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

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Human Resources for Health in Maternal, Neonatal and Reproductive Health at the Community Level: A Synthesis of the Literature with a focus on the Asia Pacific Region 2010 Dr. Angela Dawson, Human Resources for Health Knowledge Hub, School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia Dr. Natalie Gray: Burnet Institute on behalf of the Women‘s and Children‘s Health Knowledge Hub, Melbourne, Australia ISBN Photos credits from top right: Photo from Fiji Government webpage www.fiji.gov.fj/uploads/ Vy Sovanna, a midwife working with PSI Cambodia, promotes a local clinic, to be held the following day, providing birth control for local women. http://www.flickr.com/photos/sockeyed/3219025735/ Community health workers collect information from barrack residents so that local health centres can identify common health issues. Photo : IRC/Peter Biro P a g e | 1
What human resource practices in maternal, newborn and reproductive health at community level can enable HRH to deliver quality services and care that contribute to the achievement of MDG 5? Discussion & Recommendations Introduction *Review Rationale *Introduction to HR at community level in MNRH Methods Review Protocol Search strategy Approach to synthesis Findings *What barriers, issues and constraints affect HR at community level in MNRH ? *What supportive practices & approaches have been employed to strengthen: •Management & leadership •HRH policy, legislation & regulation •Working environments •Partnerships with the community •Education & training *What are the lessons learned from countries that have made progress towards MDG 5? *What do we know about scaling up HR practice at community level in MNRH? *What indictors & tools can be used to assess effective HR performance at community level in MNRH? *What options can we deduce for HR policy and practice? Page | 2
Page 1: Human Resources for Health in Mater
Page 5 and 6: Collaboration with traditional and
Page 7 and 8: Acronyms AAAH Asia and Pacific Acti
Page 9 and 10: TBA T & L UNFPA UNICEF UOG UPNG USA
Page 11 and 12: Figure 34 Potential gain in percent
Page 13 and 14: Executive Summary Addressing the ba
Page 15 and 16: Introduction What human resource pr
Page 17 and 18: Review Questions 1. What HR approac
Page 19 and 20: Effective HRH practice and quality
Page 21 and 22: is no single prescribed set of ways
Page 23 and 24: Table 3 Classification of health ce
Page 25 and 26: Figure 5 Millennium Development Goa
Page 27 and 28: (UNICEF 2007) However, the road to
Page 29 and 30: A number of steps are purported to
Page 31 and 32: Figure 10 Overview of HRH at commun
Page 33 and 34: functions, the latter involving mob
Page 35 and 36: settings‖(ICN 2009). They may be
Page 37 and 38: Table 7 What Skilled attendants can
Page 39 and 40: Traditional healers may also be inv
Page 41 and 42: Methodology What human resource pra
Page 43 and 44: Table 9 Search terms used for the s
Page 45 and 46: findings. Differences and similarit
Page 47 and 48: Barriers and constraints to HRH pra
Page 49 and 50: PHEs. In the Pacific the density of
Page 51 and 52: 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
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which was developed in 2002. This w
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al. 2008). Dual practice is another
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Figure 24 Motivational determinants
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Many of the incentives to health wo
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files suggests that more careful at
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Management autonomy at community le
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Initiative focus Details Context Re
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informal, mutual-help action groups
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Building relationships with cultura
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groups; encouraging recruitment thr
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Summary This section has identified
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encouraging midwives to proactively
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Facilitation & attendance at MOH/ N
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of community leaders improved the c
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Table 19 Examples of initiatives in
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information and advice from peers (
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esources to provide clinical and ma
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Strengthening Education and compete
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Table 20 Examples of Partnership ap
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Table 21 Learner needs analysis and
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Table 22 Some approaches to the des
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Participants/ Method / document typ
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strengthening and establishing accr
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Participants / context LMICs method
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alongside health service improvemen
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Country / cadre Niger: Birth attend
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Country / cadre Indonesia Surabaya
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Lessons learned from countries that
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Malaysia The sharp decline in mater
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although supplemented with epidemio
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A technical meeting in Bangkok in 2
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Development approach is an example
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flexibility in order to overcome ge
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up skilled birth attendance‖. The
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Scaling up of the Navrongo service
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conditions (Walt, Perera et al. 198
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Figure 37 Critical success factors
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Health system standards are explici
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prevalence rate, however in order t
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(Dieleman 2006) Selected key indica
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In order to determine the answers t
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Summary of findings This narrative
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Health worker performance is theref
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Discussion and Recommendations What
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outlines how the HRH information ba
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communities. A collaborative approa
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Table 29 Examples of HRH performanc
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Appendices Appendix 1. MDG5 Country
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World Health Statistics http://www.
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Appendix 3. Sources of all material
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Data source Keywords used in search
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Page 193 and 194:
Page 195 and 196:
Page 197 and 198:
Page 199 and 200:
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
Page 209 and 210:
IMNCI PMTCT Perinatal Period Postna
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Ambegaokar, M., Lush, L. (2004). "F
Page 213 and 214:
Barrett, B., J. Ladinsky, et al. (2
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University South Africa with the Re
Page 217 and 218:
Cruse, D. (1997). Community Health
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Elson, D., Evers, B. (1998). Sector
Page 221 and 222:
Flanagan, D., Williams, C., Mahler,
Page 223 and 224:
Greenwood, A. M., Bradley, A.K., By
Page 225 and 226:
Howard, G., Bogh, C., Goldstein, G.
Page 227 and 228:
Jhpeigo (1998). Participatory techn
Page 229 and 230:
Kroll, D., Dwyer, D. (1994). "Postn
Page 231 and 232:
Manandhar, D. S., D. Osrin, et al.
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Morisky, D. E. (1985-86). "Evaluati
Page 235 and 236:
O‘Brien-Pallas, L., Irvine, D., P
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Pfeiffer, J. and J. Pfeiffer (2003)
Page 239 and 240:
Replogle, J. (2007). "Training Trad
Page 241 and 242:
Shankar, A., S. Sebayang, et al. (2
Page 243 and 244:
Teela, K. C., L. C. Mullany, et al.
Page 245 and 246:
van Damm, W., et. al (2008). "Scali
Page 247 and 248:
WHO (2008). Global Standards for In
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