scholarly journals The state of strategic plans for the health workforce in Africa

2019 ◽  
Vol 4 (Suppl 9) ◽  
pp. e001115 ◽  
Author(s):  
Doris Osei Afriyie ◽  
Jennifer Nyoni ◽  
Adam Ahmat

Many African countries have a shortage of health workers. As a response, in 2012, the Ministers of Health in the WHO African Region endorsed a Regional Road Map for Scaling Up the Health Workforce from 2012 to 2025. One of the key milestones of the roadmap was the development of national strategic plans by 2014. It is important to assess the extent to which the strategic plans that countries developed conformed with the WHO Roadmap. We examine the strategic plans for human resource for health (HRH) of sub-Saharan African countries in 2015 and assess the extent to which they take into consideration the WHO African Region’s Roadmap for HRH. A questionnaire seeking data on human resources for health policies and plans was sent to 47 Member States and the responses from 43 countries that returned the questionnaires were analysed. Only 72% had a national plan of action for attaining the HRH target. This did not meet the 2015 target for the WHO, Regional Office for Africa’s Roadmap. The plans that were available addressed the six areas of the roadmap. Despite all their efforts, countries will need further support to comprehensively implement the six strategic areas to maintain the health workers required for universal health coverage

2021 ◽  
Author(s):  
Anup Karan ◽  
Himanshu Negandhi ◽  
Mehnaz Kabeer ◽  
Tomas Zapata ◽  
Dilip Mairembam ◽  
...  

Abstract BACKGROUND: COVID-19 has reinforced the importance of having sufficient, well-distributed and competent health workforce. In addition to improving health outcomes, increased investment has the potential to generate employment, increase labour productivity along with fostering economic growth. With COVID-19 highlighting the gaps in human resources for health in India, there is a need to better and empirically understand the level of required investment for increasing the production of health workforce in India for achieving the UHC/SDGs.METHODS: The study used data from a range of sources including National Health Workforce Account 2018, Periodic Labour Force Survey 2018-19, population projection of Census of India, and review of government documents and reports. The study estimated shortages in the health workforce and required investments to achieve recommended health worker: population ratio thresholds by the terminal year of the SDGs 2030.RESULTS: Our results suggest that to meet the threshold of 34.5 skilled health worker per 10,000 population, there will be a shortfall of 0.16 million doctors and 0.65 nurses/midwives in the total stock of human resources for health by the year 2030. The shortages at the same threshold will be much higher (0.57 million doctors and 1.98 million nurses/midwives) in active health workforce by 2030. The shortages are even higher when compared with a higher threshold of 44.5 health workers per 10,000 population. The estimated investment for the required increase in the production of health workforce ranges from INR 523 billion to 2,580 billion for doctors. For nurses/midwives, the required investment is INR 1,096 billion. Such investment during 2021-25 has the potential of an additional employment generation within the health sector to the tune of 5.4 million and contribute to national income to the extent of INR 3,429 billion annually.Conclusion: India needs to significantly increase the production of doctors and nurses(/midwives) through investing in opening up of new medical colleges. Nursing sector should be prioritized to encourage talents to join nursing profession and provide quality education. India needs to set-up a benchmark of skill-mix ratio and provide attractive employment opportunities in health sector to increase the demand and absorb the new supply of graduates.


2021 ◽  
Author(s):  
Pamela A. McQuide ◽  
Amy Finnegan ◽  
Katherine M Terry ◽  
Andrew Nelson Brown ◽  
Cheick Oumar Toure ◽  
...  

Abstract BackgroundThe COVID-19 pandemic has increased the burden on health systems, particularly in low- and middle-income countries where health systems already struggle. To meet health workforce planning needs during the pandemic, IntraHealth International used two tools created by the World Health Organization (WHO) Regional Office for Europe. The Health Workforce Estimator (HWFE) allows the estimation of the quantity of health workers needed to treat patients during a surge, and the Adaptt Surge Planning Support Tool helps to predict the timing of a surge in cases and the number of health workers and beds needed for predicted caseload. These tools were adapted to fit the African context in a rapid implementation over five weeks in one region in Mali and one region in Kenya with the objective to test the feasibility of adapting these tools, which use a Workload Indicators of Staffing Need (WISN)-inspired human resources management methodology, to obtain daily and surge projections of COVID-19 human resources for health needs.Case presentationUsing a remote team in the US and in-country teams in Mali and Kenya, IntraHealth enacted a phased plan to gather stakeholder support, collect data related to health systems and COVID-19 cases, populate data into the tools, verify modeled results with results on the ground, enact policy measures to meet projected needs, and conduct national training workshops for the ministries of health.ConclusionsThis phased implementation in Mali and Kenya demonstrated that the WISN approach applied to the Health Workforce Estimator and Adaptt tools can be readily adapted to the local context for African countries to rapidly estimate the number of health workers and beds needed to respond to the predicted COVID-19 pandemic caseload. The results may also be used to give a proxy estimate for needed health supplies—e.g., oxygen, medications, and ventilators. Challenges included accurate and timely data collection and updating data. The success of the pilot can be attributed to the adapted WHO tools, the team composition in both countries, access to human resources data, and early support of the ministries of health, with the expectation that this methodology can be applied to other country contexts.


