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

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Country / cadre Gambia Tanzania: PHC FP workers Pakistan: TBAs, LHWs Indonesia: FP counsellors India: CHWs HRH Interventions findings Method Reference TBA CHN training, increase in staff, introduction of clinical schedules real or simulated antenatal and postpartum/neonatal care clinical scenarios services, reflections on current HRH environment HRD development approach: decentralised training system, FP policy & guidelines, national training strategy & training of service providers at all levels, standardised in service training curricula, on job training & supervision system In 3 talukas randomly assigned to the intervention group, TBA were trained & issued disposable delivery kits; LHWs linked traditional birth attendants with established services & documented processes and outcomes; & obstetrical teams provided outreach clinics for antenatal care. Women in the 4 control talukas received usual care. a one week training for the providers in inter-personal communication, a low cost self-assessment protocol, and weekly peer review meetings CHWs trained to deliver packages of interventions for essential newborn care via collective meetings & 2 antenatal & 2 postnatal household visitations Women more likely to be registered in prenatal care, mean hemoglobin level was higher, more likely to seek and receive medical care for minor and major conditions, fetal & perinatal death higher may have due to under reporting in the control area performance of at primary posts was enhanced when they received training in the use of the clinic tools; and (b) receiving recognition from the employer or the client/ community, are factors strongly associated with performance, followed by (c) receiving performance feedback in postpartum care MOH & NGO partners increased the use of FP/reproductive health services over a 10-year period, from under 7% in 1989 to an estimated at 17% in 1999 Training traditional birth attendants and integrating them into an improved health care system were achievable and effective in reducing perinatal mortality self-assessment and peer review interventions are effective strategies for reinforcing training in facilitative communication neonatal mortality rate was reduced by 54[percent] in the essential newborn-care intervention RCT (Foord 1995) Clinical observation & interview Programme evaluation cluster-RCT (Fort and Voltero 2004) (Ingras 2001) (Jokhio, Winter et al. 2005) RCT (Kim 2002) Armenia /nursemidwives clusterrandomised controlled efficacy trial (Kumar, Mohanty et al. 2008) P a g e | 139
Country / cadre Indonesia Surabaya -- The East Java Safe Motherhood Project, Community Midwives (CMws) Ethiopia: Nurse midwives Phillipines/ Hilots rural Paraguay/ nurses, auxiliary nurses, auxiliary midwives Kenya, CHWs Pakistan: Lady health workers (LHWs) Pakistan, CHWs HRH Interventions findings Method Reference CMws training, antenatal risk score card Life saving skills training (LSST), health stations staffed with 1-2 staff with LSST, facility upgrade 1 week FP training c.f 1 week training + Supervision, & training, supervision & Financial incentives learning through peereducators, interactive communications, role-playing, and supervision provided in actual community services Training, supervision, job aides Introduction of new cadre, selection from local population, 15 month training, training allowance, monthly salary with increase after 2 yrs, basic kit of essential drugs and contraceptives to be replenished monthly, LHW can charge only for contraceptives, monthly supervision Primary health workers were trained to deliver the psychological intervention 3 along with intensive monthly group supervision, in the control group untrained health workers made an equal number of visits to the depressed mothers. antenatal risk score card can function as a warning & education tool to recognize complications, risk scoring based mainly on demographic and reproductive factors will not convince women to use a system when they do not believe in the risk markers which allocate them to the high risk groups Investments led to increased skills & use of EOC services. Need for consistent supervision and supply of drugs No significant difference was found in test and field performance most cost efficient scheme employs training plus supervision The average scores of the participants‘ knowledge increased The enrolment rates of pregnant women in ANC increased from 2.2 times per pregnancy in 1996 to 3.4 times in 1998 IPTp coverage increased from 19% in 2002 to 61% in 2005 for at least one dose & from 7% to 17% for two doses of SP Higher performing LHWs have higher levels of knowledge, are better supervised & supplied with drugs & equipment. They work longer hours than poor performing LHWs. Their supervisors also have higher levels of knowledge & more likely fully trained. Statistical models suggest that 2 important factors for increasing LHW service delivery are adequate supervision & supervisory transport Improved recovery rates of mothers who had depression, effect was sustained for 1-year of follow-up. Project evaluation Knowledge test, questionnair es, clinical observation, service data quasiexperimental design quasiexperimental design Communitybased crosssectional survey Evaluation: quantitative survey, economic analysis (Kwast 1995) (Laverentz 2006) (Morisky 1985- 86) (Ohnishi, Nakamura et al. 2007) (Ouma, Van Eijk et al. 2007) (Oxford Policy Management 2002) RCT (Rahman 2008) P a g e | 140
Page 1 and 2:
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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The isolated nature of much communi
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progress over time. This tool and t
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At national level, countries may ha
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evaluating and adjusting the size a
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There are a number of difficulties
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Figure 23 The Task Shifting Process
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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 and 102: Initiative focus Details Context Re
Page 103 and 104: informal, mutual-help action groups
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
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Page 139: Country / cadre Niger: Birth attend
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
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Page 153 and 154: flexibility in order to overcome ge
Page 155 and 156: up skilled birth attendance‖. The
Page 157 and 158: Scaling up of the Navrongo service
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Page 161 and 162: Figure 37 Critical success factors
Page 163 and 164: Health system standards are explici
Page 165 and 166: prevalence rate, however in order t
Page 167 and 168: (Dieleman 2006) Selected key indica
Page 169 and 170: In order to determine the answers t
Page 171 and 172: Summary of findings This narrative
Page 173 and 174: Health worker performance is theref
Page 175 and 176: Discussion and Recommendations What
Page 177 and 178: outlines how the HRH information ba
Page 179 and 180: communities. A collaborative approa
Page 181 and 182: Table 29 Examples of HRH performanc
Page 183 and 184: Appendices Appendix 1. MDG5 Country
Page 185 and 186: World Health Statistics http://www.
Page 187 and 188: Appendix 3. Sources of all material
Page 189 and 190: Data source Keywords used in search
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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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