Retention

The Oft-Overlooked Job Description

Sarah Dwyer — Fri, 15 Aug 2014 13:40:10 +0000

This post originally appeared on VITAL, the blog of IntraHealth International.

Job descriptions for health workers—it seems like a simple concept. And in fact, job descriptions can increase a community’s access to high-quality health care in low-resource settings.

But many health workers in low-income countries don’t have this basic tool.

For example, only 57% of health workers in Namibia and 38% of health workers in Kenya have job descriptions, according to data from Service Provision Assessments conducted by the countries’ ministries of health.

Research conducted in Kenya shows that health workers who have written job descriptions provide higher-quality care than those who do not. This may be because job descriptions provide structure, guidance, accountability lines, minimum skills and qualifications standards, and performance benchmarks.

Author's name:

Kate Sheahan

Publication Date:

August 2014

Supporting Country-Led Efforts to Recruit and Retain Health Workers and Improve Their Productivity

Sarah Dwyer — Tue, 04 Mar 2014 20:30:08 +0000

This post was originally published on the Global Health Workforce Alliance Members’ Platform. CapacityPlus is the featured member in March. We encourage you to join and contribute to the discussion.

In recent years, heightened attention has been given to scaling up the production of health workers in response to the global human resources for health (HRH) crisis. While many countries face absolute health worker shortages and need to increase their availability, the HRH crisis is not just a supply problem. CapacityPlus provides technical assistance to ensure that health workers are more equitably distributed—especially to rural and other underserved areas, remain working at their posts, and effectively provide health care services in order to increase access to quality family planning, reproductive health, HIV and AIDS, and other primary health services and help countries move toward universal health coverage.

Author's name:

Wanda Jaskiewicz

Publication Date:

March 2014

Two Projects Working Together to Strengthen the Health Workforce in Uganda

Carol Bales — Wed, 06 Nov 2013 16:47:38 +0000

How can a global project and a country-specific project work together to strengthen the health workforce and increase access to quality care? What about in Uganda, where there are only 14 doctors, nurses, and midwives for every 10,000 people?

The CapacityPlus global project and the Uganda Capacity Program are both funded by USAID and led by IntraHealth International. CapacityPlus has worked in over 20 countries to address the health workforce shortage, and offers tools that can be adapted for any country. The Uganda Capacity Program builds the capacity of local Ugandan institutions—like ministries, professional health councils, and universities—to plan for, develop, and strengthen the management of health workers.

Author's name:

Carol Bales

Publication Date:

November 2013

What’s the Issue? Not Enough Health Workers in Susan’s Maternity Unit

Carol Bales — Tue, 09 Apr 2013 14:54:28 +0000

When Susan Alio describes what she likes best about her job, a smile spreads across her face and her eyes light up. “When mothers come,” she says softly and swiftly, “and they have a normal birth, they go with their babies, healthy, without any complication, that one gives me joy.” She’s perfectly poised in her crisp white uniform and cap.

Susan obviously loves her job as a midwife at Naguru Hospital in Kampala, Uganda, but it’s not easy. She feels the effects of the global shortage of health workers firsthand, on a daily basis. When she’s asked about her challenges, her big smile fades and her words slow down. “My biggest challenge is usually not enough staffs on the station, because you end up being stretched, and then when you’re stretched you’re not able to deliver at your best,” she explains.

Author's name:

Carol Bales

Publication Date:

April 2013

How Using the Rapid Retention Survey Toolkit Resulted in Policy Change in Lao PDR

Carol Bales — Fri, 21 Dec 2012 14:49:37 +0000

Last week, the Rapid Retention Survey Toolkit was published and is now available to all to conduct a rapid discrete choice experiment (DCE) survey in order to design evidence-based health worker incentives. As one of the authors, I’m proud of how this toolkit was inspired from two intensive in-country applications. Developed from field testing experiences in both Uganda and Lao People’s Democratic Republic (PDR), it documents the entire survey process from planning and logistics to implementation to data analysis and presenting results to key stakeholders. The toolkit has already been used to incite real change for the health workforce.