Author(s):  
Oathokwa Nkomazana ◽  
Wim Peersman ◽  
Merlin Willcox ◽  
Robert Mash ◽  
Nthabiseng Phaladze

Background: Botswana is a large middle-income country in Southern Africa with a population of just over two million. Shortage of human resources for health is blamed for the inability to provide high quality accessible health services. There is however a lack of integrated, comprehensive and readily-accessible data on the health workforce.Aim: The aim of this study was to analyse the existing databases on health workforce in Botswana in order to quantify the human resources for health.Method: The Department of Policy, Planning, Monitoring and Evaluation at the Ministry of Health, Ministry of Education and Skills Development, the Botswana Health Professions Council, the Nursing and Midwifery Council of Botswana and the in-country World Health Organization offie provided raw data on human resources for health in Botswana.Results: The densities of doctors and nurses per 10 000 population were four and 42,respectively; three and 26 for rural districts; and nine and 77 for urban districts. The average vacancy rate in 2007 and 2008 was 5% and 13% in primary and hospital care, respectively, but this is projected to increase to 53% and 43%, respectively, in 2016. Only 21% of the doctors registered with the Botswana Health Professions Council were from Botswana, the rest being mainly from other African countries. Botswana trained 77% of its health workforce locally.Conclusion: Although the density of health workers is relatively high compared to the region, they are concentrated in urban areas, insuffiient to meet the projected requirements and reliant on migrant professionals.


2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Anup Karan ◽  
Himanshu Negandhi ◽  
Suhaib Hussain ◽  
Tomas Zapata ◽  
Dilip Mairembam ◽  
...  

Abstract Background Investment in human resources for health not only strengthens the health system, but also generates employment and contributes to economic growth. India can gain from enhanced investment in health workforce in multiple ways. This study in addition to presenting updated estimates on size and composition of health workforce, identifies areas of investment in health workforce in India. Methods We analyzed two sources of data: (i) National Health Workforce Account (NHWA) 2018 and (ii) Periodic Labour Force Survey 2017–2018 of the National Sample Survey Office (NSSO). Using the two sources, we collated comparable estimates of different categories of health workers in India, density of health workforce and skill-mix at the all India and state levels. Results The study estimated (from NHWA 2018) a total stock of 5.76 million health workers which included allopathic doctors (1.16 million), nurses/midwives (2.34 million), pharmacist (1.20 million), dentists (0.27 million), and traditional medical practitioner (AYUSH 0.79 million). However, the active health workforce size estimated (NSSO 2017–2018) is much lower (3.12 million) with allopathic doctors and nurses/midwives estimated as 0.80 million and 1.40 million, respectively. Stock density of doctor and nurses/midwives are 8.8 and 17.7, respectively, per 10,000 persons as per NHWA. However, active health workers’ density (estimated from NSSO) of doctor and nurses/midwives are estimated to be 6.1 and 10.6, respectively. The numbers further drop to 5.0 and 6.0, respectively, after accounting for the adequate qualifications. All these estimates are well below the WHO threshold of 44.5 doctor, nurses and midwives per 10,000 population. The results reflected highly skewed distribution of health workforce across states, rural–urban and public–private sectors. A substantial proportion of active health worker were found not adequately qualified on the one hand and on the other more than 20% of qualified health professionals are not active in labor markets. Conclusion India needs to invest in HRH for increasing the number of active health workers and also improve the skill-mix which requires investment in professional colleges and technical education. India also needs encouraging qualified health professionals to join the labor markets and additional trainings and skill building for already working but inadequately qualified health workers.


2021 ◽  
Author(s):  
Sabina Rodriguez Velasquez ◽  
Lea Jacques ◽  
Jyoti Dalal ◽  
Paolo Sestito ◽  
Zahra Habibi ◽  
...  

