Health Systems Strengthening

Tracking and Counting 140,000 New Health Workers

Dana SingletonThe PEPFAR Monitoring and Evaluation and Human Resources for Health Technical Working Groups asked CapacityPlus to develop tools and guidance to support country team efforts in tracking and counting the new health workers being trained with PEPFAR support.

As part of its reauthorization, PEPFAR now includes an indicator that mandates its contribution to addressing the health workforce crisis. The legislation states that PEPFAR will “…help partner countries to train and support retention of health care professionals and paraprofessionals, with the target of training and retaining at least 140,000 new health [workers].”

Conducting interviews
Dykki Settle and I began this work by conducting telephone interviews with 13 PEPFAR country teams to determine what activities were underway to increase health worker production, and what activities were being counted toward the 140,000. We then visited Tanzania to further explore these trends. After analyzing all of these data, one main ground truth emerged—it takes a systems approach to produce health workers. Read more »

mHealth: The Possibilities of the Personal

This post was originally published on the IntraHealth International blog.

Dykki SettleThere are more than 5 billion cell phones in use worldwide, which means globally nearly 70% of people—including children—would own a cell phone if everyone had just one cell. Yet in places like Germany, where the cell phone market penetration has reached more than 130%, many people own more than one mobile.

Mobile phones are so popular in part because they are uniquely personal communication tools. Their portability makes it possible to talk to colleagues, friends, and family from nearly anywhere and anytime.

With mobile phones, we’ve managed to extend our social circles from the immediate to the global. Read more »

Money Matters! A New Costing Tool for Health Worker Retention

Subrata RouthI work on health systems strengthening, mostly for low-income countries. One major challenge is attracting and retaining health workers in rural and remote areas where health services are mostly scanty. Let me quote the recent WHO global policy recommendations for retention:

Approximately one half of the global population lives in rural areas, but these areas are served by only 38% of the total nursing workforce and by less than a quarter of the total physician workforce.

Which retention strategies should be pursued, and how much will they cost? Faced with multiple priorities and limited means, policy-makers want to know up-front what a recommendation will cost, to gauge the affordability of its implementation. Uganda, for instance, developed its Motivation and Retention Strategy back in 2008, but could not implement it because it didn’t know what the incremental costs would be.

In collaboration with WHO, CapacityPlus is designing a simple and user-friendly costing tool. Instead of depending on external technical assistance, HR managers or other health officials will be able to cost a retention strategy at the district, regional, or national level.

Historically, this kind of costing has been undertaken by health economists, which can be expensive. In contrast, our new tool is designed with the layperson in mind. You don’t need to be an economist to use it and understand the results. Read more »

Building Local Health Systems with Information Systems

This post was originally published on the IntraHealth International blog.

HRIS in IndiaOn my trip to India last month, I didn’t plan to focus on maternal health care, but walking through the maternity ward in Bihar, I couldn’t help but worry about the long lines and hours that keep a woman waiting to see a doctor. The health officials I met with are incredibly committed to serving their communities. In one case, I actually had to walk through the maternity ward to reach my meeting with members of the chief surgeon’s office and the head of district medicine. I realized these men and women walk by the patients every day—women like the proud new mother who urged me to come over and take a photograph of her new daughter. Although the hospital I was in is among the nicest in the state, it lacks many of the essential information systems that can make a health system run efficiently and effectively. In practical terms, this might mean the women I walked by would not have to spend so long waiting to be seen. Read more »

Saving Mothers’ Lives

Amanda PuckettMuch literature has celebrated the recent World Health Organization report that maternal mortality declined by a third in the past decade. Though this downward trend is remarkable, the global public health community is concerned that the declaration will shift attention away from sustaining and increasing efforts to address maternal deaths throughout the world. Also important is decreasing maternal morbidity, which creates huge costs in terms of human suffering, health care expenditures, and lost productivity.

