 2 facility in-charges who declined participation in the PAC initiative cited the following reasons for lack of interest: patients‘ inability to pay for the services & counselling postabortion patients was too time consuming High performance of midwives suggests that all nurse be trained as midwives rather than upgrade nurse aids to RNs Content change to align with epidemiological situation, disease pattern, approach to the client, programs, policies and rules. Job descriptions updated but issues with agreement by all parties educational needs assessment in conflict settings necessary Reestablishment of training programmes in remote villages, upgrading education standards, twinning programmes with Australian institutions Address current skills deficit, specifically the need to increase support to Primary Midwives Recommendations for a Community Health Option in actual & possible advanced practice programs Revised content & job descriptions India: CMWs Curriculum review content was updated and content was added to strengthen clinical exercises & cover PPC (Hennessy, Hicks et al. 2006) (The East 2006) (Yumkella 1996) (Fako, Forcheh et al. 2004) (Government of India 2004) (Ehrlich 2004) (McAuliffe, Grootjans et al. 2002) (Sherratt 2006) (Herem 2000) (Government of India 2004) (Murphy 2008) P a g e | 126
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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
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partum services as being from 1:60
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husbands who oppose family planning
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Remuneration for CHWs, nurse and mi
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Supportive HRH strategies and appro
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Strengthening HRH policy legislatio
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Strategies to improve Human resourc
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there are interrelationships betwee
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Table 11 Tools for managing HR in M
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Performance management Effective ma
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The Health and Family Planning Mana
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as a guide to mentoring, delegation
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eceived from outside the routine pu
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Page 83 and 84: There are a number of difficulties
Page 85 and 86: Figure 23 The Task Shifting Process
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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
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Page 99 and 100: Management autonomy at community le
Page 101 and 102: Initiative focus Details Context Re
Page 103 and 104: informal, mutual-help action groups
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Page 109 and 110: Summary This section has identified
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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: Table 20 Examples of Partnership ap
Page 129 and 130: Table 22 Some approaches to the des
Page 131 and 132: Participants/ Method / document typ
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Page 135 and 136: Participants / context LMICs method
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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
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Page 153 and 154: flexibility in order to overcome ge
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Page 157 and 158: Scaling up of the Navrongo service
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Page 161 and 162: Figure 37 Critical success factors
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Page 167 and 168: (Dieleman 2006) Selected key indica
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Page 171 and 172: Summary of findings This narrative
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Page 175 and 176: 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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