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

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Area Barriers & constraints in MNRH Reference Leadership & Lack of CHW supervision management systems Poor quality supervision Remuneration Incentives Lack of supervision for trained TBAs Lack of replacement strategies for volunteers Lack of career structure & opportunities Poor selection processes Lack / poor quality rosters & work schedules No performance Mgt Low remuneration in public sector Frequent delays in receiving pay lack of incentives for CHW to maintain records Non-financial incentives not accounted as a motivating factor for performance by CHWs petrol, clothing allowance perceived by CHNs to be inadequate Too many out of pocket expenses for PHE (Gilson, Walt et al. 1989; Stekelenburg 2003; Lehmann 2007) (Gray 1988; WHO 1989; Tavrow, Kim et al. 2002; WHO/SEARO 2003; Manafa, McAuliffe et al. 2009) (UNFPA 1996) (Chaulagai 1993) (WHO/SEARO 2003; Haq 2008) (Ofosu-Amaah 1983; WHO 1989) (Sringernyuang 1995; WHO/SEARO 2003) (Manafa, McAuliffe et al. 2009) (Ofosu-Amaah 1983; WHO/SEARO 2003; Ferrinho, Van Lerberghe et al. 2004; McCoy, Bennett et al. 2008; Pillay and Mahlati 2008) (Oxford Policy Management 2002) (Stekelenburg 2003; Dovlo 2005) (Dieleman, Cuong et al. 2003) (Kingma 2003) (Senderowitz 1998) P a g e | 199
Area Barriers & constraints in MNRH Reference Roles & functions lack of clear roles and functions Supportive working environment Commodities, equipment & infrastructure Occupational health and safety Lack of community knowledge of HRH scope of practice lack of a clear delineation of responsibility between health care professionals TBA roles did not match actual practice Roles contradict societal and family norms •Lack of pregnancy related technology •Unavailability of HIV testing at commune level; shortage of antiretroviral drugs; lack of operational guidelines •lack of logistic support for CHW •Very large numbers of patients and the frequent reposting of health workers •Isolation inability to communicate with families •Availability of drugs & cost of travel affect performance Violence & Conflict HRH HIV/AIDS Burden Stress low morale lack of protective materials, No policy or guideline on care and support for nurses/midwives with HIV/AIDS. No light duties for chronically ill nurses/midwives Poor eyesight – lack of glasses (WHO 1989; Senderowitz 1998; Campos 2004; ESD Project 2008; Manafa, McAuliffe et al. 2009) (Pathfinder International 2005) (Creati, Saleh et al. 2007) (Bisika 2008) (Piedade 2004) (Tsu and Free 2002) Nguyen, Oosterhoff et al. 2009) (Stekelenburg 2003) (Naisho 1982) (Haq 2008) (Sauerborn, Nougtara et al. 1989) (Barcelon 1990; WHO/SEARO 2003; WHO 2005) (Dovlo 2005) (Dovlo 2005; Haq 2008) (Stekelenburg 2003; Dovlo 2005) (Chikampa 2003) (IntraHealth 2002) P a g e | 200
Page 1 and 2:
Human Resources for Health in Mater
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What human resource practices in ma
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Collaboration with traditional and
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Acronyms AAAH Asia and Pacific Acti
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TBA T & L UNFPA UNICEF UOG UPNG USA
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Figure 34 Potential gain in percent
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Executive Summary Addressing the ba
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Introduction What human resource pr
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Review Questions 1. What HR approac
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Effective HRH practice and quality
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is no single prescribed set of ways
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Table 3 Classification of health ce
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Figure 5 Millennium Development Goa
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(UNICEF 2007) However, the road to
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A number of steps are purported to
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Figure 10 Overview of HRH at commun
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functions, the latter involving mob
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settings‖(ICN 2009). They may be
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Table 7 What Skilled attendants can
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Traditional healers may also be inv
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Methodology What human resource pra
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Table 9 Search terms used for the s
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findings. Differences and similarit
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Barriers and constraints to HRH pra
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PHEs. In the Pacific the density of
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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
Page 149 and 150: A technical meeting in Bangkok in 2
Page 151 and 152: Development approach is an example
Page 153 and 154: flexibility in order to overcome ge
Page 155 and 156: up skilled birth attendance‖. The
Page 157 and 158: Scaling up of the Navrongo service
Page 159 and 160: conditions (Walt, Perera et al. 198
Page 161 and 162: Figure 37 Critical success factors
Page 163 and 164: Health system standards are explici
Page 165 and 166: prevalence rate, however in order t
Page 167 and 168: (Dieleman 2006) Selected key indica
Page 169 and 170: In order to determine the answers t
Page 171 and 172: Summary of findings This narrative
Page 173 and 174: Health worker performance is theref
Page 175 and 176: Discussion and Recommendations What
Page 177 and 178: outlines how the HRH information ba
Page 179 and 180: communities. A collaborative approa
Page 181 and 182: Table 29 Examples of HRH performanc
Page 183 and 184: Appendices Appendix 1. MDG5 Country
Page 185 and 186: World Health Statistics http://www.
Page 187 and 188: Appendix 3. Sources of all material
Page 189 and 190: Data source Keywords used in search
Page 199: Appendix 4: Barriers and Constraint
Page 203 and 204: Area Barriers & constraints in MNRH
Page 205 and 206: Appendix 5 Literature that document
Page 207 and 208: P a g e | 206
Page 209 and 210: IMNCI PMTCT Perinatal Period Postna
Page 211 and 212: Ambegaokar, M., Lush, L. (2004). "F
Page 213 and 214: Barrett, B., J. Ladinsky, et al. (2
Page 215 and 216: University South Africa with the Re
Page 217 and 218: Cruse, D. (1997). Community Health
Page 219 and 220: 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.
Page 233 and 234: Morisky, D. E. (1985-86). "Evaluati
Page 235 and 236: O‘Brien-Pallas, L., Irvine, D., P
Page 237 and 238: 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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