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

Development approach is an example of this (Family Health International 2009). Gaye et al
emphasises three main factors in accelerating the process of scale up that need to be
addressed despite the model or framework selected for scale up. This is the need to identify
and nurture champions who can spread new information and best practices, engage
stakeholders in order to promote dialogue and foster ownership and finally to ensure the
ongoing coordination of training activities (Gaye and Nelson 2009).
An example of this linked approach can been seen in the scaling up efforts of the FHI youth
PHE initiative known as Y-PEER. This involved mobilising PHEs by building NGO
networks to link stakeholders, making tools and resources available for translation and
adaptation, sponsoring international meetings and trainings to facilitate the sharing of
experiences and lessons learned, and fostering youth participation and partnerships with
adults. An electronic network and website links PHEs and enables them to interact and access
training (Adamchak 2006).
MNRH workforce policy, planning and management and scale up
Scaling up MNCH at community level is reliant on establishing and implementing workforce
action plans. A WHO policy brief (2005) highlights the need to ensure that any strategies
implemented are; beneficial not harmful, comprehensive, take immediate effect as well as
address the long term issues, take appropriate remuneration into consideration and make the
HRH crisis a matter of national importance. A systems approach to workforce planning
recognises the development of a vision, a framework for leadership, resource mobilization,
sharing of information, training and service provision. A meeting on strengthening nursing
and midwifery services in national health systems in Africa recommended that nurse and
midwives be actively engaged in the development of policy and plans to ensure ownership
and successful implementation (WHO 2007).
At the individual level the provision of quality healthcare during and after delivery depends
on health worker competence, motivation and the available equipment as well as the way in
which HR are managed. According to Koblinsky et al ―what should be scaled up is a
commitment to facilitating responsive management and organisation of services‖ (2006). The
2007 African meeting calls for the development and operationalization of supportive
workplace interventions, including gender-sensitive recruitment policies and procedures,
retention packages and clear career structures for nurses and midwives (WHO). These
practices alongside other managerial approaches such as supervision and audit have been
shown to impact upon health worker performance and health outcomes (Rowe 2005).
Scaling up skilled birth attendants
There are a number of key documents that outline how midwifery can be scaled up at the
community level with reference to country experience. The 1st International Forum on
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