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

progress over time. This tool and the action plan is now available in an electronic format and
is being piloted in Uganda with the Uganda Private Midwives Association (UPMA).
The JHPIEGO manual by Caiola provides a supervisor with guidance on working with site
staff and members of the community to set site standards, determine if standards are being
met, identify reasons why standards are not being met, and design and implement learning,
motivational and environmental interventions to improve performance. The package was
field-tested in Kenya and is most appropriate for supervisors of medium to large facilities and
district-level supervisors. A handbook for participants accompanies the manual and outlines a
competency-based training course including the course objectives, course schedule, precourse
questionnaire and learning exercises. The final tool in the table above is the Skilled
care supervision (FCI 2005) guide which contains four performance areas. These are focused
on assessment of facility in collaboration with staff.
Job descriptions
Clear job descriptions are necessary to define job duties, responsibilities, and limitations.
They are important for recruitment, selection and performance management. Ministries of
health often have manuals which provides job description for all categories of public health staff
(Datta 2009). Several initiatives have started addressing the quality and performance issues by
improving the link between job description and performance of health workers at community
level. An evaluation in 2003 of the Indonesian Development of Performance Management
(DPM) model (described above) showed that there was an increase in performance of nurses
and midwives many working at community level after they joined DPM activities (Rokx
2009). Clear job roles ensure roles for TBAs that link them with the health system to better
facilitate referral and support (Lawn, Manandhar et al. 2007).
Job descriptions need to be tailored to the special contexts in which people will be working.
Ehrlich outlines the need for descriptions that clarify not only the special skills and knowldge
required but the involvement of staff in difficult situations such as gender based violence
settings, the limits of their authority and the referral mechanisms available (Ehrlich 2004).
Reviews of job descriptions help to identfy gaps and needs by comparing existing knowledge
and skills to the knowledge, skills, and abilities that are clarified when job descriptions were
written. This allows gaps to be identified along with possible strategies to address these such
as training and recruitment.
A recent review of nursing in PNG involved the collection and analysis of position
descriptions and job specifications including that of the community nurse to determine their
suitability and relevance to the role and responsibilities of nursing staff (Duffield 2008). The
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