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

supervision;
health economics;
resource mobilization and fundraising;
advocacy and social communication;
writing and editorial skills;
fluency in the local, regional and national language(s).
A successful family planning scaling up effort in Brazil using this approach demonstrated
that the resources needed to undertake the desired changes were generated from within the
local health systems (WHO 2008). This enabled scale up through the optimal use of existing
resources.
Other approaches are CARE India‘s IDEAS (Innovation, Documentation, External
marketing, Assessment and capacity building, and Support) model (Bailey 2005 ). This
model for demonstration and replication is based on efforts in reproductive and child health.
These found that successful outcomes often depended on innovations that helped change
behaviours, leverage to improve systems or expand availability of and access to services. The
Management science for Health change approach (MSH 2007 ) outlines steps involved in
scaling up in reproductive health they include the need for addressing the HRH requirements
but there is no specific reference to the community level.
Van Damme and colleagues (2008) developed two scenarios to model scaling-up
antiretroviral treatment in Southern African countries with human resource shortage. Model
B has major implications for primary health care workers including auxiliary nurses and
midwives, CHWs, VHWs and lay carers. In terms of MNRH lower cadres, community
people and patients would be involved in the delivery of antiretroviral treatment and
counselling to pregnant women and prevention of HIV infection in infants. This would
require a mass training effort and the development of a supervisory network to ensure that
this personnel were able to execute standard instructions. This approach is very different from
the prevailing ART delivery models, and would require major changes in the way the medical
professions are conceived and regulated.
It may be useful to conceptualise scaling up in a more comprehensive manner acknowledging
the inter related nature of health workers with the health system and the community. Such an
approach builds on linking services and providing a continuum of care between community
and facility and between sexual, reproductive, maternal, newborn care. The systems based
HRD Expanded Comprehensive response (ECR) to an HIV/AIDs epidemic Capacity
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