Introduction: Since the beginning of the COVID-19 pandemic, very little data on the epidemiological characteristics among the pediatric population in Africa has been published. This paper examines the age and sex distribution of the morbidity and mortality rate in children with COVID-19 and compares it to the adult population within 15 Sub-Saharan African countries. Methods: A merge line listing dataset using a reverse engineering model shared by countries within the Regional Office for Africa was analyzed. Patients diagnosed within 1 March 2020 and 1 September 2020 with confirmed positive RT-PCR test for SARS-CoV-2 were analyzed. Children data were stratified into three age groups: 0-4 years, 5-11 years, and 12-17 years, while adults were combined. The cumulative incidence of cases including its medians and 95% confidence intervals were calculated. Results: 9% of the total confirmed cases and 2.4% of the reported deaths were pediatric cases. The 12-17 age group in all 15 countries showed the highest cumulative incidence proportion in children. COVID-19 cases in males and females under the age of 18 were evenly distributed. Among adults, a higher case incidence per 100,000 people was observed compared to children. Conclusion: The cases and deaths within the children population was smaller than the adult population. These differences can reflect biases in COVID-19 testing protocols and reporting implemented by countries, highlighting the need for more extensive investigation and focus on the effects of COVID-19 in children.


2020 ◽  
Author(s):  
Christine Onuko ◽  
Joseph Onyango

Abstract Background : A reliable and dedicated health workforce is instrumental in the attainment of Universal Health Coverage and Sustainable Development Goal (SDG) three on health. This is even more appropriate for Kenya where there is a dire shortage of health workers, and where health workforce management has been devolved to county governments. This study focusses on the influence of talent management practices (attraction, training and development, and retention) on doctor’s service delivery in four county hospitals in Nairobi, Kenya. Method : The study through a descriptive research design used quantitative questionnaires to gather data from 108 doctor respondents from four County Hospitals (Mbagathi, Mama Lucy Kibaki, Pumwani Maternity, and Mutuini Hospitals) in Nairobi, Kenya. Inferential statistics were used to analyse the data. Results : Findings show that there is a positive correlation between attraction, training and development and service delivery of doctors. Employee retention, however, did not have an association with service delivery. Conclusions : As Kenya adjusts to a devolved system of governance in relation to health, it is important that the attraction, training and development, as well as retention of doctors is given serious consideration if service delivery is to be improved.


2020 ◽  
Vol 11 (5) ◽  
pp. 152
Author(s):  
Lukamba Muhiya Tshombe ◽  
Thekiso Molokwane ◽  
Alex Nduhura ◽  
Innocent Nuwagaba

The impact of the implementation of public-private partnerships (PPPs) in the Sub-Saharan African region on infrastructure and services is becoming increasingly perceptible. A considerable number of African countries have embraced PPPs as a mechanism to finance large projects due to a constrained fiscus. At present, many financial institutions, such as the World Bank, the International Monetary Fund and the African Development Bank, which finance some of the projects, have established a department or unit that mainly focuses on infrastructure development in developing countries. The private sector in Africa is equally seen as a significant partner in the development of infrastructure. African governments need to tap into private capital to invest in infrastructure projects. This scientific discussion provides an analysis of PPPs in the East African region. This article selected a number of countries to illustrate PPP projects in the sub-region. The analysis of this study illustrates that the East African region represents unique and valuable public-private partnership lessons in different countries. This study also traces the origins of PPPs to more than a century ago where developed countries completed some of their projects using the same arrangement. This paper further demonstrates that the application of PPPs is always characterised by three factors, namely a country, a sector and a project. Experts in the field often refer to these elements as layers, which usually precede any successful PPP.


2017 ◽  
Vol 32 (10) ◽  
pp. 1361-1367 ◽  
Author(s):  
Jennifer Sherwood ◽  
Alana Sharp ◽  
Bergen Cooper ◽  
Beirne Roose-Snyder ◽  
Susan Blumenthal

2021 ◽  
pp. 698-706
Author(s):  
Chigozie Uneke ◽  
Bilikis Uneke

Background: Despite the importance of gender and intersectionality in policy-making for human resources for health, these issues have not been given adequate consideration in health workforce recruitment and retention in Africa. Aims: The objective of this review was to show how gender intersects with other sociocultural determinants of health to create different experiences of marginalization and/or privilege in the recruitment and retention of human resources for health in Africa. Methods: This was rapid review of studies that investigated the intersectionality of gender in relation to recruitment and retention of health workers in Africa. A PubMed search was undertaken in April 2020 to identify eligible studies. Search terms used included: gender, employment, health workers, health workforce, recruitment and retention. Criteria for inclusion of studies were: primary research; related to the role of gender and intersectionality in recruitment and retention of the health workforce; conducted in Africa; quantitative or qualitative study design; and published in English. Results: Of 193 publications found, nine fulfilled the study inclusion criteria and were selected. Feminization of the nursing and midwifery profession results in difficulties in recruiting and deploying female health workers. Male domination of management positions was reported. Gender power relationship in the recruitment and retention of the health workforce is shaped by marriage and cultural norms. Occupational segregation, sexual harassment and discrimination against female health workers were reported. Conclusion: This review highlights the importance of considering gender analysis in the development of policies and programmes for human resources for health in Africa.


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