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

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Contents Acronyms ................................................................................................................................... 6 Figures........................................................................................................................................ 9 Tables ....................................................................................................................................... 11 Executive Summary ................................................................................................................. 12 Introduction .............................................................................................................................. 14 Rationale and definitions ..................................................................................................... 15 Purpose of this literature review ...................................................................................... 15 The need for this review .................................................................................................. 15 Review Questions ............................................................................................................ 16 Geographic focus of the review ....................................................................................... 16 Concepts and their use in this review .............................................................................. 17 An introduction to HR and MNRH at the community level ................................................ 23 Progress towards improving MNRH ............................................................................... 23 Overview of community level HR in MNRH .................................................................. 29 Summary .......................................................................................................................... 39 Methodology ............................................................................................................................ 40 The review protocol ......................................................................................................... 41 Search strategy ................................................................................................................. 41 Approach taken to the synthesis of data in this review .................................................... 43 Findings.................................................................................................................................... 45 Barriers and constraints to HRH practice in MNRH at community level ........................... 46 Strengthening HRH policy legislation, regulation ............................................................... 58 Strategies to improve Human resources management and leadership ................................. 60 Approaches to Management practice ............................................................................... 60 Performance management ................................................................................................ 66 Staff supply ...................................................................................................................... 78 Personnel administration .................................................................................................. 89 Leadership ........................................................................................................................ 96 Summary .......................................................................................................................... 97 Strategies to develop supportive working environments ..................................................... 99 PHC teamwork ............................................................................................................... 101 Health worker partnerships across sectors ..................................................................... 102 P a g e | 3
Collaboration with traditional and cultural practitioners ............................................... 103 Socio-cultural issues ...................................................................................................... 105 Infrastructure, logistics equipment and tools ................................................................. 106 Health and welfare of staff ............................................................................................. 106 Family friendly work environments............................................................................... 107 Multiple interventions to improve workers environment .............................................. 107 Summary ........................................................................................................................ 108 Improving working partnerships with the community....................................................... 109 Tools and guides to assist HRH to work with communities .......................................... 112 HRH & the consideration of socio-cultural issues in the community ........................... 114 Case studies: Examples of community and health workers working together .............. 115 Summary ........................................................................................................................ 121 Strengthening Education and competencies ...................................................................... 122 A collaborative approach to education training ............................................................. 122 Curriculum review and development ............................................................................. 125 Approaches .................................................................................................................... 127 Selection of learners ....................................................................................................... 130 Accreditation and certification ....................................................................................... 131 Evaluation of training .................................................................................................... 132 Interventions and evidence ................................................................................................ 136 Research based Case studies of HR interventions in MNRH ........................................ 137 Lessons learned from countries that have reduced MMR ................................................. 142 Scaling up Experiences ...................................................................................................... 146 Models and approaches of scaling up ............................................................................ 146 MNRH workforce policy, planning and management and scale up .............................. 150 Scaling up skilled birth attendants ................................................................................. 150 Scaling up other workers at community level................................................................ 155 Scaling up CHWs in the Asia and Pacific Regions ....................................................... 157 Scaling up education and training .................................................................................. 158 Indicators of effective HRH Practice in MNRH at community level ................................ 161 Summary of findings.............................................................................................................. 170 HRH barriers and constraints ......................................................................................... 170 Supportive HRH approaches in MNRH at community level......................................... 170 P a g e | 4
Page 1 and 2: Human Resources for Health in Mater
Page 3: What human resource practices in ma
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
Page 53 and 54: husbands who oppose family planning
Page 55 and 56:
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:
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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
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IMNCI PMTCT Perinatal Period Postna
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Ambegaokar, M., Lush, L. (2004). "F
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Barrett, B., J. Ladinsky, et al. (2
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University South Africa with the Re
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Cruse, D. (1997). Community Health
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Elson, D., Evers, B. (1998). Sector
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Flanagan, D., Williams, C., Mahler,
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Greenwood, A. M., Bradley, A.K., By
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Howard, G., Bogh, C., Goldstein, G.
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Jhpeigo (1998). Participatory techn
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Kroll, D., Dwyer, D. (1994). "Postn
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Manandhar, D. S., D. Osrin, et al.
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Morisky, D. E. (1985-86). "Evaluati
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O‘Brien-Pallas, L., Irvine, D., P
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Pfeiffer, J. and J. Pfeiffer (2003)
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Replogle, J. (2007). "Training Trad
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Shankar, A., S. Sebayang, et al. (2
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Teela, K. C., L. C. Mullany, et al.
Page 245 and 246:
van Damm, W., et. al (2008). "Scali
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WHO (2008). Global Standards for In
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