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

feedback have been found to be effective in improving health worker performance (Jamtvedt
2006).
In their study Kongnyuy and van den Broek (2008) identify a number of structural, process
and outcome criteria that can be used for the clinical audit of women friendly care and
providers' perception in Malawi. An example is provided in the table below which highlights
criteria that are specifically related to the performance of health workers.
Table 28 Agreed criteria of HRH related standards for women friendly care
Objectives Structural Criteria Process Criteria Outcome criteria
All staff have a
positive attitude
towards all clients
• staff with skills on
interpersonal
communication and
counselling
• staff with a positive
attitude on labour ward,
post natal ward,
antenatal ward and
clinic
(Kongnyuy and van den Broek 2008)
• clients are welcomed
• clients are greeted by name.
• staff introduce themselves to
clients by name
• all procedures done (e.g. during
labour or on the ward care) are
explained by staff to the client
• client is allowed to have a
companion with her during labour
and delivery.
• clients are told how and where
they can ask for assistance
• patients are referred to & called
by their name (and not by bed
number, diagnosis etc)
• staff are polite and use
appropriate language
• client satisfaction of at
least 80%
• at least 80% of women
understand the
procedures undergone
during labour, delivery
and puerperium
• at least 80% of women
willing to deliver again at
the at the same facility in
a subsequent pregnancy
• 95% of women will
recommend the facility to
other women
• 95% of women will feel
they are treated with
dignity and respect
Combining criteria and indicators
Another approach to the development of criteria and indicators that relates to HRH can be
found in the USAID guide to the rapid assessment of health systems functioning (Islam
2007). The strengths of this approach are that HRH is seen as part of the health system and
therefore connected to the context that affects performance. HRH is included as one of six
areas that include: governance, health financing, health service delivery, and pharmaceutical
management and health information systems. Five criteria are suggested as appropriate means
of assessing system performance. These are:
Equity: Are HR distributed equitably or in equitably?
Access: Is access to care inhibited by lack of competent personnel in rural & distant
facilities?
Efficiency Is personnel use inefficient because of lack of HR planning &
coordination?
Quality: Is the quality of care affected by access to qualified personnel, provider
behaviour or incompetence?
Sustainability: Are personnel supported or given incentives? (ie through community
financing system?)
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