Reducing Geographical Imbalances of Health Workers in Sub-Saharan Africa

Reducing Geographical Imbalances of Health Workers in Sub-Saharan Africa

Author: Christophe Lemiere

Publisher: World Bank Publications

Published: 2010-12-01

Total Pages: 60

ISBN-13: 082138600X

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The human resources crisis in the health sector has been gathering attention on the global stage. To date, however, most of this attention has focused on shortages of health human resources (HRH) at the national level. At least as important are problems at the sub-national level. Massive geographic and skill mix imbalances are reflected in the perilous undersupply of HRH in most rural areas. Virtually all Sub-Saharan African countries suffer from significant geographic imbalances. Very little substantive information or documentation exists on the problem. Even less is known about the lessons from policies aimed at addressing urban-rural human resource imbalances, let alone experiences of Sub-Saharan Africa countries, with such policies. There also appears to be a disconnect between the objectives and efforts of policymakers on the one hand and the functioning of national health labor markets and labor market behavior on the other hand. This disconnect hinders policy effectiveness and the efficient utilization of resources intended to narrow urban-rural inequities. In Sub-Saharan Africa government policies, often limited to the management of public sector vacancies, appear to be elaborated, prescribed, and implemented independently of labor market considerations. Partly as a result, they are unable to effectively address urban-rural imbalances, which are an outcome of labor market dynamics. This report discusses and analyzes labor market dynamics and outcomes (including unemployment, worker shortages, and urban-rural imbalances of categories of health workers) from a labor economics perspective. It then use insights from this perspective as a basis for elaborating policy options that incorporate the underlying labor market forces. The goal of the study is to address undesirable outcomes (including urban-rural HRH imbalances) more effectively. The book is thus suitable for researchers, policy analysts and policy makers with an interest in understanding and improving the allocation of human resources for health in the developing world.


Evaluation of PEPFAR's Contribution (2012-2017) to Rwanda's Human Resources for Health Program

Evaluation of PEPFAR's Contribution (2012-2017) to Rwanda's Human Resources for Health Program

Author: National Academies of Sciences, Engineering, and Medicine

Publisher: National Academies Press

Published: 2020-06-22

Total Pages: 299

ISBN-13: 0309672058

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Since 2004, the U.S. government has supported the global response to HIV/AIDS through the President's Emergency Plan for AIDS Relief (PEPFAR). The Republic of Rwanda, a PEPFAR partner country since the initiative began, has made gains in its HIV response, including increased access to and coverage of antiretroviral therapy and decreased HIV prevalence. However, a persistent shortage in human resources for health (HRH) affects the health of people living with HIV and the entire Rwandan population. Recognizing HRH capabilities as a foundational challenge for the health system and the response to HIV, the Government of Rwanda worked with PEPFAR and other partners to develop a program to strengthen institutional capacity in health professional education and thereby increase the production of high-quality health workers. The Program was fully managed by the Government of Rwanda and was designed to run from 2011 through 2019. PEPFAR initiated funding in 2012. In 2015, PEPFAR adopted a new strategy focused on high-burden geographic areas and key populations, resulting in a reconfiguration of its HIV portfolio in Rwanda and a decision to cease funding the Program, which was determined no longer core to its programming strategy. The last disbursement for the Program from PEPFAR was in 2017. Evaluation of PEPFAR's Contribution (2012-2017) to Rwanda's Human Resources for Health Program describes PEPFAR-supported HRH activities in Rwanda in relation to programmatic priorities, outputs, and outcomes and examines, to the extent feasible, the impact on HRH and HIV-related outcomes. The HRH Program more than tripled the country's physician specialist workforce and produced major increases in the numbers and qualifications of nurses and midwives. Partnerships between U.S. institutions and the University of Rwanda introduced new programs, upgraded curricula, and improved the quality of teaching and training for health professionals. Growing the number, skills, and competencies of health workers contributed to direct and indirect improvements in the quality of HIV care. Based on the successes and challenges of the HRH program, the report recommends that future investments in health professional education be designed within a more comprehensive approach to human resources for health and institutional capacity building, which would strengthen the health system to meet both HIV-specific and more general health needs. The recommendations offer an aspirational framework to reimagine how partnerships are formed, how investments are made, and how the effects of those investments are documented.


Health Workforce Policies in OECD Countries

Health Workforce Policies in OECD Countries

Author: OECD

Publisher: Org. for Economic Cooperation & Development

Published: 2016

Total Pages: 0

ISBN-13: 9789264239500

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Foreword and Acknowledgments -- Executive summary -- Key findings -- Analytical framework of health labour markets -- Trends in health labour markets and policy priorities to address workforce issues -- Education and training for doctors and nurses: What's happening with numerus clausus policies? -- Trends and policies affecting the international migration of doctors and nurses to OECD countries -- Geographic imbalances in the distribution of doctors and health care services in OECD countries -- Skills use and skills mismatch in the health sector: What do we know and what can be done


