Health Workforce

Data for Decision-Making Series: Diana Frymus

Diana FrymusWe are joining the One Million Health Workers Campaign in a series of interviews, to hear from the experts why data on community health workers is so critical, and what needs to be done.

This week, we spoke with Diana Frymus, Health Systems Strengthening Advisor in the Office of HIV/AIDS at USAID in Washington, DC. She focuses on strengthening health systems to achieve HIV goals and sustain national HIV programs. Her focal areas of emphasis are on human resources for health, including CHWs, and quality improvement. She is the USAID co-chair of the PEPFAR HRH Technical Working Group and the Health Systems Global Technical Working Group on Supporting and Strengthening the Role of Community Health Workers in Health System Development. Read more »

New ILO Report: The World Needs More Rural Health Workers, A Lot More

Aanjalie CollureOn April 27, a new report released by the United Nations International Labour Organization (ILO) made a distressing finding: without adequate numbers of health workers, especially in rural areas, more than half of the world’s rural population—and more than three-quarters of the rural population in Africa—will go without access to effective health care in 2015.

The report, entitled Global Evidence on Inequities in Rural Health Protection, was the ILO’s response to observable trends in economic disinvestment and neglect in rural health systems around the world. Now, with this report indicating that nearly 56% of the world’s rural population—and 83% of Africa’s rural population—live without critical health care access, the ILO has provided powerful evidence to demonstrate why strengthening the rural health workforce is imperative to filling this gap. Read more »

iHRIS Champions in Ghana Share Success with Using Health Workforce Data

Gracey VaughnLike many of his fellow Ghanaians, Obeng Asomaning wanted to use his skills to help his country. As a new graduate with a degree in health service planning and management, he landed a job at the Ministry of Health’s Regional Health Office in Ashanti Region. Quickly he saw that the office was struggling to access information about the health workforce. How many midwives worked in the regional hospital? How many vacancies were there in Kwabre District? How many health workers will likely retire next year? The paper-based information system yielded no quick answers.

Answers to these kinds of questions are important because the country has a critical shortage of health workers. There are only 13.6 health workers for every 10,000 people, well below the minimum recommended threshold of 22.8 health workers per 10,000 population. To improve the population’s health outcomes, Ghana needs to make the most of the health workforce it currently has while working to increase their numbers. Read more »

Strengthening the Health Workforce through eHealth Innovation: Reflections from the GETHealth Summit

Dr. Kate TulenkoI recently had the privilege of representing CapacityPlus at the Global Education and Technology Health (GETHealth) Summit at the United Nations in New York City, speaking in sessions on distance learning in rural communities and leveraging social media to address the global health workforce gap.

While eHealth and mHealth conferences tend to be geared toward the American and European markets, I found GETHealth refreshing and timely in its focus on lower-resource settings—in fact, the governments of Ethiopia, Rwanda, and Uganda cohosted the summit.

Developing countries face different challenges including bandwidth, mobile phone service geographic coverage, and illiteracy that must be addressed when pursuing eHealth and mHealth solutions. GETHealth brought global thought leaders in health, education, and ICT together to discuss and develop technology-driven initiatives designed to empower health workers and the resource-limited communities they serve. Read more »

HRH Global Resource Center Reaches 3,000

Rebecca RhodesIn January, I added the 3,000th resource to the HRH Global Resource Center (GRC), CapacityPlus’s digital library for human resources for health (HRH) information. At such a milestone, I began reflecting on how the GRC got here and where it is going.

Over the past five years of working on the GRC, I have seen the growing emphasis on knowledge management as a tool to support evidence-based decision-making and share lessons learned to make the most cost-effective and sustainable decisions for health worker interventions. The advent of the World Health Organization’s Health Manager’s Website, the Global Health Workforce Alliance’s knowledge center, and the K4Health project demonstrate the growing interest for this information as part of the way global health development does business. Read more »

Leading the Way Back Home: Nigerian Minister of State for Health, Dr. Muhammad Ali Pate

Dr. Kate TulenkoAll eyes were on newly appointed Minister of State for Health Dr. Muhammad Ali Pate as he presented his vision of health for Nigeria: 1,000,000 lives saved and quality of care measurably improved. He expertly laid out four pillars to achieve this goal: expanding basic services; disease prevention (particularly through scaling-up Hib and pneumococcal vaccination); increasing quality of care via improved clinical governance; and unlocking the health sector’s market potential via increased public and private investment.

One of the special reasons for the excitement in the room at the “Innovative Approaches to Expanding Health Care Services in Nigeria” meeting on September 21 at Africare in Washington, DC, was the fact that many of the attendees, myself included, knew and had worked with Dr. Pate personally.
Read more »

A Head Start on Measuring Health Workforce Progress

Lindsay BonannoWhile in a small clinic deep in a rural village, I study a register and see a lot of blank boxes that should contain data. I ask the data clerk why there is so much empty space. She shrugs and meekly explains that she didn’t know how to fill out the specific information. As I talk her through the indicators, I cannot help but think of the need for accessible resources to help people like the data clerk understand what to measure and how. 

Sometimes monitoring and evaluating a program can be concrete. In a service delivery project, for instance, the metrics are usually concrete (did the person receive the medication or not?). Indicators for measuring progress in human resources for health (HRH), however, can seem pretty complex. For example, how do you wrap your mind around increased leadership accountability? Metrics for HRH aren’t as well-known or haven’t received the same level of consensus as have those for other public health areas.

But just as we need to measure progress in service delivery, so too must we find a way to define and show our gains in health workforce strengthening, both for assessing the work and for demonstrating accountability to our donors and stakeholders. Read more »

Update on the MDGs: Where Are the Health Workers?

Sarah DwyerThe UN’s Millennium Development Goals Report 2011 provides a fascinating snapshot of how far we’ve come in improving health outcomes—and how much further we need to go. Unfortunately, the report ignores the health workforce crisis in many of the countries struggling to meet their 2015 health goals. The MDGs cannot be achieved when large numbers of people lack access to a health worker, yet the persistent, severe shortage of health workers is paid scant attention in the recently released UN report.

A fundamental barrier to improving health is the health worker crisis. The report’s section on Goal 5 (Improve Maternal Health), for example, points out that far too many women are without access to a skilled birth attendant during delivery. While many regions have made progress, “coverage remains low in sub-Saharan Africa and Southern Asia, where the majority of maternal deaths occur.” Read more »

The Key to Progress: Health Workforce Lessons from the Family Planning Movement

Maurice MiddlebergOne of the great privileges of my life has been to know bold leaders in family planning and reproductive health. As I listen to the current debates about “task shifting” and “task sharing,” I am reminded of the pioneering work of Mechai Viravaidya and Allan Rosenfield in Thailand dating back to the 1960s. Along with Chitt Hemachudha, they introduced innovative approaches to family planning that can inform our current efforts to improve the health of women and their families.

The situation in Thailand at that time was similar to that faced today by many countries with a health workforce crisis. The number of doctors was quite low and they were very inequitably distributed; this meant that in large swaths of the country the doctor-patient ratio was on the order of one doctor per hundred thousand people. The Thai government had become committed to reducing the rate of population growth and improving maternal and child health. This led to the obvious conclusion that a diverse set of providers would be needed to make family planning widely available. Read more »

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