Health systems strengthening reduces maternal mortality
The headline The Top Three Things We’re Not Doing to Save Mother’s Lives recently caught our attention. CapacityPlus’s result areas—global leadership, policy and planning, education and training, workforce effectiveness, and evaluation and knowledge-sharing—are key pieces of the health systems strengthening puzzle needed to improve health outcomes for men, women, and children. Addressing the global health worker shortage, which is most critical in countries with higher maternal mortality rates, will strengthen health systems and improve more than just maternal outcomes. Read more »

Developer to Developer: Creating a Regional Support Network at the Unconference

Read about the first days of the Unconference.

Carl Leitner at the unconference, GhanaClosing the iHRIS track on Tuesday, CapacityPlus staff Dykki Settle asked how many of the participants were excited to come back tomorrow. In reply, the 25 participants—from Sierra Leone, Ghana, Mali, Burkina Faso, Nigeria, Togo, and more—including human resources (HR) managers, information technology staff, and HR directors—universally and sincerely expressed their enthusiasm for the Training Workshop/Unconference for Interoperable Applications for Health Information Systems. As this is a western African regional conference, both French and English speakers were present. Many thanks to Romain Tohouri who provided excellent translation to and from French on technical areas such as HR and software development, as well as health sector terminology. Read more »

Linking the Millennium Development Goals with Human Resources for Health

Wilma GormleyAfter being escorted past more security guards than I’ve encountered in my entire life, I arrived in a conference room in the United Nations building overlooking the East River in New York City eager to hear luminaries discuss the critical link between human resources for health (HRH) and the attainment of the Millennium Development Goals (MDGs).

I took the train from Washington, DC to NYC early this morning and watched the birth of a sunny, early fall day. I “immigrated” to NYC from Kansas after graduate school, and I still love its positive energy.

Progress in human resources for health
No Health Workforce. No Health MDGs. Is that acceptable? was a side event held at the MDG Summit this week, sponsored by the Global Health Workforce Alliance (GHWA) along with the governments of Norway, Brazil, and Cameroon, and the Health Workforce Advocacy Initiative. President of Malawi Dr. Bingu wa Mutharika delivered the keynote address, and Dr. Mubashar Sheikh from GHWA delivered the opening and closing remarks. The panelists included ministers of health from Cameroon, Malawi, Norway, and Brazil; a DFID representative; and a Japan International Cooperation Agency (JICA) vice president. Read more »

The Digital Nomad: Blogging from the Health Information Systems Unconference

Carl Leitner's badgePacked and ready to collaborate
In my suitcase there are two iHRIS Appliances, a host of books donated by O'Reilly, and several large printouts of the form maps for iHRIS Manage and iHRIS Qualify. I’m a digital nomad, I say to myself, looking at my backpack full of electronic knick-knacks that will help smooth over any technical hiccups we may encounter during the Training Workshop/Unconference for Interoperable Applications for Health Information Systems. Held in Accra, Ghana, most participants are from the Economic Community of West African States, with several iHRIS developers from Botswana and Lesotho as well. Read more »

Lessons in Optimism: How a Two-Week Course Changed My Thinking on Health Systems Strengthening

Corinne FarrellExcited to attend a two-week course on Strengthening Human Resources for Health at the Harvard School of Public Health, I checked into my hotel in Boston on a Sunday evening. At the front desk, I received my room key and the largest binder I’ve ever seen. I settled into my room and opened the binder expecting to find some overview materials and Boston tourism brochures. Instead it was full of course outlines and required articles.

Information overload

My technical expertise is in library and information science within the context of global health, so it’s hard to intimidate me with information overload. But as I began the required readings for the first day of class, pessimism dominated my thoughts due to the reinforcement of something I already knew—addressing human resources for health (HRH) challenges can seem overwhelming.

With so many topics to cover in just two weeks, could this course really make a difference? My mind raced as I read about many different frameworks for examining health system components. Who could possibly have expertise in all these areas (i.e., finance, labor markets, policy, management, leadership) as well as public health? Read more »

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