Soon after joining the CapacityPlus project in early 2012, I contributed to the Rapid Retention Survey Toolkit’s refining stages, capturing step by step how a rapid DCE survey can be implemented.

Author's name:

Rachel Deussom

Publication Date:

December 2012

“I’m a Health Worker”: Saving Lives in Rural Uganda

Carol Bales — Mon, 16 Jul 2012 15:05:43 +0000

Bernard Tayebwa knows how important his job is to his community. His favorite part of being a senior clinical officer at Rugyeyo Health Center III in Kanungu District, Uganda, is nothing less than “saving the lives of patients.”

To the north in Kabarole District, Dr. Solomon Asiimwe articulates the flip side of the lifesaving nature of their work. The toughest part of his job as a medical officer at Kitojo Integrated Development Association, an NGO hospital, “is when I care for patients and sometimes they don’t improve, sometimes they are terminally ill and they pass away.”

Author's name:

Sarah Dwyer with Wanda Jaskiewicz

Publication Date:

July 2012

Nine Reasons We Place Health Workers at the Center of Our Efforts

Sarah Dwyer — Thu, 24 May 2012 15:41:05 +0000

Maureen Kanyiginya is a young midwife with a gentle and confident presence. Sitting on a bench in a grassy area outside the rural health center where she works, in western Uganda’s Kabarole District, she looks into the camera and states, “I’m a health worker.” She says she loves mothers, and it’s easy to see how sincere she is. “I really love delivering these babies,” she adds quietly. “I make mothers comfortable.”

Her calm demeanor contrasts with the serious challenges she faces in her job. The facility where she works has no power, so she conducts her deliveries with a small lantern. She lacks the proper instruments to do her job well, and often doesn’t have the drugs that mothers need, due to stockouts. Her personal safety is also a concern. “Sometimes I walk alone in the night from my house to the unit,” she shares.

Author's name:

Sarah Dwyer and Carol Bales

Publication Date:

May 2012

What’s the Best Way to Retain a Health Worker? Just Ask Her!

Carol Bales — Mon, 14 May 2012 13:52:18 +0000

This post was originally published on Disruptive Women in Health Care.

The world currently has a shortage of some 4 million health workers. This shortage is amplified by a complete mismatch between where health workers are stationed and where they are most needed. The healthier and wealthier a community is, the more health workers it has. The poorer and sicker a community, the fewer health workers it has. The situation is worsening as every year hundreds of thousands of health workers move from poor, rural, and underserved communities to wealthier, metropolitan communities with a surfeit of health workers. This occurs both within countries (a nurse moving from a rural area to the capital city) and between countries (a doctor moving from a developing country to a wealthy country).

Author's name:

Kate Tulenko

Publication Date:

May 2012

Finally, a Major Step Forward in Protecting Health Workers and Facilities

Carol Bales — Thu, 26 Jan 2012 20:53:53 +0000

This post was originally published on the IntraHealth International blog.

Despite firm standards rooted in the Geneva Conventions to protect health facilities, health workers, and the patients served during armed conflict, and to enable health professionals to act consistently with their ethical obligations, assaults on and interference with health functions are all too common in war. Aside from the human toll they take, these attacks often compromise the ability to deliver care to populations in great need, impede efforts to reconstruct health systems after war, and lead to the flight of health workers whose presence in a time of great social stress is essential.

The international community has taken few steps to provide guidance to promote compliance with the law, or to assess and report on violations in a uniform and comprehensive manner. Sound methodologies for data collection about these assaults have not been developed. The lack of systematic reporting and documentation of these violations contributes to continued disregard for an established and internationally recognized legal framework of protection. Mechanisms to encourage compliance with these international norms are needed as a first step in preserving critical health services in conflict settings.