African Futures

African Futures

Author: Clemens Greiner

Publisher: Africa-Europe Group for Interd

Published: 2022

Total Pages: 412

ISBN-13: 9789004470811

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"The essays in this collection are written to make readers (re)consider what is possible in Africa. The essays shake the tree of received wisdom and received categories, and hone in on the complexities of life under ecological and economic constraints. Yet, throughout this volume, people do not emerge as victims, but rather as inventors, engineers, scientists, planners, writers, artists, and activists, or as children, mothers, fathers, friends, or lovers - all as future-makers. It is precisely through agents such as these that Africa is futuring: rethinking, living, confronting, imagining, and relating in the light of its many emerging tomorrows"--


Historical Perspectives on the State of Health and Health Systems in Africa, Volume II

Historical Perspectives on the State of Health and Health Systems in Africa, Volume II

Author: Mario J. Azevedo

Publisher: Springer

Published: 2017-01-24

Total Pages: 305

ISBN-13: 3319325647

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This book focuses on Africa’s challenges, achievements, and failures over the past several centuries using an interdisciplinary approach that combines theory and fact and evidence-based practices and interventions in public health, and argues that most of the health problems in Africa are not a result of scarce or lack of resources, but of the misconceived and misplaced priorities that have left the continent behind every other on the globe in terms of health, education, and equitable distribution of opportunities and access to (quality) health as agreed by the United Nations member states at Alma-Ata in 1978.


The Labor Market for Health Workers in Africa

The Labor Market for Health Workers in Africa

Author: Agnes Soucat

Publisher: World Bank Publications

Published: 2013-04-26

Total Pages: 382

ISBN-13: 0821395580

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Sub-Saharan Africa has only 12 percent of the global population, yet this region accounts for 50 percent of child deaths, more than 60 percent of maternal deaths, 85 percent of malaria cases, and close to 67 percent of people living with HIV. Sub-Saharan Africa, however, has the lowest number of health workers in the world-significantly fewer than in South Asia, which is at a comparable level of economic development. The Labor Market for Health Workers in Africa uses the analytical tools of labor markets to examine the human resource crisis in health from an economic perspective. Africa's labor markets are complex, with resources coming from governments, donors, the private sector, and households. Low numbers of health workers and poor understanding of labor market dynamics are major impediments to improving health service delivery. Yet some countries in the region have developed innovative solutions with new approaches to creating a robust health workforce that can respond to the continent's health challenges. As Africa grows economically, the invaluable lessons in this book can help build tomorrow's African health systems.


The Human Resources for Health Crisis in Zambia

The Human Resources for Health Crisis in Zambia

Author: Monique Vledder

Publisher: World Bank Publications

Published: 2011

Total Pages: 112

ISBN-13: 0821387618

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'The Human Resources for Health Crisis in Zambia' is part of the World Bank Working Paper series. These papers are published to communicate the results of the Bank’s ongoing research and to stimulate public discussion.Despite reporting some health gains since the 1990s, health outcomes remain poor in Zambia and it will be very challenging to achieve the health-related Millennium Development Goals by 2015.The Government of Zambia recognizes that the improvement of child and maternal health and the reduction in mortality from HIV/AIDs and malaria require better access to an appropriate number of wellperforming health workers or human resources for health (HRH). This paper compiles recent evidence on the Zambian health labor market and provides some baseline information on HRH to support the government as it addresses its HRH challenges. In addition, the paper analyzes the available evidence on the national health labor market to better understand the number, distribution, and performance of HRH in Zambia.The paper also explains HRH outcomes by mapping, assessing, and analyzing pre-service education and labor market dynamics and well as the core factors influencing these dynamics.This working paper was produced as part of theWorld Bank’s Africa Region Health Systems for Outcomes (HSO) Program.The Program, funded by the World Bank, the Government of Norway, theGovernment of the United Kingdom, and the Global Alliance for Vaccines and Immunization (GAVI), focuses on strengthening health systems inAfrica to reach the poor and achieve tangible results related to Health, Nutrition, and Population.The main pillars and focus of the program center on knowledge and capacity building related to Human Resources for Health, Health Financing, Pharmaceuticals, Governance and Service Delivery, and Infrastructure and ICT. More information as well as all the products produced under the HSO program can be found online at www.worldbank.org/hso .


The World Health Report 2006

The World Health Report 2006

Author: World Health Organization

Publisher: World Health Organization

Published: 2006-03-23

Total Pages: 237

ISBN-13: 9241563176

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The 2006 World Health Report focuses on the chronic shortages of doctors, midwives, nurses and other health care support workers in the poorest countries of the world where they are most needed. This is particularly true in sub-Saharan Africa, which has only four in every hundred global health workers but has a quarter of the global burden of disease, and less than one per cent of the world's financial resources. Poor working conditions, high rates of attrition due to illness and migration, and education systems that are unable to pick up the slack reflect the depth of the challenges in these crisis countries. This report considers the challenges involved and sets out a 10-year action plan designed to tackle the crisis over the next ten years, by which countries can strengthen their health system by building their health workforces and institutional capacity with the support of global partners.