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

Country /
cadre
Indonesia:
midwives
Cameroon
HRH Interventions findings Method Reference
In service training,
deployment, supervision &
participation in audit
TBA training, nurse
supervision
increased skilled attendance &
midwives skills & confidence
30 PMTCT-trained birth
attendants in 20 villages
counselled 2331 pregnant
women tested 2310 (99.1%) for
HIV. 82 women had a positive
OraQuick HIV test (3.5%). 42
of these mothers were delivered
byTBAs , with 88.1% of
mothers and 85.7% of newborns
receiving single-dose nevirapine
prophylaxis. Nevirapine-treated
babies tested after 15 months of
age, & 2 of 13 HIV-exposed
infants had positive rapid HIV
antibody test (15.3%
transmission rate with
treatment)
Project
evaluation
quasiexperimental
design
(Ronsmans,
Endang et al.
2001)
(Wanyu, Diom
et al. 2007)
Clearly there is not one package or approach that best fits all situations and a coordinated
approach which involves linking multiple interventions may be more conducive to enhancing
performance. At community level this is dependent on linkages between the community
providers and organisations which are based on strong relationships and partnerships. The
process of implementing these interventions is therefore critical requiring shared
understanding and responsibility for health care and services.
Comprehensive training and supervision are required in addition to adequate equipment and
commodities which facilitates the enhanced performance of health worker and therefore
quality MNRH services. This confirms Bhutta et als findings that strategies to improve
quality of care require the upgrading the skills of community cadres in conjunction with
health systems strengthening and the facilitation of referrals. This comprehensive approach
has shown demonstrable impact on perinatal mortality (Bhutta, Darmstadt et al. 2009).
Summary
This section found lack of evidence for strategies and regard for complexity possibly due to
the scarcity of studies that pay attention to rigorous methodology. Information about the
context is difficult to glean and not always included in discussion need for rigorous
evaluation, indicators and tools for assessment.
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