Author's name:

Leonard Rubenstein, guest blogger

Publication Date:

January 2012

Hundreds of HR Management Professionals Network and Learn in Nairobi

Carol Bales — Wed, 07 Dec 2011 15:29:15 +0000

It was a great opportunity for me to sit among hundreds of human resources professionals from Kenya and the East Africa region during the recent 16th National human resources management forum organized by the Kenya Institute of Human Resource Management (IHRM) in Nairobi. The forum was graced with highly experienced and resourceful facilitators from different sectors and it was very exciting to learn from their experiences, successes, and challenges.

A key highlight for me was hearing the direction that most successful institutions are now taking in managing their human resources—focusing more on the strategic function of human resources management (HRM) over the administrative components. They are placing an emphasis on talent management as a way to have the upper edge in a competitive environment, while acknowledging effective talent management processes begin with careful selection and deployment practices, or “getting it right from the start.”

Author's name:

Doris Mwarey

Publication Date:

December 2011

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

david — Fri, 23 Sep 2011 13:32:53 +0000

All 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.

Author's name:

Kate Tulenko

Publication Date:

September 2011

International Nurses Day 2011: Increasing Access and Equity

jennifer — Thu, 12 May 2011 13:15:53 +0000

May 12 is celebrated the world over as International Nurses Day, with this year’s theme calling particular attention to issues of access and equity in health care.

Nurses make up the bulk of the health workforce, especially in sub-Saharan Africa, which has 5.5 nurses and midwives for every physician. While nurses’ contributions to the health system are well-established in the literature, to date, scant attention has been directed toward many of the critical issues nurses face in their careers.

Education
The status of nursing education in developing countries is poorly understood.

Author's name:

Shaun Noronha

Publication Date:

May 2011

Creative Approaches to the Global Health Workforce Crisis

jennifer — Tue, 12 Apr 2011 13:03:49 +0000

Five years ago the World Health Organization told us that 57 countries had a critical shortage of health workers—fewer than 2.3 service providers for every thousand people. Today, all 57 countries are still below this threshold. What’s holding us back from faster progress?

First, the good news: many of these countries have national health workforce plans in place. Forty-four of the 57 crisis countries have a plan, according to the Global Health Workforce Alliance’s recent progress report.

Now, the bad news: not all of these countries are implementing their plans. Among the 57 crisis countries, only 24 have evidence-based and costed plans and are in the process of implementing them. Countries may be daunted by perceived barriers to implementation.

That’s why it makes me hopeful to see how many countries are trying creative approaches and moving from planning to action.

Author's name:

Maurice I. Middleberg

Publication Date:

April 2011

Mind over Matter

jennifer — Wed, 23 Mar 2011 13:26:53 +0000

Can we condition health workers to believe that they should work in underserved areas? Among the nonmonetary incentives used for retaining workers in rural areas, intrinsic motivation—or inherent willingness—can be a significant influence. The problem with intrinsic motivation is that by definition, it’s intrinsic, and cannot be cultivated or systematically introduced into a cohort of health workers. Or can it?

Cognitive dissonance
A classic study by psychologists Leon Festinger and James Carlsmith (1959) on cognitive dissonance—the phenomenon by which a person states an opinion different from what he or she believes to be true—may hold the answer.

Author's name:

Shaun Noronha

Publication Date:

March 2011

Retaining Health Workers in Rural Kenya: What We Can Learn from Other Countries

jennifer — Thu, 10 Feb 2011 16:04:52 +0000

This is an excerpt from an original post on the IntraHealth International blog.

In the northern arid lands and other remote parts of Kenya, the Capacity Kenya project has been working with the Ministry of Health to design simple packages to attract health workers and encourage them to stay. Starting with a selected list of diverse pilot sites, the project set out to design intervention packages, implement them, and systematically evaluate their impact on health worker retention over time.

A couple of weeks ago I attended the Second Global Forum on Human Resources for Health in Bangkok, which gave me a unique opportunity to learn about the struggles, successes, and constraints of other countries. As I listened to the experiences of others and what they see as best practices, I kept thinking about what new interventions might work best in the Kenyan context.

Author's name:

Achim Chiaji

Publication Date:

February 2011